As someone who works as a carer, I must have had better training than these shams. I would never dream of bullying a patient/service user/client (delete as appropriate). My training taught me to be alert for signs of abuse, and to never force a patient to do something they didn't want, even if it was in their best interests. I've seen it happen on wards though - I was told to be more forceful than I would like with a patient and a continence pad - but all I can do is be persuasive - dementia or not.