The recent report on the often-neglectful treatment of frail, aged people in hospital comes as no surprise to many of us.

Who has not experienced seeing ill, aged relatives struggle to manage in acute-care hospital wards? For example, assistance with meals often just does not occur and so, in many instances, family members have to time their visits in order to ensure that their relative is adequately nourished...

The report also documents other issues – some relating to pressure sores, wound management, medication and inappropriate discharge>.

The simple fact is that acute-care hospitals are not equipped, or staffed, to provide the care that older people, who often have multiple and chronic conditions, require.

This report was commissioned by the Aged Care Association after widespread anecdotal evidence from nursing-home staff. But of course, solutions to the issue of providing quality health care to frail people do not just lie with hospitals.

For example, an aged aunt of mine who lived in residential care, was routinely carted off in an ambulance every time she sneezed. She had a lung condition, the place was staffed with carers rather than nurses and no-one was prepared to take responsibility for her health care. The experience of continually being bundled about from hostel to hospital, and back again, did great harm to both her physical and psychological well-being.

So part of the problem surely lies with the aged-care facilities themselves. If nursing homes and hostels continue to rely more and more on untrained staff, then frail people are far more likely to be sent off to hospital – often for minor problems. And if it remains difficult to obtain routine visits from general practitioners, then facilities will depend more and more on hospitals to provide necessary clinical care.

Health Minister, Tony Abbott, blames the states for the inadequate hospital care. But the blame game between the states and the commonwealth about aged care must surely stop. A joint, wholistic approach to the health and well-being of frail people is urgently needed.

By the way, did anyone see any comment from the Minister for Ageing on this important report? I didn't. I guess he is busy out there campaigning for his own survival.

Posted on  Thursday, 09 April 2009
by  guest

I began my career in 1994 , as an Enrolled Nurse (EN)working in Nursing homes. There were quite alot of us back then, we had no Personal Care Attendants(PCA) and I was one of 15 ENs over seen by 2 supervising Registered Nurses (RN). We heard of places that were utilising untrained staff, they were cheap and basically it gave the organization flexiability. The PCA had to do whatever role was required back then. Slowly the PCA role seeped into most areas of aged care but there was still a large Trained staff componant.But in time, and because PCAs were cheaper and more pliable, there was more and more of them. These people had no training and the training they had lacked the discipline and focus of Nursing. They basically took the Nurses out of Nursing homes and then people wondered why our elderly are not being " NURSED" properly anymore. Centrelink has a course not, to train people to be PCAs. Anyone can do it, these elderly wont complain and it keeps the unemployment numbers down.

I am now a RN in an Emergency Department and I see them arrive all the time. Elderly people who simply can not be medically managed because there is no nursing staff in their...nursing home.

Our system gets clogged up by ambulances arriving with patients from these places, dehydrated and unwell. An ED is not the right place for these people but what else do you do with them? there are no medically trained staff to deal with their unstable conditions in the home they came from.

Heres another example. Occasionally I would work agency and agreed to take a shift in a Care facility for Acquired Injury patients. There was myself, the only trained staff and four PCAs. The PCAs spoke little english and seemed more concerned about emptying bins so they could start their breaks without even once mentioning things like pressure area care or checking on your patient. When they spoke to the residents it was demeaning and with no respect whatsoever. Then at eleven o'clock at night , they all settled down in the front lounge and slept. And slept and slept. I waked them, they simply rolled over and went back to sleep.

There were 40 residents to care for !...all immobile, all incontinent. At five there was a rush, they grabbed a linen skip, flew into rooms, tore patients bed clothes off with no explanation to the patient , tore their pad off , smacked a dry on on without even washing them and, without so much as washing their hands,moved onto the next poor soul.

These patients were not even regarded in any way. They were slabs of meat to these People, that was all. It was, disgusting.

Nursing doesnt teach that, that is not the kind of behaviour Nursing tolerates. We were taught patient focus and discipline, respect and compassion.

What I have witnessed after the introduction of Untrained staff is a drop in standards and a problem that is being white washed by insitutions and governments. The sad thing is, its the resident in a care facility, totally powerless and voice less who suffers this outrage quietly and alone.

Sadly, I think its only going to get worse. But dont blame the Nursing profession for this, we told you this would happen the moment it started years ago.

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