(Quebec) Around fifteen cases of mistreatment of an elderly or disabled person are now reported every day in Quebec.
Complaints and reports of mistreatment received by health network watchdogs continue to increase. And not just a little. They exploded by 120% in one year.
Quebec attributes this increase to better knowledge of the law in the health network and to the rather recent broadening of its scope of application. Clearly, mistreatment is not necessarily more widespread, it is above all more reported.
According to a report from the Ministry of Health and Social Services (MSSS) tabled in the National Assembly, 5,756 suspected or proven cases of mistreatment were reported to the network authorities in 2022-2023. This is a new record: there had been 2,618 the previous year.
There were 866 five years ago, in 2018-2019, the first full year of application of the Law aimed at combating mistreatment of seniors and any other adult in a vulnerable situation.
Long underestimated, mistreatment is gradually coming out of the shadows since the adoption of this law in 2017. It was improved in 2020, then in 2022.
Denounce “without delay”
Abuse takes many forms. It’s an employee who bullies an elder. A resident who sexually assaults another. A son who financially abuses a parent. An establishment that does not provide basic care to its residents.
A victim of abuse or a witness to abuse can file a complaint with the local complaints and service quality commissioner of their CISSS or CIUSSS.
The law also requires health network workers and professionals to report “without delay” to the commissioner any situation of mistreatment that they witness or suspect against a senior or vulnerable adult housed in a private or public CHSLD. , a seniors’ residence, an intermediate resource (RI) or family type resource (RTF). They are also asked to denounce the abuses they observe during a visit to a patient’s home.
This reporting obligation has expanded over the years, which partly explains the increase in cases reported in 2022-2023, according to the MSSS report.
“There is also the fact that care and service providers have better knowledge of their role and responsibility thanks to the numerous training courses offered in the health and social services network, in order to protect any adult in a vulnerable situation. », we add.
” Excellent news ”
The explosion of denunciations, “this is excellent news!” », Says Jean-Philippe Payment, president of the Regroupement des commissariats aux complaints et à la Qualité des services du Québec.
“Finally, the mistreatment is denounced. I suspect that for many years to come, we will have increasing numbers. » He recalls that a vast survey published in 2020 by the Institute of Statistics of Quebec (ISQ) concluded that no less than 6% of seniors living at home are victims of mistreatment.
According to Mr. Payment, there is “clearly a change of attitude” in the health network. The fight against mistreatment has become a priority and workers are better aware of the provisions of the law today.
With the Dubé reform, the complaints commissioners will no longer report to the boards of directors of the CISSS and CIUSSS, but to a national commissioner who will be under the aegis of Santé Québec. The financing of their activities will also be set by the new agency.
Jean-Philippe Payment welcomes these two changes, which guarantee greater independence to commissioners and protect them from pressure from establishments.
No criminal sanctions yet
A change to the law last year provides for criminal sanctions to counter abuse, but their entry into force has been slow.
According to the MSSS report, 18 files requesting investigation for criminal sanctions were admissible and being processed, as of September 15. Twenty other files were deemed inadmissible by the Ministry’s Investigation Department, four of which were transmitted to the police authorities.
The MSSS Investigations Department has therefore not yet transmitted any files to the Director of Criminal and Penal Prosecutions (DPCP).
“After verifications, no prosecution has yet been initiated by the DPCP in relation to this Law”, reports Me Patricia Johnson, deputy spokesperson for the DPCP.
The law provides for criminal penalties of $2,500 to $25,000 for a staff member who fails to report abuse they witness or suspect. Perpetrators of mistreatment are liable to fines of $5,000 to $125,000 in the case of an individual, and of $10,000 to $250,000 for an establishment or legal entity. There are also criminal sanctions against those who retaliate against a complainant or who obstruct the work of Ministry investigators.
Criminal sanctions are obviously not the only punishment to which a perpetrator of mistreatment is exposed. Criminal prosecution may be initiated. An offending employee can be suspended or even fired, which happens in a few cases each year.
Abuse in figures
The MSSS report provides an overview of 558 cases of mistreatment which required a special intervention process by the authorities, a process provided for by law to help victims.
Sex of victim
66% are women
34% are men
Average age of victim
74 years old
Place of residence of the victims*
Private home: 61%
Private seniors’ residence: 16%
CHSLD: 10%
Intermediate or family-type resource: 5%
Other: 8%
* A third live alone
The sex of the abusive people
65% are men
Relationship with the victim
61% are a family member
9% are a “person offering services”, therefore a worker in the health network
6% are a roommate
24% are other people such as a neighbor, another resident or a friend
Types of abuse*
Financial: 62%
Psychological: 49%
Physical: 27%
Negligence: 27%
Sexual: 10%
Others: 8%
* The cumulative total exceeds 100% given that more than one type of abuse may be present in the same situation.