Dear Prime Minister, 

I have an issue with the situation I saw at my aunt's nursing home.  My elderly aunt had been there for a few months before she passed away in September. I found I needed to intercede on her behalf to ensure her wishes were respected as to how she was treated during her stay.

During the first few days after she was admitted, she was made to sit in a general area with many other aged persons who could not walk without assistance, and they were left there to watch TV all day in a brightly lit room, no matter how they felt about it.  My aunt was in distress about this when I saw her on the Sunday two days after her admission. 

I had to have a strenuous discussion with the nurse in charge to get permission for my aunt to stay in her room lying down if she preferred, which she did. She was virutally dying. She was upset and uncomfortable when forced to sit and watch TV all day. She was suffering from cancer and a brain tumour and was meant to be on palliative care, but she was receiving very little palliation.

Her first days there were not palliative at all, I was shocked at her level of distress when I visited her. She had been a highly independent woman and the nursing home immediately stripped her of any control over her day whatsoever and ignored her protests.

She was admitted in late July and passed away in September. I believe the stress of being in the aged care home contributed to the harsh speed with which death took her. The exact cause of death at the time was never investigated as she had a terminal illness and the doctor simply noted that she died of her condition. I believe the immeidate cause was the condition of being in the nursing home where she felt abandoned, alone and lonely as never before. However, she had the most stoic character and apparently had resigned herself to her terrible inescapable fate. 

The night before she passed away, she had a visitor who tells me she was given a dish of tinned baked beans for dinner which she brushed aside and refused to eat. She often would refuse these excuses for meals, she had special tastes and habits in relation to meals and had been very fussy.   

My mother had been preparing her lunch and dinner every day and it just had to be exactly what she wanted or she would refuse to eat it.  At this nursing home her wishes were not respected or enquired of as to what she wanted to eat and one could never make her do anything she didn't want to do, if the food was not to her liking she would not eat it. She complained to us she was given small sandwiches for dinner.   

I complained to the head nurse about this and got a denial that this was true, that it may have happened once only on a weekend with some excuse about the staffing.  I believed my aunt when she told me she wasn't given proper meals.  She lost weight so rapidly, her condition deteriorated quickly. She visibly weakened so fast it was amazing to us and we all felt helpless to do anything. One small comfort was that she was ready to die, was not interested in her disabled life. She wanted to die and I remember her words "when you get old, it is just terrible".  

Even the day before her death, knowing she was served baked beans,  something she would never eat, makes me cringe and feel awful for her. How miserly they would have looked on her dish and given her no comfort at all. As well, the visitor/witness of the evening before her death (who was also her lawyer) told me that no one at the centre alerted them that my aunt was in her last hours.  

We did not get any phone call advising that my aunt was about to die in a matter of hours. The nurse I spoke to later told me she could see that she was incredibly weak and her breathing was shallow. She must not have reported this to the management.  No one phoned us nor did they call a doctor, nor did she have assistance to breathe.  A doctor should have been on hand to check on her and a Catholic priest was required by my aunt to give her last rites, and I do not believe her wishes in that regard were carried out. I have enquired of the aged centre whether this happened and I have not had any response on it. They were going to check and get back tome. So I can safely assume she had no religious attendance and the nurses who attended her on the last morning did not mention calling for a priest.  

One nurse told me that she could tell by the odour in the room even days ago, that my aunt's ending of life was very imminent.  She said it was the odour of death, but she did nothing about it. She did not call a doctor, did not call the next of kin - she just ignored the signs and did not report my aunt's severely deteriorated condition. This comment of the nurse about the odour I believe is not in the reports of the nursing home.  The last breakfast and subsequent death happened early Saturday morning around 8 am on 2 September. 

On Saturday 2 September at about 10.00 am as we were preparing to visit my aunt, my mum and I got a phone call from the nursing home advising us that my aunt had passed away some minutes before, at around 8 or 9am. We were stunned that we were not called earlier.  We went to the nursing home and talked to the nurse on hand there who told us about my aunt's last moments, about the breakfast and my aunt's last choking breaths and then death. That's when she mentioned she had smelt death on her breath some days before.  Why weren't we advised then, that my aunt's death was so imminent?  No one phoned us to let us know, no one was told and if we had known we would have visited earlier, spent the last hours with her. 

We visited my aunt's room and collected some of her things. My aunt was still in her bed with a towel tied around her head. The nurse there told me it was to keep her mouth from falling open. We were asked to remove my aunt's personal belongings otherwise the home would dispose of them. We sat with her for a while, it was rather a relief to feel her suffering was over, at peace at last and there was nothing for us left to do. 

On leaving the nursing home, we walked past the general area where all the elderly people are seated with or without their consent, to watch TV all day.  I am told the staff come and take each one of them to the bathroom every few hours, whether they need it or not.  The scheduled bathroom visits are adhered to and if anyone wants the bathroom at any other time than the scheduled time, they are not assisted. If they cannot walk by themselves that is. And many there were bedridden, unable to walk without help.  This is what I was told by the nurse at the time.  

There is no way to get a nurse's attention if one is needed, except to yell it seemed. In my aunt's case she could not yell, she had only been able to make laboured sounds and complained of being ignored and no one asking her what she wanted until I interceded on her behalf and she was permitted to stay in her room. As I described earlier above. 

