Aged care providers have reported more than 112,000 incidents of substandard care, the royal commission has heard. Monday’s hearing in Sydney also heard of missing medication, a lack of translation services for overseas-born residents, and an elderly woman trying to change her own soiled continence aids.
Mr Gray QC, counsel assisting, said residential aged care providers have reported more than 112,000 incidents of substandard clinical care in response to the commission’s request for information.
Of those, nearly 68,000 incidents were related to inadequate medication management, more than 35,000 incidents were related to deficient personal care, and more than 12,000 cases related to inadequate nutrition.
Vital medication not given
Darryl Melchhart, 90, told the royal commission her crucial heart medication spray was taken from her, other residents were sometimes violent, and incontinence pads were rationed.
Mrs Melchhart said she needs Glyceryl Trinitrate spray to control her angina. Without the spray, she said, she “could have heart failure and die, or I could go to hospital”. She was instructed to carry the spray with her at all times to use if her angina flared up.
But Ms Melchhart said the spray was taken from her for “three or four” days.
“I should have that medicine in my hand so I can take it anytime… [but] they want to hang on to it, [they] say “I’ll give it to you when you need it”, but that’s no good because they could be way over there and I could be way over here,” she said.
Ms Melchhart said one woman forcibly took away her walker, and could become “vicious”.
Ms Melchhart said it could be “terribly difficult” to get additional continence pads, even if they were needed. She told a story of one of her friends.
“She saw I had some pads that I’d just been given in my little basket underneath my wheeler and she said, ‘I haven’t got any, and that’s why I didn’t come up to the happy hour the other day.’ I would have liked to have given her one but I thought no, you’ll have to fight for herself.”
“I find her hands covered in faeces”
Eresha Dilum Dassanayake said 87-year-old mother’s incontinence was poorly managed, and the first nursing home her mother lived in did not support her cultural differences.
Ms Dassanayake said she goes to feed her mother breakfast every day, and often “I find her hands covered in faeces,” she said.
Though Ms Dassanayake said she had brought the matter up with the nursing home staff “on many occasions”, even two days prior to the hearing it was still occurring.
“Once it is dried, it hurts her hands,” she said.
Ms Dassanayake said her mother, who has dementia, was left in a dirty nappy overnight and had tried to take off the nappy herself.
Ms Dassanayake also said the nursing home pressured her to convince her Sri Lankan-born mother not to wear her sari because it was a trip hazard.
“I forced that on her and I remember her crying and saying ‘why are you doing this to me’,” Ms Dassanayake said.
Ms Dassanayake eventually moved to a new nursing home which encouraged her to continue her cultural practices, including wearing her sari.
The deputy director at the nursing home, in fact, said to Ms Dassanayake, “Please bring saris in. Even if she doesn’t wear it, it’s good for her to practice putting it on.”
“This isn’t a proper life”
Merle Mitchell said she arranged external counselling for herself, at her own expense, to help her cope with the transition to living in a nursing home and she believes all aged care facilities should have counsellors available for residents and staff.
“There’s a shock when you move into aged care,” she said.
“There’s the feeling of suddenly I’m in an institution. I have to follow what the institution wants, the time to get up, the time to have meals and there’s no – there’s no choice. So you lose your choice totally when you come into aged care. And that’s one of the things that needs to change,” she said.
She said many residents lose their cognitive abilities when they move into residential aged care.
“Staff don’t have time to provide that sort of support for you. So people come in and they’re told this is your home now. Well, it’s not. It’s an institution, and it’s where you live. But it’s not a home.”
Ms Mitchell said not having her own things around her made her feel she isn’t living a “proper life”.
“I haven’t got my own things around me. I have got a lot of things around me, but I can no longer reach out and grab an atlas if I hear something on the news. I can no longer reach out and get my favourite book because there’s a limit in how much you can actually bring with you.
She said, “And there’s just that feeling that this isn’t a proper life, and so there is that feeling that the quicker it’s all over, the better it is for everybody.”
Broken English mistaken for dementia
George Akl told the royal commission his Egyptian-born father’s English language skills declined as he aged and became more unwell, and his broken English was mistaken as a symptom of dementia.
But when his father spoke Egyptian to a nurse on a short-term contract, he could speak perfectly.
“It was just like he was a different person in the two different languages,” Mr Akl said.
Akl said nursing homes lack translation services to help elderly migrants communicate.
“He didn’t lose consciousness of who he was or who I was or where he was or anything like that, maybe up until the next couple of weeks until he died. And that was really frustrating for him to have to be in a world where he couldn’t be himself, and he wasn’t ready to give that up.
“He still had the ability to communicate. There just wasn’t a space for him to communicate properly,” Mr Akl said.
Image: Merle Mitchell speaking at the royal commission.