I am a Residential Care Aide. This is also sometimes referred to as a nursing assistant, nurse’s aide, care aide, RCA, HCA, Home Care Worker, Community Support Worker.

I have worked for a variety of companies, private and public. I have worked for facility homes, private group homes, senior’s care homes, as well as assisted living condos, and in people’s own personal homes.

I am going to reveal to you some of the awful things I have encountered. I am doing this in the hopes that 1. if you have a loved one in a home, you know what to look out for and can have a real behind the scenes look. 2. as an eye-opener for those thinking of moving their loved one into a home 3. as a statement on the way health care in BC is administered and managed. 4. To show the dangers of PRIVATIZATION of health care. Contracting out health care to private, FOR PROFIT companies is truly horrendous and disgusting and not acceptable. The Government should be ashamed of themselves.

Disclaimer – I am not, and will not, reveal the care homes I have worked at, nor my last name, nor specific location, so please do not ask. I can’t afford any legal battles. These are my personal experiences and may or may not reflect the quality and type of care that some people may have encountered. None of my patient’s names or family names are included for privacy.

I am not quite sure how to approach this subject, in an organized manner. I am simply going to being listing things that have come to my attention. If you have any questions or want clarification, please feel free to write in the comments and I will get back to you as best I can.


1. Private, for-profit senior’s home.

-The people do not matter. This is absolute. Neither the seniors living there nor the staff matter at all to the private care homes that I have worked at. The only thing that matters? MONEY. Bottom line. They will pay employees as little as possible, buy the cheapest care products for their patients, skimp on anything they can, and the food… I wouldn’t feed most of it to my dogs. I would certainly never eat most of it my self. And yet was required to feed it to these poor souls.

-One care home I worked at, the cost for 1 month of living there was well over $5000.00. For that the seniors got a small room/furniture, disgusting food, a forced schedule run by the nurses in charge, little to no choices or autonomy over their lives, little attention and interaction, ONE bath or shower per week (and if they refused or were too difficult they were skipped until the following week – horrid and disgusting), pretty much being bathed with janitor’s liquid hand soap for their hair and body, unless they or their family provided their own products, limited time in the bath of less than 30 mins – we were usually pressured to do it in half that amount of time.

-Do not bring/have anything valuable in a care home. Ever. Some employees WILL STEAL. There are a few in every shift that cannot be trusted. Please note – most of the staff are honest, hard working, caring people, doing the best they can. But a few rotten apples spoil the bunch. And there are always a few. Any electronics, jewelry, even nice clothes/accessories, WILL GO MISSING. ESPECIALLY CASH. Sometimes families will leave the senior with a wallet loaded with bills. This is so terribly unwise. Cash will go missing, or also, senior’s may hide it or stash it somewhere in fear of it being stolen, and then forget where they put it, or have it sent to laundry/thrown out by accident, etc.

-Also note – the rate of dementia is rising, and the rate at which health care providers can handle it is very low. We are not well trained or well equipped to deal with severe dementia/alzheimers cases. Seriously. They are extremely difficult, and no matter what a facility tells you, I have yet to see one that can properly handle these types of people. It is extremely sad and pathetic that their reward for working all their life is confusion, fear, and being treated like this. Alzheimers/Dementia patients can wander into all areas of a care home, including into your loved ones room. They can take items, they can hit other seniors, they can abuse and assault, they can sneak into rooms while others are sleeping, take food, eat food that is spoiled, eat from the garbage or toilet (YES this has/does happen – it is not their fault, they DO NOT know what they are doing!!!). Some dementia patients try to bathe in their toilets, try to eat things that aren’t food IE eating cream for a rash, drink mouthwash, eat/drink cleaning supplies, etc. Sometimes they also have serious problems with hoarding, I have found hoarded items such as old food, used diapers (YES almost all of them wear diapers, even if they don’t want to or need it they are almost always forced to), used/other people’s toothbrushes, hairbrushes, bras, undergarments, pillowcases, band aids, medical supplies, medications, other people’s dentures… the list goes on and on.

-Accountability – there is none. I have seen / heard nurses and care staff flat out lying to family members. Or misinforming them. Or making up stories or reasons for this and that. Or ignoring problems, brushing things under the rug, etc. Go to your superiors/bosses and tell them of the issue? Any issue? I was brushed aside, told it was not my business, told it would be handled (and it wasn’t), told I needed evidence and to go get some then come back (what am I a detective? ) and generally made to feel that as long as no family members found out what happens behind closed doors, that the management did not care.

-products: when you are a for-profit company, money is the bottom line. The diapers they used were essentially the same quality as a plastic grocery bag stuffed with toilet paper. Someone would urinate in their diaper and it would be left on for hours, soaking wet, stinking. Daily occurrence. Any personal care products, if not being brought in by family members or bought by the seniors themselves, was extremely low quality, like cheap dollar store quality at BEST, usually worse. NONE of it I would ever use on my own body.

-Staffing – OVERWORKED AND UNDERPAID is really all I have to say about that. Management absolutely did not care about their staff. If you were sick, tired, sore, injured, NO ONE CARES, GET BACK TO WORK was the attitude. They would not care if you had just worked 12 days in a row, if you were ill, or having personal problems, or anything. As long as they had a worker there to fill that spot in the schedule you could be on your death bed for all they care. This is dangerous. And sad. Seniors are not getting good care from someone in this situation. They are not getting proper attention. THIS IS NEGLECT! So much neglect.

