Form Class Action CHSLD

1 If user resided in more than one care center, a separate form must be filled out for each center.
2 The class action covers individuals who are currently residing, or have in the past 3 years resided (as of July 2015), in a CHSLD (residential and long-term care center).




Annexe 1

Please check the box or boxes which best correspond to the deficiencies in the care and services that you have received :

Baths (inadequate, infrequent, etc.)I am incontinent but my diaper is not changed often enoughI am not incontinent but I am forced to relieve myself in a diaperThe abject odour of soiled diapers permeates my living area and makes the air unbreathableUnsatisfactory dental hygieneLack of treatment for dental cariesBedside care and basic hygiene provided incompetently or insufficientlyPayment of fees for services and goods which should be included in the contribution paid by residents (e.g. shampoo, soap, toothpaste, laundry, compression stockings, etc.)Inadequate medical follow-upMismanagement of medicationAbusive resort to antipsychoticsExcessive use of physical or chemical restraintsLack of physiotherapy or ergotherapy treatmentMeals and diet (inadequate, poor quality, etc.)Insufficient meal timePayment of staff under the tableDisregard for patient’s right to sleepWhen being woken and/or when being put to bed, either due to lack of know-how or lack of time, I am jostled, hurt, or hit as I am placed in or taken out of bed by the staffPatients with dementia or Alzheimer’s placed in isolation, or left errant in the hallsI am forced to pay in order to have air conditioning in my room for the summerDuring the last heat wave, I suffocated in my room because I did not have sufficient ventilation or air conditioningEven when I ring my bell, make requests, or make official complaints with regards to the issues I have with my care or services, no one listens to me or follows up on my complaintsI am afraid of making a complaint because I fear that the staff or administration will subject me to reprisalsMy room, my wheelchair and/or the sheets and bed covers on my bed are rarely washed or cleaned




* Required Field

If you have any documents or materials related to your allegations that you wish to send to us, please attach them to the email address below.

Email: chsld@larochelleavocats.com

Please note that all details shared with us in your form will remain strictly personal and confidential. We are well aware of the risk of reprisals faced by users who denounce the conditions in CHSLDs, and we remain committed to protecting all data shared with us by residents.