The causes of violence in the workplace are complex and shaped by factors across our social, health care and organizational systems when all of these are brought together in the context of care. Solutions require collaborative systems-based approaches involving organizations at all levels of government. For the purpose of this presentation, I will focus on residential care; however, these issues are also experienced in our acute care and community care settings.
Our members report working chronically understaffed and facing crushing workloads to provide the quality care their residents deserve. Working quickly through care routines, with limited flexibility for providing basics such as baths or helping a resident to the toilet, are examples of factors that contribute to the potential for aggressive behaviour and violent incidents.
Our members also see a reduction in the resources to provide their residents with social, cultural and recreational activities, such as music and outings, which would support a meaningful quality of life and alleviate challenging behaviours arising out of confusion, isolation, frustration and boredom.
Our members also note that family members who are frustrated with care delivery or staffing changes due to shortages can also contribute to the potential for violence. They report having to manage the distress of family members who are frustrated, angry and exhausted when they're unable to continue caregiving on their own, encounter challenges accessing home and health care supports and fear having to accept the first available bed in a facility apart from their partner, family support system and their established social communities.
The B.C. seniors advocate reports that almost 85% of the residential care facilities in British Columbia are understaffed compared to the guidelines that have been put in place by the province. Residential home and community care services must expand to meet the growing needs of Canadian seniors and their families. Increasing staffing of both direct and support staff to meet or exceed the minimum staffing guidelines is critical. Residents in long-term care are increasingly frail, and their needs are rising. Ensuring that staffing guidelines keep pace with those needs is essential.
Investment in building infrastructure, violence prevention programs and education is also required. Our members talk about the physical environment being poorly suited to the care needs of residents today and point to a connection between design and violence risks. They talk about their residents needing safe and secure environments that eliminate barriers to mobility, look more familiar than institutional, increase engagement and reduce confusion and disorientation. They also identify the importance of staff safety features, such as clear lines of sight, spaces with multiple exits and the equipment to reliably call for help in emergency situations.
In our members' experience, better strategies are necessary to ensure violence alerts and effective behavioural care plans are implemented and shared across the system, comprehensive risk assessments are done, and “code white” teams are well trained. In addition, they also highlight a need for comprehensive violence prevention education that is available in multiple languages, is specific to their residents' care needs, such as dementia care and mental health, and includes support for practical application, such as peer coaching.
Our members have the right to work in a safe workplace. It's imperative that strong action be taken to establish and maintain safe and healthy workplaces that support a high quality of care.
Thank you.