Mr. Kevin Rudd – Prime
Minister
Mr.Tony Abbott- Leader of the
Opposition
Dear Sirs,
What are you going to do
about it – appoint an Age-care Minister?
Looking forward to hearing
from you so that we can decide whom to vote.
Eddie Hwang
President
Unity Party WA
http://twitter.com/unitypartywa (published)
Phone/Fax: 61893681884
Environmental
friendly - save the trees - use email.
UPWA is
the only political party that calls a spade a spade.
More than 100 nursing homes around the country are providing inadequate basic, dignified care for residents.
Transcript
EMMA
ALBERICI, PRESENTER: And now to the national debate on aged care.
TONY ABBOTT, OPPOSITION LEADER: All of us absolutely accept and understand that we do need better aged care systems.
KEVIN RUDD, PRIME MINISTER: It is a growing challenge for the country as our population ages and any country worth its salt is seeking to deal with this in an effective way.
EMMA ALBERICI: That was Sunday night's leaders' debate. The vague responses from the Prime Minister and the Opposition Leader have reportedly surprised aged care industry leaders. But our audience has been much more focused. Our six investigations over the past 12 months have generated very specific claims of poor care, unnecessary pain and even death. We've had hundreds of emails, phone calls and social media contacts, and while good care is provided in many facilities, Lateline has been given shocking examples of inadequate basic dignified care in 100 nursing homes or more around the country. Tonight we're going inside the system to hear from the people on the front line of the aged care industry where one worker has told us he knows he's breaking the criminal code every night by locking dementia patients in their rooms. Margo O'Neill has our exclusive report.
MARGO O'NEIL, REPORTER: It's another busy night in a chronically understaffed nursing home. An elderly man buzzes for help to go to the toilet but he's left waiting for 30 minutes or more. A carer finally appears to tell him...
LYNETTE DICKENS, REGISTERED NURSE, SPECIALST PALLIATIVE CARE: According to him she said well you've just had a pee, you don't need to go again. And he said, "No, I do, I do." And she abused him and walked outside.
He kept ringing the buzzer, and then she returned about 30 minutes later and he said, "I'm going to wet myself. Please help me to stand up" because he needed assistance. And then she grabbed the buzzer and threw it down the end of the bed and said, "I've got better things to do." So we put in an incident report, nothing was done.
MARGO O'NEIL: Aged care workers from around Australia have told Lateline there's just not enough of them to ensure dignified and compassionate care for our most vulnerable elderly residents in many nursing homes. Staff often struggle to complete basic tasks like regular toilet ing.
LYNETTE DICKENS: They're very disillusioned, they're demoralised, they feel...they know that they want to do a good job, they want to do it but it's just not possible.
MARGO O'NEIL: With no mandatory minimum staff to patient ratio we've been told of shifts where there's one carer for twenty or thirty high care patients. It means residents can be left for hours in incontinence pads risking dangerous skin and urine tract infections. And in a sordid version of Oliver Twist, our elderly may even have to plead for more because pads are locked up.
LYNETTE DICKENS: In my experience incontinence pads are rationed. Residents are given generally three per day, two during the day and one overnight. They're stored, they're locked away in a cupboard and only one person is privileged enough to have the key. So anybody wanting extras has to come to the person with the key and get permission.
MARGO O'NEIL: Is three enough?
LYNETTE DICKENS: No, I don't believe so. Many would say that when it came to doing toileting and changing, that the person was saturated from, you know, ankle to head or in bed in the morning, they'd be absolutely drenched in stale, brown urine.
MARGO O'NEIL: Not surprisingly some staff end up cutting corners.
SOPHIE CUTRISS, REGISTERED NURSE, AGED CARE TEACHER: It's easy to pull someone out of bed with their nightie off, shove them on a toilet chair and take them straight down to the bathroom where often privacy's not particularly respected and it's quicker to let them defecate or urinate in the shower recess rather than take them to the toilet and leave them there for 10 minutes to use the toilet facility.
There are elderly people who are being dragged out of bed early in the morning because the staff feel that they won't have time later in the day to give them a shower. This is quite common, that in order to get through those tasks quickly with limited staff, and I must, I must remind you that the staff are mostly caring, compassionate, empathetic, trying to do the best, trying to make a difference.
MARGO O'NEIL: This photo was taken last week after staff incorrectly left pressure stockings on overnight which can cause serious circulation and skin problems.
Some staff crack under the pressure, or they're the wrong kind of person to be working with the frail elderly.
LYNETTE DICKENS: Abusive, yes, yes, rough, rough, verbally abusive, generally short tempered and unkind. I saw one elderly lady who was sitting at a table, went to get up and she was smacked and pushed back into the chair.
MARGO O'NEIL: Smacked where?
Across her face?
LYNETTE DICKENS: Yeah.
