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Studies which have attempted to validate the causes of abuse and neglect in a long term care facility describe a multi-dimensional problem. Some studies have stated that causes of abuse and neglect are often interactional and therefore difficult to understand, measure and prevent. Poor communication issues because of the different language and cultural backgrounds of many workers and residents lead to misunderstandings. Other studies point to denial of abuse and neglect as a major issue and its acceptance as part of institutional life. Structural factors are also noted such as inadequate staffing, undertrained staff, and burn-out among the staff.

In one study, researchers found evidence that the maltreatment of residents was a response to highly stressful working conditions. Staff who were burned out and who experienced aggression from residents were most at risk of becoming abusive toward residents. A recent article in Le journal de Montreal (see Les CHSLD vus par ceux qui y vivent et qui y travaillent) provides an alarming depiction of working conditions from the point of view of those doing the work. Caregivers (aka PABs) are on the front line and exhausted due to a lack of personnel and resources.

The website to evaluate CHSLDs (see evaluationderesidences.ca) promotes transparency and is a step in the right direction. You can also check out the results of the government inspections of CHLSDs (see Visites d’évaluation de la qualité des milieux de vie). If you are choosing a CHSLD, this site should be verified to get a general idea of where the institution needs improvement.

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