We invited members of our community to share their experiences and perspectives of aged care services. Disclaimer: These stories have not been independently verified. They do not necessarily represent the opinion of Aged Care Reform Now and are shared for information purposes only.
This is the second of two stories submitted by this community member.
My 82-year-old husband W.S., had a respite stay in April 2018, at a residential care centre in Adelaide, South Australia. This followed a hospital stay for decreased mobility and other serious medical issues.
The following issues concerned me at this new facility. I was a personal witness to all issues as I spent nearly all day, every day with him. I was able to do this, as the respite period was not for my needs, but because our home care provider (different entity) needed time to organize equipment and training of home support worker staff for W.S. return to home.
The following regards the above residential care centre where he spent 3 weeks. All residents had single rooms with ensuite toilets and showers.
W.S. required full assistance in personal care issues.
Inexperienced staff and staff level issues
Included incidents such as:
- Bloody urine overnight urostomy drainage bag emptied in hand wash basin. Bedpan was flushed in the shower area.
- Soiled washer towel left in the shower area for two days.
- Sling/hoist lifter/commode techniques sometimes causing considerable pain in private parts. Also lack of experience in “positioning tabs”.
- Shower not done for first few days, as Easter time, less staff. Finally, routine shower time set at 10.30 meaning breakfast in bed, not able to do anything till nearly lunchtime. Staffing unavailable to remove from the commode in toilet for a considerable time – including one occasion when my husband was sitting on the commode for 45 minutes, with myself lifting and stretching his numb, extremely painful stroke affected leg.
- Communication/English language issues with some staff, – in fact some of my husband’s statements and requests were totally misunderstood. He was totally mentally aware and had no speech or communication issues.
Medication issues
- Vagueness and confusion as to who distributed medications – RN or Carer. Husband was offered Warfarin, important blood thinner medication in the early a.m. – and was not believed when he stated it was always in p.m. Very important to have at regular times. He was also asked, “Has anyone given you your medications yet?”
- Laxatives were not given according to GP’s instructions – forgotten completely, – given at completely varying times of the day.
- Husband had to remind staff at 7.30 p.m. to give him medications including warfarin so he could sleep.
- Other resident’s medical charts left on my husband’s bedside table.
Equipment issues
- Though warned by the hospital and given documents about the Pressure Risk Assessment, waited nine days after admission before finally a required air mattress was supplied.
- Ceiling hoist tracks were in every room, and three motors were said to be available for these, but in practice for the three weeks stay, only one motor was available, plus a sling/hoist lifter. This was for an area dealing with 15 high-level residents needing lifter, so mornings were spent with considerable waiting for essential toileting and shower issues.
- Toilet area call bell was unreachable as it was on the wrong side for a person with right hemiplegia. When notified of this a promise was made to “supply a hand bell’ – this never happened.
- No “recliner” chair in the room – armchair not appropriate for my husband’s disabilities, backpain, and leg swelling. This meant he spent most of his time in bed as his current wheelchair had been assessed as no longer comfortable/appropriate.
Food and nutrition
- Written planned menus and “diet assessment” done by the registered nurse on admission did not relate to the actual food supplied.
- Food served to those in rooms arrived cold; mushy “frozen” vegetables; food sometimes average, sometimes inedible; or inappropriate for digestive needs e.g. “lentil and french onion – soup of the day” – for someone known to be having bowel issues.
- Though at assessment, my husband said “No sweets” – every meal continued to be served sweet puddings, and when queried about the “fresh fruit” we were told “You need to ask”.
- Cordials always served at dining tables, no plain water jugs available.
Management Issues
Intimidation / possible “black listing”?
A “suggestion box” was available on the front reception desk, though the actual process was vague. Forms were in a separate strangely named folder on the table at the front entrance.