SOPHIE CUTRISS: They get told "You smell like you've got a dead rat up your arse". That's a really good one. Being yelled at, being told "Stop doing that." "Get out of there. ""You silly old man." "You dirty old man" words like that.
MARGO O'NEIL: There are more ill, dependent elderly needing more complex medical care in nursing homes than ever before. At the same time there's less medically qualified staff than ever before. 70 per cent are now low paid, low skilled carers. Many complete thorough training courses but others do quick online courses and some have a poor grasp of English. And once they're on the job they can be pressured to perform tasks beyond their limited training.
SOPHIE CUTRISS: Carers are attending complex wound care without adequate training that they're attending catheter care, again, which is not supposed to be within their scope. That they're giving medication that's completely outside their scope.
MARGO O'NEIL: So you would hear about instances of where carers are pushed way beyond the limits of their medical training to do potentially quite consequential medical care once a month, once a week?
SOPHIE CUTRISS: I would say once a day.
MARGO O'NEIL: Carers are supervised by a dwindling number of registers nurses who can be responsible for more than 100 patients and almost impossible job. But made doubly so by the mountainous paperwork they're required to fill out each shift so management can access government subsidies.
JOACHIM STERMBURG, GP HEALTH CARE ACADEMIC: The way the system works is that ticking boxes on paper is more important than actually looking after people.
Frailty is a concept that is not well understood. Frailty means that your physiological capacity to respond to changes in your system are very limited. Frailty is essentially the stage before you pass on.
MARGO O'NEIL: Good medical care for the frail elderly requires vigilance.
JOACHIM STERMBURG: If something small happens to you like you get a urine infection that develops into delirium if you get met Pollock changes your liver function or renal function alters. They're very simple things to tip you over to demise and ultimate death. That's why it's so important that we have staff that is able to pick subtle changes in the patient.
MARGO O'NEIL: Many facilities still provide good care because of dedicated staff. But even the industry acknowledges it's a stressed system and families are and now staff say it means patients often needlessly suffer pain and indignity and sometimes die because of substandard clinical care.
JOHN WALKER, AGED CARE NURSE: If the nursing staff had responded to my initial concerns and had they done assessments then, as I had requested, the numbers would have been telling them something was wrong.
And they needed to intervene.
MARGO O'NEIL: And she might still be alive?
JOHN WALKER: And could still be alive.
MARGO O'NEIL: John Walker works as an aged care nurse outside NSW. He thought he could trust the staff looking after his mother in a NSW nursing home that was fully accredited.
But as her health dangerously declined, no one even checked her temperature.
JOHN WALKER: And she asked my sister, was she going to die?
MARGO O'NEIL: By the time John Walker demanded an ambulance his mother's blood pressure was 63/0 and her lower body had turned purple.
JOHN WALKER: Her body was shutting down. Looking at her lower limbs they were purple as well and very cold so there's peripheral shutdown happening.
MARGO O'NEIL: Just that morning staff showered and dressed Thelma Walker. No one reported the purpling of her lower body. Astonishingly they also failed to report that a piece of surgical mesh from a prior operation was protruding through her stomach.
JOHN WALKER: And nobody had said or done anything about this.
And I knew...well I really knew what was happening.
MARGO O'NEIL: Thelma Walker died that night.
The nursing home sent John Walker a letter expressing sincere apologies for any upset and anxiety that may have been caused.
It thanks him for his feedback, saying it helped the nursing home to continuously improve our performance.
JOHN WALKER: I found this letter insulting and patronising.
MARGO O'NEIL: He wanted management to be held accountable but the federal complaints scheme said its job was done once the nursing home promised more training.
Many staff also complained that doctors can be hard to find. Lynette Dickens remembers how one woman was left to die convulsing and affixating on her own vomit for hours.
LYNETTE DICKENS: Grimacing and thrashing around and it was quite traumatic. You know, somebody choken on their own vomit.
MARGO O'NEIL: After intervening best she could, Lynette Dickens first tried the woman's doctor - who didn't respond, then the locum - who refused to come, then the hospital - which refused admittance and finally an ambulance which at least meant the dying woman received some oxygen as the nursing home supply had run out.
Lateline no doubt has become a magnet for those with complaints about aged care. But in phone calls and emails with scores of families, carers, nurses, facility managers and even former federal health bureaucrats, a pattern of failure emerges in many facilities because of an inadequate staff and training.
VICTORIAN CARER (MALE VOICE OVER): Two of us look after nearly 40 high care dementia patients over night, but because of the sheer volume of the duties, I have to lock patients in their rooms to ensure their safety, even though I know this breaches the criminal code - I do it every night because managment ignored my request for more staff.
MARGO O'NEIL: Staff tell us they often don't get time to properly feed, hydrate or toilet residents, that broken bones and infections can go undiagnosed, that there are frequent medication mistakes, at least 10 a month. Most are afraid of losing their jobs if they speak up publicly. But all believe too many elderly are suffering.
