When Jane Seaholme's mother Phyllis moved into a nursing home, it was at her mum's insistence.  Ms Seaholme's mother soon realised that she couldn't stomach the food.   After Jane went public to media about her mum's experience in two nursing homes, she setup a petition to mandate staffing levels and skills. 

This is the speech that Jane presented to the Royal Commission's Community Forum in Maidstone, Victoria, on Friday the 3rd of May.  Jane has also made a detailed submission to the Royal Commission into Aged Care Quality and Safety.


My dear mother Phyllis was in two nursing homes and neither was satisfactory.

The first home was community run and served inedible food as well as having other problems. If I hadn't taken mum food she would have starved.

When I took her concerns about the food to management they were defensive and said things like "you are the first person in forty years to complain about the food" and "don't you eat hot dogs at home?".

The committee chairman said "residents should be grateful they have somewhere nice to live".

The Government complaints department just took the word of the facility as fact and were unhelpful, and Advocacy group Elder Rights Victoria were very supportive, but had no power to make changes and commented:

... it's not in the interest of the government to find things wrong with aged care ...

After several complaints, the facility sent me a solicitor's letter threatening me with an intervention order and ten years jail. They were complete bullies. So after trying every avenue for complaints with no success, I went to the media.

Unbeknownst to me, the second home had a wandering male resident who entered my mother's room on several occasions at night. Two days before she died she wrote an official complaint about this man entering her room at 10.30pm.

I was to find a photocopy of the written complaint eight months after she died.  My mother was in an unsafe environment and although the facility knew this, they did nothing to protect her. She died suddenly and I have been left with the feeling that something untoward happened, I have many unanswered question.

The night she died, mum wrote in her diary "tea time meal disgusting, I'm getting quite disappointed".

After going to the media about our experiences at the first home, many people reached out with horrendous stories of aged care and still do.

The common theme is neglect due to lack of staff and also how ineffectual the Government's Complaints, Accreditation and Advocacy systems are.

In 2012, I started a petition to mandate skilled staff to resident ratios - - - that petition is now up to 312,000 signatures - - - this is more people than there is in aged care.

Doctors, Nurses, Gerontologists, aged care workers, loved ones of people in care, people who received terrible care and concerned citizens have signed the petition.  There are over 20,000 comments and it's one of the largest petitions for an Australian issue ever.

For those who want to see, there is plenty of research to say that staff ratios have a direct bearing on the quality of care.  Like any service industry, if you have unskilled workers and not enough staff, you will provide poor care. 

Because aged care is now a business, the main concern for many aged care providers is profit and with no staff ratios mandated it's easy for unscrupulous providers to employ less staff and serve junk food to save money.

The government need to stop giving aged care licences to unsuitable people who lack the empathy, compassion, experience and values needed to be entrusted with the care of our elderly.

Aged care is a service; it should not be a business making enormous profits at the expense of care and should be in the hands of people with service and care experience. 

We need the owners of aged care to love people, respect people and want the very best for their customers.

In summary, my suggestion are:

1. Staff/resident ratios

One of the most significant factors in providing quality residential aged care is to ensure that there is sufficient skilled staff on hand to provide that care.

Staffing skills and levels have declined significantly over the years and there are currently no minimum requirements for nurse training or time available per resident per day.

2. Suitability of staff

Not everyone is suited to working with the vulnerable. We need pre-employment checks to ensure staff have the right traits or characteristics. This is essential to weed out the cruel and unkind. 

3. Suitability of approved providers

The fitness of aged care providers should be thoroughly evaluated for values that are in line with a caring profession and every board should have members that meet a criteria set by the government ideally these could include a gerontologist a doctor, a nurse, aged care workers and social workers. 

The assessment of approved provider's suitability was abolished in 1997. It should be brought back.

4. Need for local and empowered supports

The supports already in place failed my mother and many others miserably. 

There is an urgent need for an ongoing and empowered local presence to advocate on behalf of vulnerable residents, family members and staff.

5. Room for co-operative models

I have been involved with two parent-run co-operative schools in Victoria which were successfully run. They were independent schools that received government funding, employed fully trained teachers, and were run by the parents.

Attracting approved providers with a co-operative model would be desirable and may even address workforce issues such as attracting and keeping staff.


I'd like everyone to spare a thought for the hundreds, if not thousands of residents in aged care who will be neglected today because of Australia's appalling staffing levels.

We will only find out which homes this is happening in when disgruntled people after exhausting every avenue will go to the media through desperation.

