Experts say the reports provided by Ontario and Alberta to The Canadian Press under access to information laws suggest standards of care have fallen short for some of Canada's most vulnerable people, despite government regulations.
Reports on alleged abuse were released by the two provinces on cases that date back to 2010.
The records are the latest that have been obtained by The Canadian Press using freedom of information laws from provinces that require the reporting of incidents involving people in care.
The reports done on those incidents by government investigators reveal the level and types of abuse people with developmental disabilities face in the institutions where they live.
Nova Scotia is among those provinces that adopted legislation to protect people in care. Similar government records released in 2009 by Nova Scotia describe the mistreatment of people with developmental disabilities, which led the province to take greater control over the boards of directors at facilities for people with intellectual disabilities.
The provincial governments in Ontario and Alberta say the reports and investigations of abuse are a step forward, and that the vast majority of people with disabilities are living in safe conditions.
But David White, 58, who has an intellectual disability and advocates for the rights of fellow residents at Vita Community Living in Toronto, says the accounts are a disturbing sign that more work remains to be done.
"Some caregivers have to grow up," he said in a telephone interview from Toronto.
"We can do a lot more to show people what is the cause of abuse, and we have to train the caregivers to understand the problem first. ... Some don't understand the problem. Some of them don't and some do."
The nature of the reported abuse is wide ranging. It includes yelling that frightened residents, neglect that left people lying in their own excrement and unwanted sexual advances.
In Ontario, serious incident occurrence reports for a one year-period from Oct. 1, 2010, until Sept. 30, 2011, say 36 staff were fired following alleged abuse or mistreatment and six staff were charged with criminal offences. Four employees also resigned during the period covered by the reports, while 36 people were disciplined, with punishment ranging from suspensions to letters on their personnel files.
There were also 14 reports describing residents mistreating other residents — ranging from unwanted sexual advances to biting — resulting in residents being moved or policies being changed to protect them.
The province says in a letter that the vast majority of the 60,000 people it cares for are healthy and thriving. It says it brought in tighter regulations last year to ensure training on reporting and preventing abuse.
In Alberta, investigators found there were 39 incidents of abuse for the period between July 1, 2010, and May 1, 2012, according to decision reports. There were 21 cases of staff mistreating people in their care, the reports say.
Frank Oberle, Alberta's associate minister responsible for persons with disabilities, says care homes in the province are safe and the number of abuse cases is small.
"My feeling is that it's not widespread," he said. "We have excellent staff out there and excellent caregivers and, where there are abuses, we've put mechanisms to catch them."
Dick Sobsey, who teaches educational psychology at the University of Alberta in Edmonton, says the decades-long shift of people away from institutions into community settings is a positive trend that promotes dignity and independence.
But he said there must be careful placements, good supervision and careful oversight in all cases.
Too often, he said, social workers are occupied with clerical work, rather than spending time visiting homes and observing living conditions.
"It's more of a challenge when you have a lot of group homes to properly supervise them, and I don't think we've given enough attention to actual supervision," said Sobsey, who has worked with people with disabilities for 40 years.
"With community-based settings you have some things that are wonderful but because you don't have things to unify the quality, you can have things that are terrible at the same time."
David Hingsburger, a consultant and the director of clinical services at Vita Community Living Services in Toronto, says a key to reducing abuse is the self-advocacy movement among people with intellectual disabilities.
That means training people with intellectual disabilities to recognize when abuse happens, he said.
"Anything we do for people with disabilities to increase their skills, their voice and their options, it makes them much more difficult to offend against," said Hingsburger, adding that new regulations in Ontario require facilities to provide such training to residents.
The courses range from teaching people with disabilities the names of their body parts to role playing that helps them identify inappropriate behaviour by staff or fellow residents.
However, Starr Olsen, the executive director of Community Living Thunder Bay, says she is concerned about the ability of agencies to make progress during a time of funding restraint in Ontario.
"How do we get our residents to good conferences where they can learn about what their rights are if I haven't got the money?" she asks. "What else do I cut in this agency so I can do that? It becomes bizarre."
Sarah Declerck of the Canadian Union of Public Employees, which represents about 8,000 care workers in Ontario, says abuse can't be seen in isolation from the issue of tightening funds and housing shortages.
"No new funding inevitably means there have been ... cuts to staff," she said. "It's not a good thing for safety for staffing to be insufficient."
For White, the records in the two provinces are a reminder of the importance of continued vigilance, discussion and training.
"We have to teach people how to respect our bodies," he said.
"I wish it didn't happen ever in this world, ever."
— With files from Maria Babbage in Toronto.
Note to readers: With Care-Home-Alberta moved Prairies/BC and Care-Home-Ontario moved Central.Suggest a correction