On this day after we had visited my aunt's deceased body in her room at the nursinghome, as my mum and I were leaving, we walked past the general room where there are maybe 12 or so aged persons who cannot walk by themselves, in various stages of immobility and some can speak and some cannot, and we just don't know how they are feeling being parked in this way with only the sounds of the large TV emanating through the room.  They are there all day I am told so the nurses can see them and don't have to bother visiting them in their rooms and providing them with food and taking them to the toilet, this saves a lot of time I imagine and that is what the purpose is.  

As my mum and I were leaving this last day, one of the aged residents was calling out for a nurse. She was crying "Nurse Nurse Nurse Nurse" non stop.  It was easy to hear her, her voice was loud and carried well in the quiet over the sounds of the TV.  There was no nurse answering the call.  I went over to the lady and asked her what was wrong. She said "I feel terribly ill, i feel terrible and the nurse is not coming".  I said what would you like to have done?  She said "i want to go to bed and the nurse won't come".  She was very distressed and I was surprised that no one was attending to her.   

I went to the nurse's station/office which is virtually adjoining the room where these elderly people were watching TV. There was a nurse around the corner at a desk within ear shot virtually hiding, pretending not to hear the cries "nurse nurse". The nurse deliberately ignored the calls for help until I insisted that she came out and attended to the sick resident.  The nurse said that she preferred to leave her where she was as if she was put into her room she may not go to bed.   

I just would not accept that response and told the nurse that if the lady wanted to go to her room she must be allowed to do so.  Finally the nurse agreed that when the other nursing attendants came back from their rounds, they would come and put the lady to bed, but that they could not do anything in the meantime. She certainly was not going to do this herself.  Now what was this nurse doing at the nursing station situated close to the elderly, if she was not answering their calls. What was her purpose of being there at all?  I was dumbfounded and shocked. 

I told the distressed lady that someone would be coming to put her to bed soon, and she was so relieved. There was anxiety and panic on her face, the distress and the cries for 'nurse nurse' were very disturbing especially when they went ignored.  I don't know her name and I don't know what happened, whether she was put in her room, but from what I have seen, this kind of treatment, ignoring their needs, may be regular occurence.  

I don't know what needs to be done but such disrespect the elderly are shown here, the callous disregard for their comfort and wishes is just unacceptable. I discussed the situation once with the RN, who told me that there just was not enough staff. She told me that there was minimal staffing, just the minimum the law required, and the staff just were not able to cope and unable to provide more adequate conditions in which the residents could live by.

I spoke with another resident who told me she just lies in her room all day with nothing but the TV and life is hopeless.  She told me she was 98 and had barely no visitors as she was from Sydney and her son in Melbourne had placed her in the nursing home but was too busy to visit her. She said that nothing was provided to her in the way of stimulating company or activities.  I asked her about "recreational activities" which I had been told about by the management on my aunt first being admitted.  This lady said "what activities? I don't know anything about any activities".  So I can only assume there were misrepresentations made to us and to my aunt before she was admitted. I remember my aunt looking forward to 'musical concerts' which she was told were performed for the nursing home residents. My aunt later said there were none.  

We had visited on several prior occasions to my aunt's death, and others who visited my aunt also commented at the horror of seeing so many elderly immobilised people quietly spending hour after hour parked in a room with only the TV for stimulation, and little nursing attention and unable to request to be moved elsewhere. And I saw that woman, as explained above, asking for help and being ignored. 

I contacted media about these concerns, particularly about the woman who was crying "nurse nurse" and her calls were being ignored and the nurse when I got her attention, was reluctant to do anything, in fact was deliberately not responding, just seated at a desk doing I know not what.  I don't know what else to do except let the relevant people know what I saw and how shocked I was by it all.

***********************************

I visited a few more times after to check conditions and I found same happening. 

Comments  

#1 Amanda 2019-11-02 21:44
Your story is not isolated, in fact I think it’s a common situation most nurses who work in aged care have experienced. Most nurses don’t go into nursing to ignore, abuse or hurt those in their care. Unfortunately so many times in the media that is the face of aged care, the nurse ignoring someone who is calling out, or roughly removing their clothes.

Originally the government provided funds to aged care homes for nursing staff, allied health, food etc etc. if the funds weren’t used the home received a lesser amount the following year. In those days, there were plenty of trained staff and a great skill mix.

Now the government just gives the growing aged care sector a huge pot of money based on the resident funding tool,the owners of these aged care businesses, spend a fortune making the residence look wonderful with cafes and beautiful soft furnishings but underneath all of that there is little substance, limited and often poorly trained staff, poor food and cost cutting.

Greed is behind much of the aged care crisis.

Nursing staff are often caring for ten to fifteen residents or more over a shift. Many of the people for whom they care have complex needs.Pushed staff often haven’t got the time they need to look after residents.

There is absolutely no excuse for cruelty but time constraints often result in residents not being showered daily, poor grooming, dentition and not offered adequate food and drinks.Residents are frequently all lumped together in a room in front of the TV, because they can be watched by one staff member. Allied health and diversional staff only work Monday to Friday during business hours, due to cost.

Nurse to staff ratios are often so bad, clients with dementia are often just allowed to roam, or restrained chemically or physically. It is a disgrace and our aged need and should be receiving so much more.

Unfortunately I believe a blind eye is turned by the powers that be, so these businesses keep building aged care facilities.

These businesses are allowed to keep operating with the barest minimum of staff and the sanctions imposed during accreditation are frequently overturned and the businesses however bad, keeps operating with no consequences.

That’s why so many nurses can no longer work in the aged care sector. Their conscious won’t allow them to keep working in a sector where al resident is merely seen as income.

Aged care is a business and the government should stop looking at nurses and look at the greedy providers.
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