Residents and family members say they are afraid of the possible consequences of voicing their concerns about treatment in long-term care homes.
A recent investigation by Ontario Ombudsman Andre Marin revealed hundreds of complaints have been filed in the past two and a half years.
It also found that people who spoke up about their concerns were often threatened with being banned from the facility.
At a press conference in July 2008, Marin said "They don't have the health to express themselves, they don't have the voice to express themselves and I'm thinking that we've only touched the tip of the iceberg."
Diana Vidal is a long-term care personal support worker who most recently worked in Kitchener. She says she's seen physical abuse, "I consider grabbing people by the arms and pulling them abuse."
Carol Buschert and Janet Brumell each began to have concerns about their respective mothers, who were in long-term care, when they found bruises.
Brumell says "Because these are old people nobody seems to care. If these were your children being treated like this, everybody would be up in arms."
They are among the 450 people who filed complaints after Marin's findings were released.
Buschert, who is also a personal support worker who works in home care, says she found her mother's bedding wet a total of ten times, which Marin has found to be a common complaint.
She adds "Many times I went in at three in the afternoon and my mother was in the same diaper she was in the day before…because it had to be 80 per cent wet before they'd change it...then they're prone to bed sores and all kinds of things."
Betty Miller is with Senior Guardian Angels, and she says residents and family appear to be afraid to complain mainly because of possible retribution from the staff.
But those who run the facilities say there's often more to the situation than is immediately apparent.
Nancy Kauffman-Lambert is the administrator of the Golden Years Nursing Home in Cambridge.
She says "There are challenges, it's a difficult job. The residents have dementia, they don't know what they're doing. Many of the residents may be aggressive and so there are those ways, techniques that need to be used to work with responsive behaviours."
The Ministry of Health and Long Term Care is making changes to how care is provided and recorded.
The Long-Term Care Homes Act came into effect in July 2010, which includes a zero tolerance policy when it comes to abuse and neglect. It also outlines a more enforceable bill of rights for residents.
But until she sees some real change Buschert has brought her mother home to live with her, an option that's unfortunately not available to everyone.
Coming up in part two: What needs to change and privacy concerns about cameras in long-term care homes.