BScN, RN, GNC(C) President,
Eldercare Home Health Inc.

One of the underlying questions that is not addressed in this article is Why did Sylvia Bailey suffer for so long with a fractured leg? Why was she denied investigation and treatment? Her condition was not invisible, there was an incident leading up to her pain and she was able to articulate that she was in pain.

Why did no one act? Who allowed a simple injury to escalate and become a case of senior abuse?

The facility had caregivers, a physiotherapist, a doctor and nurses. They all interacted with her.

We have found that this failure to act is not uncommon in senior care settings. Being an advocate for Clients, to assist them to get the care that they deserve, is an important part of our role. The reasons that professionals who are charged with the responsibility to care for others, in fact are getting paid to do just that, don’t, are complicated.

From what I have been able to glean from my 30+ years of working and volunteering in health care settings, failure to act is a learned behaviour that is developed in a setting where there is a pervasive culture of not acting.

In these kinds of settings, I often find that there is little or no leadership and no accountability. In some circumstances it is that the medical staff are intimidating and discourage staff from contacting them outside of regular visiting hours-even though they are supposed to be on call. Add to this that many facilities now hire Registered Practical Nurses for roles where they once hired Registered Nurses.

Many “in charge” positions are held by people who are newly graduated. The newer graduate will not have the experience or confidence to suggest to a doctor or administrator that care should be delivered differently. Also, the workloads in a facility setting may be very heavy. Care decisions that allow staff to get their daily assignments done are favoured over those that may take additional hours to complete and have them at odds with an unhappy physician who has been paged in the evening.

If you are a family member who is concerned about the care your relative is receiving in a facility setting, you should speak to the person in charge of the delivery of that care. If you do not feel that the issues are being addressed, document your concerns and ask to talk to the next senior person in the organization. Be polite, be firm, be reasonable, be an advocate.

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