-If there is not enough staff on, or they cannot get someone to fill a sick-call etc., then whatever staff do show up, still have to do all the work, while missing one or more persons. This is extremely taxing, and means that people are not getting the care that they need and deserve. The seniors are rushed through everything from waking to bathing to dressing to toileting to eating etc. And not getting close attention.

-There. Is. Feces. EVERYWHERE. Almost all of these seniors are wearing diapers. Sometimes being left to sit in their own mess for hours at a time, whether due to staff shortage, staff laziness, staff being unobservant, etc. Sometimes seniors with dementia/Alzheimers will touch their own feces, or other peoples, play with it, even eat it. YES MANY TIMES I HAVE SEEN THEM EAT IT. THEIR OWN OR OTHER PEOPLES. THEY DO NOT KNOW WHAT THEY ARE DOING. And they do not have enough support/supervision. None of the seniors wash their hands regularly. Housekeeping does clean and try to keep up, but with same a dozen housekeepers and over 200 residents, good luck. They also sometimes will overflow their toilets, throw their poo, smear it on walls and linens and furniture. I have found residents covered in their own diarrhea rolling around their beds or the floor or chairs etc. I have found diapers filled with feces stuffed into drawers in their rooms, or cupboards, hidden away for who knows how long. 

-The food – if you can even call it food. It is disgusting. Mass produced. Does your loved one have allergies? Sensitivities? Vegetarian? Vegan? Celiac? Lactose Intolerant? Once they are in a care home, all of that is basically disregarded. The food is revolting. I would not eat it. I would not feed it to my dogs. They repeat the same menu usually monthly. Little to no variety. Little to no nutritional value. Disgusting, stinking, cheap meals.
Examples: Seafood pie (unidentifiable, rotten fish stinking goo inside a pie crust), a lunch of a small sandwich on white bread with only margarine and plain ham slices, with some canned beets and tomato slices. A stir fry dinner which looks like Mr. Noodles topped with inedible chewy beef strips and some peas in a mystery thick sickening brown sauce.
Not to mention contamination – Food Safe is a joke in these places. Also, other residents at the same table (they all eat together in a mess hall basically) can freely touch and eat each others food and drinks, again all with unwashed hands …

-Staff who use threats and / or intimidation to make seniors do what they want ie force them to take a bath if they don’t want to, or to eat, or dress, etc. Staff withholding things such as meals or medicine for the same purposes.

-Staff power tripping/hierarchy. IE a nurse who is the team leader acting superior and control freak to staff who are “lower” than her. Nurses who have more seniority refusing to do certain tasks or to see certain residents who are more difficult or “gross” or ill. Picking and choosing what they want to do and pushing less desirable jobs onto us lowly care staff. 

-Resident favoritism – if one little old lady is sweet and kind, and one is grumpy and surly, which one do you think gets better care? Faster response time? Gets their care and meals first? Gets their pain medication first? 

-If a senior has children or other family members who come visit, and who are in charge of their care, the family member’s attitude and actions also dictate the seniors care in many cases. The family member is rude? Demanding? Demeaning? (And yes, many are, I have been treated like an absolute piece of garbage, like a servant, by visiting family members on many occasions  however I have also been treated with kindness and respect by many as well)

The senior will possibly suffer due to an unpleasant family member. They may receive lesser care or be moved to the bottom of the priority list. A family member who is too demanding will get nothing more than rolled eyes and empty promises. A Family member who micro manages may even have their visiting hours limited or supervised.

The bottom line is – trust your gut. If you think something is not right, then it isn’t. Keep a close eye on your loved ones. Visit often. Bring them things they need, ie toiletries, food, clothing, diapers, makeup. They certainly won’t get the best of it from the care home, if they even get it at all. Watch closely for signs of abuse. (bruises, flinching, dirty fingernails, stench/foul body odor, weight loss, confusion, sadness/depression, isolation, the list goes on)

Find a nurse who you trust and communicate respectfully with them. Every team has a good nurse or two. Communicate directly with the nurse who is directly in charge of the area that your loved one lives in. Not the “head nurse” or “charge nurse” – they DO NOT know the daily goings-on and will rarely be able to “get to the bottom of ” any issue. Build a positive relationship with staff, and treat them with respect, and a little compassion – most are over worked, tired, running ragged, and doing their best. If one stands out, say so. If one stands out for negative reasons, say so. Record staff names and positions so you know who is looking after your loved one and when. Keep track of personal belongings, but know, that things WILL go missing ,it is inevitable, and do try to be reasonable about it.
One of the best things I have ever seen family do for their loved on – the family made large signs  on posterboard, outlining the seniors preferences, foods they liked, clothes they liked, helpful hints, tips and tricks, everything they could think of to help the staff care for their loved one better. They also brought in some of the seniors’ favorite foods and treats, makeup, and bath products, so that everything needed was there in the room. They came tp visit often, and they even asked what good times were to come and visit.

(Good times – afternoon, 1pm to 5 pm.
BAD times – early morning, anything before 10am, because we are trying to get everyone up and dressed and fed breakfast, noon-ish, because we are trying to feed everyone lunch, and after dinner time, because we are trying to bathe/give medications/settle for sleep. Unless you are willing to help out with your loved one ie. feeding them lunch or supper then PLEASE don’t come and hinder us at these times if at all possible. We already have enough to manage without the addition of family members and friends)

Anyways, I know this is a bit disorganized, I apologize, I kind of just let it all fall out onto the page as I thought of things. I may go back and edit to make things more clear and concise at a later date. Again if you have any questions or comments please feel free to share them in the comments section.