Comments  

#12 Kath Donohue 2019-09-18 18:10
The facilities should be providing contracts that outline the standard of care that potential residents will get. For instance EVERY resident should have their teeth seen too at least twice a year and their eyes checked maybe every year.

Audits should also be done of these companies to see where all the money is going to - what perks management is getting for instance. Underpaying of foreign staff is common place, that is why they don't like to hire Australians because they want to get away with underpaying. The thing is though it could end up biting the employers in the backside when the overseas nurses find out that they can get their back pay.

The govt too lets these employers sponsor foreign labour rather than employing Australians and the Australians are losing their skills. Maybe the politicians need to have their bank accounts audited too, just incase they are getting kickbacks.
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#11 Bridgette Pace 2019-05-27 19:44
It makes me both sad and angry that people in nursing institutions would want to take the option to end their lives because of such appalling conditions, which I am fully aware of and have experienced first hand. The twilight years are ones which should indulge and treat with kindness the elders and disabled in this country. Age should never be an excuse to mistreat, disrespect and devalue these people - we all all human beings irrespective of circumstances. I believe the government provides a great deal of funding which would allow aged care institutions to operate a decent nursing home (currently they are only institutions) but the greed, and lack of accountability, allows those despicable service providers to abrogate their responsibilities and take the financial booty for themselves. True nursing homes should first and foremost be established for the wellbeing of the residents - after all, they pay for it. It is the fat pay packets of the owners and shareholders that leave very little to provide optimum care. The whole industry needs a shake up and clean out but governments prefer to pay out the funding with no due care, diligence or accountability. Thus, they simply become warehouses and the govt. justifies its wilful blindness by spouting forth how much they provide for aged care services. That is not good enough, never has been and never will be. Govt. have poor records for managing projects. If service providers were granted licences after having complied with a strict set of criteria (a conscience and a good sense of humanity would be a start) then we may have a chance of addressing the shame this country is guilty of in the callous disregard for the wellbeing of its most vulnerable citizens.
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#10 Margaret 2019-05-25 11:22
Quoting Rosemary Jacob:
At 83 I am still mobile and independent but well aware that my body is ageing. I dread the thought of no longing having freewill over my life yet would not want to be dependent on any of my children. I am a strong supporter of assisted dying and think it should be available, irrespective of terminal disease, pain levels etc.



Rosemary I agree. So many of the elderly in nursing homes I believe would have rather passed onto the other side. So the question has to be why are we warehousing them? That is what we are doing, isn't it? Forcing them to live in horrible conditions, not allowing them the outlet of dying if they wish to. Who does it help? The client; don't think so? The family: what to watch a loved one go through that? The government overall; putting much needed money towards a person so they can live a horrible life? The private business owner who gets a profit from them? I think I may have found it. All these old people passed life merely existing in a nightmare so a few can make a profit off the backs of them.

No all aged care should be not for profit and run by the state.
All people should have an option to sign a form for euthanasia if they become invalid and whereby it is obvious that will be for the rest of their lives.

