Family calls for more transparency in long-term care abuse investigations

Brian Forbes thinks it should be easier to get answers.

Two years ago, Forbes and his brothers were alerted to an incident involving their mother and a care worker at Bay Side Home in Barrington, N.S., where she had been a resident since 2013.

Mamie Forbes was 87 at the time. She had dementia, no short-term memory, weighed about 100 pounds and couldn't carry on a conversation.

"She had a lot of difficulty just finding words to express a thought or feeling," Forbes said of his mother.

On March 13, 2017, Mamie Forbes was at the dinner table when she started picking up her plate and dropping it repeatedly. That's when a care worker rushed over to her and yanked off her bib without undoing the clasp — it would take two attempts — causing her to jerk in her chair.

The worker then quickly spun her around in her wheelchair and took Forbes to her room. By the time concerned witnesses arrived at the room, Mamie Forbes had already been put into her bed.

"'Not gently' was the phrase that was used," Forbes said of the call his brother received from the home describing what happened that day.

The family was informed the home would conduct an investigation, as would the province per the terms of the Protection for Persons in Care Act.

Lack of transparency

But Forbes said the family struggled to get information, particularly from the home, about the investigation status, what was happening with the employee and whether she'd have any contact with their mother. He said it felt like the home blocked their attempts to get what he believes are reasonable details.

"It's outrageous," said Forbes. "To me, it would be within our rights to have that kind of assurance … There should be some provision in this case that the family of the person that's being mistreated has access to full information as the process moves along."

Home says it 'fully co-operated' with investigation

In an email, Bay Side administrator Paula Hatfield said the site takes all complaints of resident abuse seriously.

"We fully complied with our obligation to report any such concerns under the Protection of Persons in Care Act. Staff from the Nova Scotia Department of Health conducted an investigation and Bay Side Home fully co-operated with that investigation," she wrote.

Hatfield said the safety of and respect for residents is paramount at Bay Side. She referred other questions to the Health Department.

Forbes said his family was never officially told by the home what happened with the worker, although they eventually learned she no longer works there.

In a final report released to the family last month, a provincial investigator determined an allegation of physical force resulting in pain, discomfort or injury was unfounded, but an allegation of mistreatment causing emotional harm was founded.

'Likely abuse'

The investigator also determined "likely abuse" occurred.

Bob Lafferty, the director of investigation and compliance for the Health Department, said the term applies when a person might not have the mental capacity to understand or appreciate what occurred, but if they could, the circumstances would have likely resulted in an abuse finding.

"We still indicate that it is a founded allegation of abuse," he said. "If we were to determine there was likely abuse to occur, it's still the same finding as a founded [case of] abuse and the same directives could be issued."

Lafferty said an investigation under the act happens whenever someone suspects or witnesses abuse. The Health Department recently started posting statistics related to those files and their results online.

While investigations by homes mainly focus on human resources matters, the province focuses more on system issues.

Homes might have their own directives around what is disclosed, but Lafferty said the province tries to be as open as possible. Information is shared when an investigation is launched, after preliminary work is complete and when the final report is ready, which would include outcomes, decisions and any directives issued.

In the case of Mamie Forbes, several directives were identified, but only the one that still required work is listed in the report: that all staff requiring education are made aware of their duty to promptly report allegations of abuse.

Failure to do so in this case meant an assessment of Forbes's mother could not be completed at the time of the incident.

Police report filed

Forbes said he and his family were frustrated throughout the process. In an attempt to get more information and due to their concerns with what happened, they filed a report with police, who investigated and charged the worker. She was found not guilty following the trial in September.

The family remained pleased with the care their mother received at Bay Side right up to her death in December, but Forbes said they continue to be concerned about the specific incident and how it was handled by administration. They hope to discuss their frustrations with the home's board.

Lafferty said it's up to homes to determine what information is released about employee status. He said there could be mitigating factors, such as legal advice, that would factor into those decisions.

Considering a mandatory registry

Forbes, meanwhile, also has concerns about the future.

The employee might have been found not guilty in court, but the province's report makes clear that mistreatment and likely abuse took place. For that reason, Forbes would like to see a registry for care workers that ensures people with problems in the past are flagged for prospective employers.

"To me, there should be something that follows that person that clearly indicates [the findings of the report] to anyone considering her for employment," he said.

'A bad experience'

"Our family had a bad experience, our mother had a bad experience and there need to be adequate steps taken to make sure that similar things don't happen to other people in care who are often not able to speak for themselves."

A spokesperson for the Health Department said a voluntary registry for continuing care assistants exists now for the purpose of workforce tracking. But following a recommendation from the expert advisory panel on long-term care, the department is now looking at options to implement a mandatory registry.