SOPHIE CUTRISS: Their deaths are hastened and they're much more unpleasant than what we would wish for people that we care for. Do we want that for ourselves? Do we want that for the people that we love? Our parents? Our grandparents? Of course we don't.
TONY ABBOTT, OPPOSITION LEADER: All of us absolutely accept and understand that we do need better aged care systems.
KEVIN RUDD, PRIME MINISTER: It is a growing challenge for the country as our population ages and any country worth its salt is seeking to deal with this in an effective way.
EMMA ALBERICI: That was Sunday night's leaders' debate. The vague responses from the Prime Minister and the Opposition Leader have reportedly surprised aged care industry leaders. But our audience has been much more focused. Our six investigations over the past 12 months have generated very specific claims of poor care, unnecessary pain and even death. We've had hundreds of emails, phone calls and social media contacts, and while good care is provided in many facilities, Lateline has been given shocking examples of inadequate basic dignified care in 100 nursing homes or more around the country. Tonight we're going inside the system to hear from the people on the front line of the aged care industry where one worker has told us he knows he's breaking the criminal code every night by locking dementia patients in their rooms. Margo O'Neill has our exclusive report.
MARGO O'NEIL, REPORTER: It's another busy night in a chronically understaffed nursing home. An elderly man buzzes for help to go to the toilet but he's left waiting for 30 minutes or more. A carer finally appears to tell him...
LYNETTE DICKENS, REGISTERED NURSE, SPECIALST PALLIATIVE CARE: According to him she said well you've just had a pee, you don't need to go again. And he said, "No, I do, I do." And she abused him and walked outside.
He kept ringing the buzzer, and then she returned about 30 minutes later and he said, "I'm going to wet myself. Please help me to stand up" because he needed assistance. And then she grabbed the buzzer and threw it down the end of the bed and said, "I've got better things to do." So we put in an incident report, nothing was done.
MARGO O'NEIL: Aged care workers from around Australia have told Lateline there's just not enough of them to ensure dignified and compassionate care for our most vulnerable elderly residents in many nursing homes. Staff often struggle to complete basic tasks like regular toilet ing.
LYNETTE DICKENS: They're very disillusioned, they're demoralised, they feel...they know that they want to do a good job, they want to do it but it's just not possible.
MARGO O'NEIL: With no mandatory minimum staff to patient ratio we've been told of shifts where there's one carer for twenty or thirty high care patients. It means residents can be left for hours in incontinence pads risking dangerous skin and urine tract infections. And in a sordid version of Oliver Twist, our elderly may even have to plead for more because pads are locked up.
LYNETTE DICKENS: In my experience incontinence pads are rationed. Residents are given generally three per day, two during the day and one overnight. They're stored, they're locked away in a cupboard and only one person is privileged enough to have the key. So anybody wanting extras has to come to the person with the key and get permission.
MARGO O'NEIL: Is three enough?
LYNETTE DICKENS: No, I don't believe so. Many would say that when it came to doing toileting and changing, that the person was saturated from, you know, ankle to head or in bed in the morning, they'd be absolutely drenched in stale, brown urine.
MARGO O'NEIL: Not surprisingly some staff end up cutting corners.
SOPHIE CUTRISS, REGISTERED NURSE, AGED CARE TEACHER: It's easy to pull someone out of bed with their nightie off, shove them on a toilet chair and take them straight down to the bathroom where often privacy's not particularly respected and it's quicker to let them defecate or urinate in the shower recess rather than take them to the toilet and leave them there for 10 minutes to use the toilet facility.
There are elderly people who are being dragged out of bed early in the morning because the staff feel that they won't have time later in the day to give them a shower. This is quite common, that in order to get through those tasks quickly with limited staff, and I must, I must remind you that the staff are mostly caring, compassionate, empathetic, trying to do the best, trying to make a difference.
MARGO O'NEIL: This photo was taken last week after staff incorrectly left pressure stockings on overnight which can cause serious circulation and skin problems.
Some staff crack under the pressure, or they're the wrong kind of person to be working with the frail elderly.
LYNETTE DICKENS: Abusive, yes, yes, rough, rough, verbally abusive, generally short tempered and unkind. I saw one elderly lady who was sitting at a table, went to get up and she was smacked and pushed back into the chair.
MARGO O'NEIL: Smacked where?
Across her face?
LYNETTE DICKENS: Yeah.
SOPHIE CUTRISS: They get told "You smell like you've got a dead rat up your arse". That's a really good one. Being yelled at, being told "Stop doing that." "Get out of there. ""You silly old man." "You dirty old man" words like that.