Oh and Mary sign up at http://www.dignitas.ch/?lang=en
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#9 Fran MANDERGEDDES 2019-05-08 12:43
Having had my darling mum in a care facility where the residents were not separated in spite of dementia or aggression in some, the comments of others made me cry.
The elderly have worked hard, raised families with little help and contributed to our lives in so many ways- yet are too often not only neglected but abused and despised because of their age and treated with contempt.
I am so angry and upset by the things i see and have heard. These “facilities “ must be held accountable without any delay or procrastination on the part of providers and/or governments and political parties. They make me sick!
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#8 Rosemary Jacob 2019-05-07 16:10
At 83 I am still mobile and independent but well aware that my body is ageing. I dread the thought of no longing having freewill over my life yet would not want to be dependent on any of my children. I am a strong supporter of assisted dying and think it should be available, irrespective of terminal disease, pain levels etc.
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#7 Anne Mills 2019-05-07 16:08
Both my parents were adamant they didn't want to be a burden to their children, so they both went into to an Aged Care facility 9 months apart. Mum had alzheimer's and was the first to be placed. She hated where she was immediately, so after much convincing the nursing home took her out of the secured area into a room with more freedom. Thankfully she behaved herself and didn't try to escape. Dad then entered the nursing home and they were in rooms side by side which gave them both a secure feeling now together. The home was wonderful until there was a change of hands, then came the unforgetable differences in clean ammenities, and the quality of food. As there was a coffee shop on the premises, every time I visited they would have a snack and a cappuccino, and I would join them. They would look forward to this treat when my brothers and I would visit and we tried to make sure that someone was visiting almost every day of the week. The laundering of their cloths was so bad. Many items would go missing constantly and Dad's black trousers were ruined by the laundry using bleach. The most concerning thing was that when my parents would want to go to the toilet they would have to wait a very lengthy time for staff to show up, and then once on the toilet had to wait until staff had the time to return to assist them. In the meantime they would mess themselves and that was most upsetting. I would search the whole building sometimes seeking that help, but with few staff they could do only so much. With more competent caring staff and discontinue the contract cleaners (used to have their own cleaning staff until then), Aged Care would be more appealing. Right now Aged Care represents a prison of uncaring faces where management only want to make money. A criminal in prison gets better care.
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#6 Paul McDonall 2019-05-07 15:27
My aunties spent their last few years in a nursing home in the Wollongong area. Both were well looked after and the nursing home in general was very well run. The family was quite pleased with the care they received. But one aunt eventually died early (earlier than we believed she should have) from sepsis due to a bed sore. There was a court case held ... called by the hospital...not by us. The final outcome was that various changes were required in training and the running of the facility...especially the frequency of access by doctors to the clients.
When the government sells off services (roads, rail, buses, hospitals, nursing homes etc) the quality of the 'service' usually goes down as the new private owner is in it to make as much profit as possible...and the government could care less!!
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#5 Peter Wiles 2019-05-07 14:29
My sister was in an excellent nursing home, till it changed hands. Overnight the place changed dramatically. Staff numbers decimated, activities disappeared etc. The NSW government complaints process was biased towards the management.
It was all about policy and not practice.
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#4 dianne haines 2019-05-07 13:38
As you say, aged care is big business. My mother in law was 93 when she entered one of these homes. It was terrible. She shared a room with a lady who had dementia, although she was of sound mind herself. She was made to shower at 7am although she wanted to sleep in. She had to be in bed by 8.pm, and was restricted to the bed after she had got up through the night. It was awful and she only lived for two months after entering the home. I believe it was the unhappiest time of her life.
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#3 Geraldine Wooller 2019-05-07 13:28
My mother was in care in two facilities here in Perth. In the first I found her one day with her nose complete swollen and the colour of beetroot. When I enquired, the head woman told me that she had been found in her room rubbing her nose on the carpeted floor.
In the second place she was bullied in presence by a carer whose task it was to have my mother choose who to vote for in an election! Of course Mum had no idea what it was about and as I tried to gently explain, the carer belligerently took over saying something like: 'You want to vote for.....don't you?' Mum acquiesced and put her name to a party neither she nor I would have ever agreed to. If I had challenged it and argued with the 'carer' my mother would have been even more confused and distressed. There's more but...I still suffer from the guilt, yet circumstances made any alternative impossible. GW
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#2 Meg Watts 2019-05-07 13:21
Six years ago I was admitted to an aged care facility in country WA. I was 60 yrs old, & my husband was in a Perth hospital receiving cancer care. I had been in the same facility 3 yrs earlier for 2 wks respite. Since my prior admission things had gone downhill at this facility. (BTW, I am a retired nurse & university lecturer). This time I endured 3 months there & had a fight to be discharged as I had no home to return to (due to selling ours to move to Perth due to my husband's health care). I felt there was a restraining order placed on me as I couldn't go on excursions or leave the premises to go to the local shops. Apart from issues affecting myself, the care of some other "clients" affected me more. I realise that care & prevention of injuries are paramount in this environment, but nursing people on a mattress on a floor had me aghast. The reason to prevent injury from falls is not an excuse for this. Whilst meals for those who could feed themselves & chew their food was adequate, those who needed soft diets &/or couldn't feed themselves were not appropriate - more like slops fed to animals. Clients who were unable to leave their beds were checked - from the door, & changed with scant privacy. Staffing was woefully inadequate; trained staff was based on 1 or 2 registered nurses; other staff had little training. I will state, however, that a number of staff were friendly & did their best in the circumstances. I admit that I was relieved to be discharged when I was - & after stating that I would contact higher authorities if not "allowed".
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#1 Hans Paas 2019-05-07 13:07
The idea that with tight budgeting by successive governments that an Aged Care Home can be run for profit appears to be in some cases a fatal mistake. Regulation of all Aged Care Homes should be prescriptive and strict and complaints processes need to be simple and readily accessible. I too have witnessed self-defeating routines and culture in Aged Care Homes that lead to diminished quality of life in the elderly people those routines are supposed to be serving.
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