A caregiver at one of the Golden Age Homes is working in fear after being physically assaulted by one of the mental health residents of the Home.

The 53-year-old was assaulted and punched twice in the face on March 17, 2023, while attending to the residents of one of the state-run Golden Age Homes.

It was a traumatizing incident that she is still trying to recover from.

Note: For privacy issues, we have decided not to name the victims and mental health patients.

“He punched me twice, and he pressed my neck towards the wall to where his clothes were kept. It was fortunate that another senior citizen came, and pulled my hand and asked me to run away,” the caregiver said.

Weeks after the incident, she is still nursing a swollen face and a weak jawline.

“Since he punched me, I am really disturbed, and I can’t really focus on my work,” she said.

“I have been very sick, I got a swollen face, and broken tooth, and within a week or two, I must get medical checkup. I still must go to work when I am rostered.”

The caregiver claimed that the mental health patient has assaulted three to four female staff.

She claimed that no one from the Ministry of Women, Children and Poverty Alleviation had offered support to her since the incident.

She further claimed that she was not given any leave to go Home and rest and had to transport herself to the hospital after the incident.

What is the issue? Fiji does not have the facility to permanently house these mental patients and provide them with the services they need.

Senior citizens, who are discharged from the St Giles Psychiatric Hospital, are referred to the Department of Welfare if they do not have any families to pick them.

They are housed together with senior citizens in the Golden Age Homes in Labasa, Lautoka and Suva.

MULTIPLE INCIDENTS 

The caregiver is not the only victim of physical abuse in her place of employment.

Just a few months earlier, another long time serving female staff at the Home was physically assaulted by the same mental health patient.

It is understood the resident manager and the Department of Welfare are aware of the multiple incidents involving some of the female staff and mental health patients of the Home.

There is an internal process that is followed when dealing with these complaints.

The caregiver graduated with a certificate in caregiving from the Australia Pacific Training Coalition in 2017.

She looked after her elderly parents before landing a caregiving job at the Home two years ago.

Like herself, all caregivers are not equipped with the skills and knowledge to look after mental residents.

But they have no choice but to bath, dress and attend to mental residents a risky endeavor they must endure because they are paid to do so.

“We caregivers are only trained to look after senior citizens; we are not trained to look after mental patients,” she said.

“The mental health patients are very serious and dangerous because if they are given spoon and fork to eat, or if they bath and two residents bath together, a mental patient can punch anybody, and that’s very serious.”

In these Homes, residents dine together, but have separate cubicles. Some nights, staff members must try to break a quarrel between mental health patients.

“You can control senior citizens, but with mental health residents, you can’t do anything.”

Since the incident, the caregiver has been advised not to go near the mental health patients.

“I bath all the residents except him,” she said.

There are four mental health patients at the Home, with three having serious conditions.

Two are females. There are only 11 staff doing shift work to cater for close to 30 residents.

MINISTRY’S RESPONSE 

Permanent Secretary for Women, Children, and Poverty Alleviation Josefa Koroivueta said the ministry was aware of the risks posed on the lives of caregivers who cared for mentally unstable clients.

The ministry evaluates these psychiatric residents on a case-by-case basis.

“We have an understanding with Ministry of Medical Health and Medical Services whereby mental health professionals cross train our staff in standardized care for mental health clients in our Homes,” Mr Koroivueta said.

Only mentally stable residents are admitted to the Homes with an open referral system with St Giles Psychiatric Hospital.

In unfortunate cases of staff assault by mentally challenged residents, the staff is reported to management for any physical injuries, and proper medical treatment and care is given if necessary.

But there is no compensation. The Ministry realises the need to strengthen its partnership with the Accident Compensation Commission Fiji as a response measure.

Trauma counselling is also provided to the staff, and a root cause analysis is undertaken to prevent any further occurrence.

“Residents will be referred to mental health professionals for acute medical care to stabilize them and provide maintenance regimen and continuum of care,” Mr Koroivueta said.

He reiterated that mentally challenged residents are not only in state-owned aged care Homes but are also in Homes administered by non-governmental organisations.

There are 56 residents who are psychologically challenged in the three Stated-owned Homes.

REPORTS FROM HOMES 

There have been several physical abuse cases and other complaints, that are dealt with internally – involving the Department of Welfare.

Some of these complaints include elderly people who are not satisfied with the services provided to them.

It’s not only the staff who are assaulted. There have been reports received by the department of mental residents also assaulting other senior citizens.

Former Director for the Department of Welfare Rupeni Fatiaki said they could only do so much when matters involved mental residents because of their condition.

St Giles only provides temporary treatment for psychiatric patients before they are discharged to rejoin their communities.

The department only works with St Giles on the medication and therapeutic treatment for these patients.

“At the moment, we have to take them because there is nowhere else to place them,” Mr Fatiaki said.

SEPARATE FACILITY 

The only other option is having a separate facility for those who are mentally challenged, which is a long shot.

Some of the compounding challenges include the finances to construct the facility, having the right personnel, those with the skills to treat these patients.

“There have been discussions that there needs to be a place separated from the elderly persons. And that is to be inclusive of everyone who is mentally challenged, not just the elderly,” Mr Fatiaki said.

THE CAREGIVERS 

Caregivers in these Homes are obligated to provide the same service to all the residents, despite not having the qualification or expertise to look after those with mental health problems.

Caregiving courses in Fiji do not have modules that focus on caring for those with mental problems. For years, this has been the challenge for the department.

“Some of them maybe trained caregivers, but they are not trained on how to handle mental patients, some of them do not know how to deal with them. They don’t have the technical expertise and the know-hows,” Mr Fatiaki said.

He said caregivers were dealing with a challenging work environment, and this had an emotional, physical, and mental impact on them.

FAMILY SUPPORT 

For some of these senior citizens, including those who are mentally challenged, there is limited or no family support.

This is quite discouraging. When these residents pass away, family members and relatives then notify the department that they would like to bury their relative.

Family support is important to ensuring that our senior citizens are well cared for and given the treatment that they rightfully deserve.

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