MARGO O'NEIL: There are more ill, dependent elderly needing more complex medical care in nursing homes than ever before. At the same time there's less medically qualified staff than ever before. 70 per cent are now low paid, low skilled carers. Many complete thorough training courses but others do quick online courses and some have a poor grasp of English. And once they're on the job they can be pressured to perform tasks beyond their limited training.
SOPHIE CUTRISS: Carers are attending complex wound care without adequate training that they're attending catheter care, again, which is not supposed to be within their scope. That they're giving medication that's completely outside their scope.
MARGO O'NEIL: So you would hear about instances of where carers are pushed way beyond the limits of their medical training to do potentially quite consequential medical care once a month, once a week?
SOPHIE CUTRISS: I would say once a day.
MARGO O'NEIL: Carers are supervised by a dwindling number of registers nurses who can be responsible for more than 100 patients and almost impossible job. But made doubly so by the mountainous paperwork they're required to fill out each shift so management can access government subsidies.
JOACHIM STERMBURG, GP HEALTH CARE ACADEMIC: The way the system works is that ticking boxes on paper is more important than actually looking after people.
Frailty is a concept that is not well understood. Frailty means that your physiological capacity to respond to changes in your system are very limited. Frailty is essentially the stage before you pass on.
MARGO O'NEIL: Good medical care for the frail elderly requires vigilance.
JOACHIM STERMBURG: If something small happens to you like you get a urine infection that develops into delirium if you get met Pollock changes your liver function or renal function alters. They're very simple things to tip you over to demise and ultimate death. That's why it's so important that we have staff that is able to pick subtle changes in the patient.
MARGO O'NEIL: Many facilities still provide good care because of dedicated staff. But even the industry acknowledges it's a stressed system and families are and now staff say it means patients often needlessly suffer pain and indignity and sometimes die because of substandard clinical care.
JOHN WALKER, AGED CARE NURSE: If the nursing staff had responded to my initial concerns and had they done assessments then, as I had requested, the numbers would have been telling them something was wrong.
And they needed to intervene.
MARGO O'NEIL: And she might still be alive?
JOHN WALKER: And could still be alive.
MARGO O'NEIL: John Walker works as an aged care nurse outside NSW. He thought he could trust the staff looking after his mother in a NSW nursing home that was fully accredited.
But as her health dangerously declined, no one even checked her temperature.
JOHN WALKER: And she asked my sister, was she going to die?
MARGO O'NEIL: By the time John Walker demanded an ambulance his mother's blood pressure was 63/0 and her lower body had turned purple.
JOHN WALKER: Her body was shutting down. Looking at her lower limbs they were purple as well and very cold so there's peripheral shutdown happening.
MARGO O'NEIL: Just that morning staff showered and dressed Thelma Walker. No one reported the purpling of her lower body. Astonishingly they also failed to report that a piece of surgical mesh from a prior operation was protruding through her stomach.
JOHN WALKER: And nobody had said or done anything about this.
And I knew...well I really knew what was happening.
MARGO O'NEIL: Thelma Walker died that night.
The nursing home sent John Walker a letter expressing sincere apologies for any upset and anxiety that may have been caused.
It thanks him for his feedback, saying it helped the nursing home to continuously improve our performance.
JOHN WALKER: I found this letter insulting and patronising.
MARGO O'NEIL: He wanted management to be held accountable but the federal complaints scheme said its job was done once the nursing home promised more training.
Many staff also complained that doctors can be hard to find. Lynette Dickens remembers how one woman was left to die convulsing and affixating on her own vomit for hours.
LYNETTE DICKENS: Grimacing and thrashing around and it was quite traumatic. You know, somebody choken on their own vomit.
MARGO O'NEIL: After intervening best she could, Lynette Dickens first tried the woman's doctor - who didn't respond, then the locum - who refused to come, then the hospital - which refused admittance and finally an ambulance which at least meant the dying woman received some oxygen as the nursing home supply had run out.
Lateline no doubt has become a magnet for those with complaints about aged care. But in phone calls and emails with scores of families, carers, nurses, facility managers and even former federal health bureaucrats, a pattern of failure emerges in many facilities because of an inadequate staff and training.
VICTORIAN CARER (MALE VOICE OVER): Two of us look after nearly 40 high care dementia patients over night, but because of the sheer volume of the duties, I have to lock patients in their rooms to ensure their safety, even though I know this breaches the criminal code - I do it every night because managment ignored my request for more staff.
MARGO O'NEIL: Staff tell us they often don't get time to properly feed, hydrate or toilet residents, that broken bones and infections can go undiagnosed, that there are frequent medication mistakes, at least 10 a month. Most are afraid of losing their jobs if they speak up publicly. But all believe too many elderly are suffering.
SOPHIE CUTRISS: Their deaths are hastened and they're much more unpleasant than what we would wish for people that we care for. Do we want that for ourselves? Do we want that for the people that we love? Our parents? Our grandparents? Of course we don't.
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