Content warning: Sexual assault
The recent case of an academic who indecently assaulted an 82-year-old woman with dementia in her rest home raises questions around how aged care providers can maintain the safety of their residents.
Grant Hannis was visiting a relative in May 2018, when he followed another rest home resident to her bedroom and began touching and kissing her while she tried unsuccessfully to push him away.
According to the police summary, a caregiver entered, saw the pair in darkness and switched on the light. Noticing Hannis was red in the face and receiving no reply when she asked what was going on, the caregiver left to find a manager.
Hannis then resumed kissing and touching the victim and exposed himself to her before pulling down her pants and underwear.
An employee needs the ability to seek help when required, especially in relation to confronting situations which are outside the scope of their normal role. However, it seems the victim in this situation was exposed to further assault after being left alone with the perpetrator again.
New Zealand Aged Care Association Chief Executive Simon Wallace says although every rest home has security protocols around visitors entering the facility, he is not aware of any nationally standardised protocols in the event of an assault.
“On the whole every rest home has quite strict protocols around the entry and exit of visitors,” he says.
“It’s a balance between the visitation of family members and friends and also protecting the safety and rights of residents and staff.”
In this particular case, the rest home seems to have followed the correct process, Wallace says, and no additional measures could have prevented the assault from occurring.
“This person was visiting his mother in the rest home and clearly the rest home staff knew who he was. There was a degree of trust which he broke and whatever protocols are in place could not have prevented this kind of incident from happening and the intent of this man,” he says.
“I think in this case, this proves that the processes that the rest home had worked really well. The caregiver immediately challenged the person and then went to get their manager.
“This is not due to the processes of the rest home that this incident happened.”
While incidents of this nature do happen, they are very rare, he says.
“One like this is one too many, but no matter what processes were in place here, which I think were the right processes, we can’t prevent the intent of a person such as this.
“I think we need to keep that in perspective and I firmly believe that all our rest homes have very good security and visitor access processes.”
“This is an unsavoury incident and our thoughts should be not only with the victim and her family, but also with other residents and the staff of the rest home.”
Assaults on residents rare
St Andrew’s Village CEO Andrew Joyce says he has never heard of a situation of a resident being assaulted. Assaults against staff are more common, but still rarely happen.
“Physical assault in aged care is not something that we ever really come across,” he says.
“We have had a few instances over the course of 14 years where a resident has struck out at a staff member, it might be with a walking stick or grabbed their arm, but it tends to be relatively low key. If it does happen, it tends to be a resident that has some form of cognitive decline.”
Joyce’s staff has access to free counselling sessions through an employee assistance programme (EAP), regardless of whether an incident has occurred, he says.
“Should anything happen and staff are feeling upset or vulnerable, they have independent access to the counsellors.”
St Andrew’s Village HR manager Lee Keegan says she is also unaware of any national guidelines in case of an incident, but believes all rest homes would have a policy about dealing with anybody entering the premises whose behaviour is inappropriate.
“I think all aged care facilities would have to have that because we’re so closely audited and watched by the Ministry of Health and our local DHB. That would be one of the things they would check when they did an audit, that we had an appropriate policy to deal with that,” she says.
“It’s basic common sense, our policy. Staff must protect themselves and the residents at all costs and call the police immediately.”
Staff also receive training around ‘challenging behaviour’. This typically relates to the behaviour of residents, but could be applied to any person behaving inappropriately, she says.
“We have full and intensive training on managing strategies, de-escalation techniques, all of those things to cover that, but that is mostly in people with advanced dementia,” she says.
“Part of it is understanding what is happening, being able to deescalate a situation as quickly and effectively as possible, so that principle of behaviour would be the same if you were dealing with someone who was acting inappropriately, whether it was a resident or a visitor.”
Following an incident, staff and residents would receive support from the service’s internal pastoral care team as well as the external EAP scheme.
“We’d have debrief sessions obviously, meetings around how the situation happened, looking how to move forward, and the EAP and internal counselling for staff as they required.”
Better quality dementia services needed
Alzheimers New Zealand Chief Executive Catherine Hall says symptoms of dementia vary according to which part of the brain is affected, but typically involve changes to thought processes, decision making, behaviour, emotions, personality and memory.
“Those changes progress and get worse over time. They affect the person’s ability to look after themselves, so one of the things that happens is people living with dementia can become very vulnerable. In fact, they’re amongst the most vulnerable people in New Zealand.”
Although only one third of people living with dementia live in a rest home, there is a real need for better, more coordinated, more nationally consistent and better quality services, Hall says.
“People living with dementia are vulnerable and a group that are falling through the cracks wherever they live. There’s an urgent need to do more and better for people living with dementia here in New Zealand across the board.
“We know that the services are inadequate, we know that they are delivered inconsistently across the country and we know that they’re of variable quality. We must do better.”
The responsibility for regulating aged residential care providers falls to the Ministry of Health. Aged residential care providers are required to be certified under the Health and Disability Services (Safety) Act 2001 and to meet the Health and Disability Services Standards.
Ministry of Health spokesperson Blair Cunningham says the standards aim to ensure consumers are treated with respect and receive services in a manner that has regard for their dignity, privacy and independence.
It is important for rest home residents and/or their families to speak up if they have concerns about their care or the home support services on offer, he says.
“Never hesitate to voice any concerns you have, or make a complaint, about your home support services.”
The Ministry did not respond to a request on whether national guidelines on how to deal with an assault on a resident were available at the time of this article.
Where to get help:
- If it’s an emergency and you feel that you or someone else is at risk, call 111.
- If you’ve ever experienced sexual assault or abuse and need to talk to someone. call the confidential crisis helpline Safe to Talk on 0800 044 334 or text 4334.
- Alternatively, contact your local police station.
- If you have been abused, remember it’s not your fault.