Saturday, November 22, 2025

Loving the Work, Facing the Violence

Front-line workers love what they do, but growing resident aggression highlights the urgent need for government action, training, and support

By Pam Mulder, RN, Shalom Manor

I love my job. I love my job. I love my job. . . . I really do love my job. But there are days when I have to repeat this phrase over and over again just to convince myself to return to work tomorrow.

Talk to any nursing professional working in a long term care home in Ontario, and you might hear the same thing. What’s not to love? We find deep satisfaction in helping our elderly population live with quality and dignity. That’s the most common reason we give for why we love our jobs.

But this sentiment is being heard less often from front-line staff in long term care homes lately. It’s not about money or scheduling. It’s about the violence we endure daily on the job.

So, what does this violence look like? Resident violence in Ontario long term care homes typically refers to resident-to-resident aggression and resident-to-staff violence—often described as responsive behaviours because they usually stem from underlying conditions such as dementia, environmental triggers, or unmet needs. Reports of these incidents have been a persistent and growing concern across the province.

A 2019 study found that 90 percent of Canadian caregivers had experienced physical violence from residents. That study is already six years old, and the numbers have only risen since then. Provincial data shows that reports of resident-on-resident abuse doubled in just five years—from 1,580 incidents in 2011 to 3,238 in 2016.

Experts link this increase to the growing number of residents living with dementia. A large portion of long term care residents now have some degree of cognitive impairment, which can manifest as aggressive or agitated behaviour. Unfortunately, there isn’t adequate staffing to handle these behavioural challenges, and many PSWs haven’t received sufficient training in intervention strategies for dementia-related behaviours.

Another factor is the reduced use of antipsychotic medication to manage aggression as a symptom of dementia. In 2012–2013, nearly one-third of Ontario’s long term care residents were prescribed antipsychotics without a psychosis diagnosis. Those numbers have since decreased due to serious side effects such as confusion, falls, and even death.

However, an analysis of more than 600 long term care homes in Ontario found that as antipsychotic use went down, resident-on-resident abuse went up. Julia Kirkham, a geriatric psychiatrist and researcher in Kingston, has said it’s a daunting task to reduce the use of antipsychotics while also preventing violence.

Globally, the challenge is only expected to grow. One major international study predicts that by 2050, 135 million people worldwide will be living with dementia—and warns that governments are woefully unprepared for the crisis ahead.

But amid all these statistics, we must keep empathy at the centre. Aggressive behaviours are not acts of malice; they’re symptoms of cognitive impairment. Residents aren’t trying to be violent—they’re trying to communicate.

We also have to remember the families and caregivers who faced burnout before their loved ones entered long term care. These facilities exist to provide relief and ensure proper care, which means we must learn how to care for residents with complex behaviours—without burning out ourselves.

Thankfully, CLAC is hearing this message. In the spring of 2025, a small group of front-line long term care workers made the trek to Queen’s Park to deliver a message to our MPPs: we need action.

For 2026, this concern is once again on the front burner. Consider joining our Lobby Day and sharing your story. Together, we can continue to push the government to make the much-needed changes that protect both residents and those who care for them.

Pam Mulder is Local 302’s vice-president, a steward, and bargaining committee member. She works as a registered nurse at Shalom Manor in Grimsby and advocates passionately for safer, more supportive long term care workplaces.

Loving the Work, Facing the Violence

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