[Reproduced with kind permission from a speech given at our Adelaide rally on March 17th 2018]
Image: The NursePath Blog.
My name is Margaret and I would like to tell you some of the experiences I have had in the Broken Aged Care System.
My husband suffered from Parkinson’s disease and Lewy Body Dementia.
After 13 years of home care I had to have him admitted to a residential facility at age 70.
The first stumbling block was getting the staff to ensure that he had his Parkinson’s medication at regular intervals. It took at least a year to get this happening, and during this time my daughter phoned the home every morning to check he had his morning medication and I visited either in the afternoon or evening to check that he was being given those doses at the right time. Often it was up to 45 minutes late or early which is not acceptable for that type of medication.
As recently as 20 days before he passed away last October, his medication was given by a carer – NOT A NURSE – two hours before it was due, and this was not discovered until the next dose was due.
I BELIEVE MEDICATION SHOULD ONLY BE GIVEN BY A REGISTERED NURSE WHO HAS BEEN TRAINED TO OBSERVE AND GIVE MEDICATION CORRECTLY.
Not enough staff are employed to give adequate personal care.
My husband, who had always dressed neatly and taken pride in his appearance was often dressed inappropriately for the weather, with thick clothing in the summer months and thin short sleeve shirts in winter.
Oral hygiene was poor. Two people’s toothbrushes kept in the same cup at the sink. Toothpaste too hard to get out of the tube. Filthy teeth and a broken tooth not noticed by careworkers. Difficulty in getting the visiting dentist to visit and keep appointments.
Eye care suffered too. Often he was not wearing his spectacles. Sometimes he was wearing someone else’s spectacles. Often his spectacles were covered in food.
Sometimes he would be sitting in wet clothing and no staff member had noticed the smell.
LACK OF SUPERVISION
Particularly in the evening when family members tend not to be around and staff numbers are short, lack of supervision of residents leads to falls and injuries. In the first six months of his residence my husband had many falls, sometimes because he was getting up quickly out of his chair to prevent someone else having an accident or to prevent a resident attacking somebody else. He had two cracked vertebrae, and a broken hip in his first year, and later on a head injury requiring 5 staples.
In the evening when staff are putting people to bed from as early as 6 pm, other residents are seated in front of a television with no supervision and nothing to do. People with dementia wander around aimlessly and get on others’ nerves, creating tension and more confusion. I have seen one resident roughly push another aside in her wheelchair and bully her, slapping her arm.
LACK OF EQUIPMENT AND SERVICES
I had to lobby at a public meeting for a suitable wheelchair for my husband as most of those at the home had bits missing or were too small for him. Until I tackled the issue publicly with the organisation’s CEO I was fobbed off.
Physiotherapy services were limited to basic massage for people in chairs. After hip surgery it was easier for the home to put my husband in a large princess chair than to get him walking again. I employed a private neuro-physiotherapist to visit him weekly and went daily myself to give him exercises to enable him to sit and stand and walk again.
But residential facilities aren’t the only problem.
UNFORTUNATELY OUR HOSPITALS ARE ALSO AT FAULT.
When my husband fell and broke his hip he was shunted between three hospitals, on and off trollies, in and out of x-ray departments and ambulances before finally being admitted in a private hospital where he could be operated on in a reasonable timeframe. Because he had dementia and was unable to respond to direction he was not medicated on time – his medication was missed completely on two consecutive occasions – he was not fed – his meal was left in front of him and he did not have the capacity to feed himself. He became dehydrated as he was unable to drink by himself. He was left in a wet bed. He was not given physiotherapy and was told he would probably not be able to walk again. I had to spend almost all day every day with him to ensure that he got some food and liquid and to chase up the staff to ensure that he got his medication.
WHAT I HAVE TOLD YOU TODAY IS ONLY THE STORY OF ONE PERSON IN THE AGED CARE SYSTEM. IT SHOWS YOU THAT THE SYSTEM IS BROKEN.
WHAT I SEE AS THE NEEDS ARE:
GOOD STAFF RATIOS IN RESIDENTIAL FACILITIES.
REGISTERED NURSES ON DUTY AND RN’S OR TRAINED EN’S GIVING MEDICATION AT ALL TIMES.
BETTER TRAINING FOR CARERS AND FOR AGED CARE NURSES ESPECIALLY IN DEMENTIA CARE.
UNANNOUNCED VISITS FROM THE ACCREDITATION AUTHORITY AND MORE DEMONSTRATION OF CARE RATHER THAN SIMPLE TICK THE BOX ON POLICY STATEMENTS FOR ACCREDITATION.