Concerned Friends assists with research study on responsive behaviours in LTCHs

Concerned Friends (CF) is proud to have contributed to the recently published research conducted by a team from the University of Windsor and York University. The
article, entitled Analysis of Inspection Reports and Responsive Behaviours, explores the
relationship between regulations, inspections and responsive behaviours* in long term

The research focus emerged from a meeting between CF Volunteer Reviewer, Gerda
Kaegi, and the lead research author, Lorna de Witt, Associate Professor in the Faculty
of Nursing at the University of Windsor. Three of our own Review Team volunteers
contributed their advice and knowledge to this important research. Many thanks to Lois
Dent, Gerda Kaegi and Lorna MacGregor.

The study analyzed incidents involving responsive behaviours that were documented
in government inspection reports. The study covered 535 Ontario long-term care homes
from 2016 through 2018. The findings noted a number of differences between for-profit
and not-for-profit homes. For example, of the total incidents, the proportion among for-
profit homes was more than double that among not-for-profit homes. Six of the eight
director’s orders relating to responsive behaviours occurred in for-profit LTC homes.
And the analysis revealed a total of four penalties related to responsive behaviours, all
issued to for-profit homes.

Requirements regarding how LTCHS are to address responsive behaviours were delineated in the regulations following the 2007 Long Term Care Homes Act, and reiterated in the 2022 regulations.

Given the frequency of issues related to how staff address and document responsive behaviours, Concerned Friends questions whether homes are adequately funded to meet the required standards. Strategies to address responsive behaviours (for example “one-to-one” supervision) require higher levels of staffing and training than is generally available. 

Concerned Friends is grateful for this research that highlights important issues related to quality care. Our Inspections Review Team, our Advocacy Committee and Board will continue to monitor compliance and be a voice for significant improvements in the care of those most vulnerable LTCH residents.

* Responsive behaviours is a term used to refer to behavioural and psychological symptoms of
dementia, the most common of which is aggression. Symptoms may manifest as being verbally or physically abusive, socially disruptive, resisting care and assistance, irritable outbursts, pushing or hitting, and it includes resident-to-resident aggression.

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