Recognizing red flags and choosing the right care facility for elderly loved ones

With news that Ontario Provincial Police laid six more charges against accused serial killer Elizabeth Wettlaufer last week, the issue of safety at long-term care homes is in the spotlight yet again.

In response, elder care advocates are pushing for long-term cultural changes relating to elder discrimination and fixes to existing policies, but in the short-term, they want families to know how they can protect their elderly loved ones.

"We have to be our family's advocates," said Ruth Adria, chairman of the Elder Advocates of Alberta Society. "It is the responsibly of family to be aware (of the care their family member is receiving)."

Adria wants families to be as pushy and nosy as is necessary when it comes to knowing how their loved one is treated in a long-term care facility.

We speak with Adria and other elder care advocates to get tips on how to how to choose the right long-term care facility, how to recognize red flags and what to do if you see a pattern of concerning behaviour.

Selecting a facility

In Ontario, most people eligible for long-term care residency can list up to five different homes on their admission application, facilitated by the local Community Care Access Centre, said Jane Meadus, a staff lawyer with Ontario's Advocacy Centre for the Elderly, a legal clinic for low-income seniors.

"We tell people, 'You never put a home on a list that you haven't seen or had someone see on your behalf,'" she said, noting homes almost always have wait lists, sometimes years-long. "If it's on your list and a bed comes up, you must accept that or there will be a penalty."

In Ontario, people who turn down homes on their lists are removed from all wait lists for 12 weeks, unless they are in hospital, said Meadus. Then, they have to start the process all over again, she said.

This process differs province by province, but no matter where you live it's important to check out a home in person, she said.

"Nothing can take the place of a physical visit," Meadus said. "Some homes have 'virtual' tours online – but like anyone who has seen a house for sale online and then gone in to actually see it, looks can be deceiving."

One additional resource is the Nursing Home Ratings.ca website, where families of residents can review and rate nursing homes. 

When you visit

Request tours of the homes you're considering and keep your eyes peeled when you're there, said Wanda Morris, vice president of advocacy with CARP, a seniors' advocacy group.

"Do the care staff seem to know the individual people in there?" she said. "Do they treat them like human beings? Are they treated with dignity? Or do you see the staff chatting in one corner and people falling asleep in front of a television in another?"

Morris suggests asking staff about the activities accessible to residents, ensuring they're offered more than access to a TV, and paying close attention to the cleanliness of the facility. It should be clean, but not sterile, she said.

Also, ask about visiting policies.

"What you want to see is transparency: 'Can i drop in and visit any time?'" she said, noting you should push for being allowed unadvertised drop-ins. "If staff think at any time you might be there, they will treat your loved one accordingly."

Her takeaway? "Trust your gut."

This checklist from Concerned Friends of Ontario Citizens in Care Facilities, a registered charity dedicated to helping people in long-term care, may also be helpful.

Do facility-specific research

For Ontario residents, Morris recommends taking a look at individual facility reports and data available through the Health Quality Ontario website.

Information listed includes facility-specific and/or region-specific data on antipsychotic medication use, wait list times, worsened symptoms of depression among residents, pressure ulcers and pain among residents, falls among residents and use of physical restraints on residents at long-term care homes.

Katrina Clarke is a Toronto-based journalist who writes about relationships, health, technology and social trends. You can find her on Twitter at @KatrinaAClarke.