BACKGROUND: Elderly women (age 75+) who are residents in Ontario long-term care (LTC) facilities are at an increased risk of physical injuries caused by other seniors (Banerjee, 2007). According to AGING WITH CONFIDENCE: Ontario’s Action Plan for Seniors (Ontario Ministry of Seniors Affairs, 2017), “in 2016, 16.4% of Ontario’s population was 65 years or older. By 2041, it is projected that 25% of Ontario’s population will be 65 years or older, almost doubling from 2.3 million seniors in 2016 to 4.6 million seniors” (p. 9). Information from Statistics Canada shows that in 2010 there were 4.8 million seniors in Canada of which 2.7 million, or 56% were women. It is projected that by 2031, in Canada, there will be 9.6 million seniors and 53% of these, or 5.1 million seniors, will be women. In 2031, 1.6 million of those women will be over 80 years of age (Milan and Vezina, 2011). LTC facilities usually house seniors experiencing two or more chronic conditions such as arthritis or heart disease (97%), 90% of these residents have some form of cognitive impairment. Cognitive impairment contributes to 46% of the residents’ aggressive behavior or a mental health condition and 40% have a mood disorder such as anxiety, depression, bipolar disorder, or schizophrenia (Ontario Long Term Care Association, 2016). 65% of seniors diagnosed with dementia over 65 years of age are women (Chambers, Bancej, and McDowell, 2016). In addition, 2011 statistics show that from age 65 up to age 74, the proportion of men and women living in these facilities are about equal, but from the age of 75 the number of women increases by age 85 and over to 33.4% versus 21.5% for men of the population (Milan and Bohnert, 2011). In Ontario’s Long-Term Care Homes Act, 2007, the Residents’ Bill of Rights states: “every resident has the right to be protected from abuse” and “every resident has the right to live in a safe and clean environment” (Part II, Sec. 3). Regulations require that reports are to be filed with the Government of Ontario, Ministry of Health and Long-Term Care (MOHLTC) in all instances of abuse and especially injury to a resident by anyone in all public and private facilities and persons are guilty of an offence if they fail to make a report. In addition, training of LTC facility staff and MOHLTC inspections are carried out annually to ensure compliance with the Act (Government of Ontario, 2007, Regulation 143). Reports are available online listed by long-term care facilities but there appears to be no compilation available for statistical purposes outlined by abuse types (Ontario Ministry of Health and Long-Term Care, 2017). Bill 160, Strengthening Quality and Accountability for Patients Act, 2017 has made changes to the Long-Term Care Homes Act, 2007 and the Mental Care Consent Act, 1996, that repeals the current “secure units” provisions in facilities and enacts a system that deals with restraining and confining of residents (Government of Ontario, 2017a). The AGING WITH CONFIDENCE action plan initiatives include: working with the long-term care community to develop strategies to care for those seniors who require a higher level of support in dealing with complex needs caused by cognitive and physical decline and conditions such as dementia, increasing direct patient care per day to four (4) hours, and working to prevent and respond to elder abuse through public education, increased service provider training, research, and improved community response (Ontario Ministry of Seniors Affairs, 2017). Since 2015, the three industries with the greatest share of women (relative to men) were in the services producing sector, health care and social assistance (82.4%), and educational services sector (Moyser, 2017).The recent and proposed changes in legislation is a start to protect women housed and working in long-term care but more needs to be undertaken to keep them safe.