My husband and I shared a list of small issues we thought could be improved and placed it in the suggestion box. The following day the manager of the centre came to my husband’s room and had a very intimidating conversation with us. We had intentionally not signed the suggestion list, and the manager stated that he had taken a while to work out who was “responsible”. He then went through the list, answering various points in a very defensive and sometimes illogical manner e.g. “There is no water on tables because some of our residents have swallowing issues and residents can ask for glasses of water if they wish.” My comment that cordial is surely the same consistency as water, was not well received.
The following day a staff member quietly said to me – “If you are considering a permanent placement for your husband, – be aware that you need to take a “low profile, because “he” – i.e. manager, – does not appreciate forthright women”.
After 19 days of respite my husband was readmitted to hospital due to an infection. Nine days later, as our Home Care Provider was still working on equipment needs for return to home, we needed further respite for his discharge from hospital.
On speaking to the responsible residential centre staff member by phone I was told that a further respite bed would be available, in fact, two more would be available. However we later received a phone call from the centre’s assistant manager that no beds were available – and none would be available in the foreseeable future!! This was confirmed a few days later!!
We did within a few days obtain a respite bed at another residential care centre in the same area.
I am of the opinion that we could have been “blacklisted” and therefore not offered a second session of respite by the first centre.
Following this experience, I placed a “post” on the “Care Opinion” website about our experience with the centre in Adelaide. I was quite amazed to see that this was responded to in fact by the very manager at the centre who had “intimidated” us, so I did not take him up on the offer of further communication!
Financial Issues
We received an invoice from this residential centre, which was for 33 days respite. As my husband’s stay was 19 days only, as he had been admitted from there to the hospital – and we had never at any stage specified how long a respite we would need – we were quite surprised to be charged for a full month’s respite.
We had been advised by another agency about the Government regulation, which states – “Respite arrangement ceases on hospital admission”. We queried the invoice and finally were sent another invoice for the correct amount. This was more than $700 less than initially invoiced. Had we not found out about this regulation, we would have paid the initial amount.
Summary
Though this specific residential aged care centre gives the initial impression of being a 4-star hotel, with single rooms, “Smart-TV”, “latest equipment”, varied menus and so on, it failed miserably in staffing levels, staff training, communication, nutritious food, and management issues.
Comments made at various times during his stay, by my totally alert and always good-humoured husband, a man who was never depressed, were the following.
“I can’t go on like this”! – “If I knew I would end up like this, I would have done something about it”! – “Don’t know how long I can stand this’!
He stated that the only thing that kept him going was being able to lie in bed in the morning and watch the sunrise over the Adelaide Hills in the distance. Even this necessitated my putting a sign on the window, as staff insisted on closing the heavy curtains every night.
My husband returned home with a home care package, able to spend his last seven months in his own surroundings, before passing away.
If this story caused sadness or distress, please reach out for help.
Lifeline: 13 11 14 or lifeline.org.au
Beyond Blue: 1300 22 4636 or beyondblue.org.au
Headspace: 1800 650 890 or headspace.org.au
Do you need to lodge a complaint? We have information on which government agency to contact, and how to explore legal support here: https://agedcarereformnow.com.au/resolving-complaints/where-to-make-an-aged-care-complaint/
Do you need support? OPAN provides free services to support older people and their representatives address issues related to Commonwealth-funded aged care services and informs people of their rights and responsibilities: 1800 700 600 or opan.com.au
We hear about the very serious issues of neglect, abuse, even sexual abuse in Aged Care – the issues which really stand out. Without downplaying these in any way, my article which might seem too detailed (even to myself), highlights the fact that it is the accumulation of the “little failures”, the mundane daily failures in aged care which grind down residents and families, and often make them incapable of voicing their needs and opinions.
As the author of this story I now wonder about sharing so much detail of “private” issues. But those are the sort of private issues which have such importance in “quality of life”… a phrase often used, but not always given total recognition and understanding. Aged Care is a massive system, with huge problems, but until we take the “Providers” down to the grass roots level it will continue to fail. We need politicians and Providers to “Get Real”. And understand you are trying to offer “systems” which are massively flawed in their basic approach! New Aged Care Act! New Aged Care system!