Residences with continuous assistance “on the edge of the abyss”

Quebec is facing a housing crisis for people living with an intellectual disability and/or an autism spectrum disorder (ID-ASD). The duty spoke with some 40 families, resource owners, health network employees and experts who are sounding the alarm.

Residences with continuous assistance (RAC) are considered « intensive care » for people with intellectual disabilities or autism spectrum disorder presenting with a serious behavioral disorder. Although these public resources operate 24 hours a day in the presence of specialized educators, they struggle to fulfill their primary mission: rehabilitation. This situation is denounced both by the parents of users and by the professionals of the establishments who confided in the To have to.

“The RACs are supposed to be a springboard to land in a living environment such as intermediate resources or family-type resources. Now, it’s not uncommon for us to see a user stay there long term when it’s supposed to be less than six months. These users need stability and the opposite is being offered to them at the moment, » explains Josée Fréchette, First Vice-President of the Alliance of Professional and Technical Personnel in Health and Social Services (APTS), pointing the finger at staff turnover, but above all at the lack of training of stakeholders in the RACs.

At the CIUSSS du Centre-Sud-de-l’Île-de-Montréal, the number of paid hours of independent labor has notably increased sixfold since 2018, and more than half of the worker positions are to be filled, according to the data sent by the APTS to the To have to.

This reality is also shared by the CISSS de la Montérégie-Ouest, where Annie Couture is assistant director of programs for intellectual disabilities, autism spectrum disorders and physical disabilities.

The latter must deal every day with the lack of personnel in its services, despite the incentive measures put in place to recruit new candidates from CEGEP.

“Finding an educator is very difficult; in open spaces day and night, even more so! We are in competition, for example, with schools, during the day, from Monday to Friday. We ask them to work nights, weekends! « says Sewing.

“We need at least a hundred educators right now. To be able to do the job at the height, without using an agency, my positions would have to be filled, and this is not the case. Currently, it is my managers who come to work shifts in the field every week,” she laments.

In a national survey it has just conducted among its members working in RAC and that The duty was able to consult, the APTS also revealed that nearly 40% of responders questioned had not received any training before arriving in RAC.

Worried special educators

The duty also spoke to six special educators who work or have worked in RAC. They all requested anonymity for fear of being reprimanded by the health establishment that employs them.

Marilyne* is a specialized educator who has been working in RAC for nearly ten years. She continues to cling to the small victories she manages to win with some of the users to continue her work despite the current conditions. “We give the minimum of what we can give to a human being. With our more or less trained staff, our staff turnover, we save the furniture, ”she says.

“This requires a certain expertise that we don’t see in special education: we don’t see serious behavioral problems, we are in the generality. I can work in a primary school as well as a day camp, but also in a RAC! It’s the same training,” adds Marilyne.

The specialized educator believes that staff turnover makes rehabilitation much longer. Her colleagues are also concerned about the increasing complexity of the cases they receive.

“This requires workers who have the necessary experience and training. It’s not possible to train them in the field, we don’t have the time. This translates into readings of situations that are not fair and leading to interventions that can contribute to the escalation of behaviors. All of this increases the risk for workers, but also for users,” explains Karine*.

Maria* believes that staff turnover directly affects the well-being of users.

“That’s why a lot of parents will complain. Patients with an intellectual disability or an autism spectrum disorder have certain characteristics that mean that when the clinical continuity of intervention is lost, the user will develop more behavioral problems, » she explains. .

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