Autistic man's confinement was abuse: province

An autistic man was locked in a room at a special care home in Nova Scotia for 15 days, sometimes urinating in the corner when nobody knew he needed to go to the washroom, says his mother and staff at the facility.

"I think it's ridiculous," said a worker, speaking on the condition of anonymity. "He was locked in there like an animal."

Several days after hearing about his confinement — which was broken by daily exercise and other tasks — his mother went to visit him at the Braemore Home Corp. in Sydney.

She says she demanded that a double lock be removed and that he be given access to a washroom.

Martha Gillis, director of licensing for the Department of Community Services, also said that the 20-year-old man had a light shining near his bed 24 hours a day while a video monitored him from a nursing station during the period of his confinement from Sept. 12-26.

"I was shocked. It was disbelief. This can't be happening in this day and age," said the mother, who asked that the family's identity not be released, from her home in Cape Breton.

"He looked nervous.… He didn't look very well. He was white looking. I mean, he'd been locked in a room."

The man's mother said her son, who moved to Braemore more than a year ago, became frustrated by his environment and started to "act out" by breaking things in his room or exhibiting aggression toward others. However, she said she didn't know if that was the reason her son was placed in the room.

The provincial government said the man was also allowed to leave the room to do activities with case workers and to have meals, as well as bathroom breaks when workers were able to see that he needed the toilet.

'It horrifies me': minister

Investigators with the Department of Community Services determined the case constituted abuse under the province's Protection of Persons in Care Act. The abuse was described in the department's report, which was provided to The Canadian Press by the government, as a "failure to provide adequate care" by the institution.

Community Services Minister Denise Peterson-Rafuse and the department's director of services for persons with disabilities confirmed that one person was locked up against his will at Braemore, a privately operated, non-profit centre, which is provincially funded and houses about 134 people.

A department spokeswoman said "the individual spent time in a locked room over a period of 15 days."

Debra MacPherson, the chief executive of Braemore, said she can't comment on the case, citing confidentiality of the resident. She said that in general the facility attempts to avoid abuse through education.

"We deal with it through educating staff and training. Staff have been provided education sessions to heighten awareness and understanding of awareness of the Protection of Persons in Care Act," she said.

Pressed repeatedly for details on her knowledge of the incident, she responded: "I'm not going to discuss any specific incidents with you … if you'd like to move on from that."

Peterson-Rafuse said her department ordered an investigation after receiving an anonymous complaint in October.

"It horrifies me that that incident took place," she said.

The report from the department's licensing branch says the video camera should be removed from rooms and measures have been taken to "ensure that the resident has the same physical environment as all other residents."

'We can do better'

Dr. Andre Blanchet, a Massachusetts-based physician who has worked for the state to improve housing and care of the disabled, said the allegations suggest deeper problems.

"We can do better," said the doctor, who began his career working in Canada.

"Most of these kinds of residents need one-to-one support in an environment that is healthy and respectful.… It's hard to do that in an institution."

Disability advocates have demanded for 10 years that the province shift to community-based facilities from larger institutions, while also improving training for those who support the most severely disabled.

MacPherson wouldn't discuss the specifics regarding the man's case and the actions taken in response.

However, she said that in general, staff at Braemore have training in dealing with autism and aggressive behaviour.

"Our staff are trained to work with clients that are classified for our care," she said in an interview, adding that some staff have received specific training on treating autism.

She also said the size of the facility isn't a factor.

"Incidents can occur in any environment where care is provided, whether a large facility, a community-based option or a health-care facility," she said. "Incidents can occur in any setting, of any size."

Province negotiating service standards

But two staff members at Braemore said they didn't have the training to assist a severely autistic man as he reacted to a new environment.

"If there's no intervention, no education for the staff, you're not going to know what to do," said one worker. "Why would you keep bringing people in with autism and give no education to the staff?"

Peterson-Rafuse wouldn't comment on the specifics of what is being done in response to the case. She said until recently, the province had limited say in the adult residential centres and has only recently started to attempt to negotiate agreements with required standards.

"They will know they are accountable because we actually [will] have a signed contract with them," she said.

A spokesman for the minister said in an email that the department hasn't finished negotiating service standards with Braemore.

Several facilities in Nova Scotia have been investigated by the province after abuse was documented over the past two years.

At Braemore, government documents obtained under freedom of information legislation show there have been four other cases of either sexual or physical abuse by one resident on another resident in the past two years.

Statistics from the Workers Compensation Board show Braemore also has one of the highest rates of violence against residential care workers in the province. The board accepted 24 claims for injuries caused by violence in 2009 and 2010 at Braemore.

'He was scared'

The autistic man's mother said she worried about how her son would cope with Braemore from the day he moved in more than a year ago.

She said he had been shifted out of group homes after being aggressive with other residents, and he had briefly been placed with two other residents in a smaller home before he was assigned to the main building at Braemore, which also runs three community residences.

Being with dozens of people on the Braemore wards was frightening for her son, she said.

"He shows his emotion with his eyes. He was scared and was wondering why he was there."

The man's mother describes her son as being able to communicate basic ideas in several words and until 2009 he attended school.

Although her son had begun to act out at Braemore, she said his behaviour improves when he is given small jobs outdoors because it "helps him to burn off energy."

She said the situation for her son has improved since he was locked in the room, including getting more access to exercise.

Ultimately, she said, the province must examine the systems in place.

"My son's very kind. He's very lovable.… If I went over there right now he'd give me a big hug and a kiss on the cheek," she said.

"I do believe that things need to change.… Are things going to change? I don't know."