Health sector reacts to aged care failings report

dementia-friendly communities: older hand held by younger hands

The Prime Minister has announced a Royal Commission into the aged care sector, as an ABC report highlights poor treatment of residents and inappropriate medication use

Four Corners is airing a two-part investigation into the aged care sector, titled Who Cares? covering failings of care.

The report emerged from a crowd-sourced project in which Australians were asked to tell Four Corners about their experiences with aged care. More than 4,000 responses, from families, staff and the industry, came back.

In the piece, by reporter Anne Connolly and presented by Sarah Ferguson, aged care workers and families of residents told harrowing tales of residents being left alone in bed in the dark for extended periods of time; of being dressed warmly with no air conditioning during hot periods; and of falsification of documents to exaggerate patients’ deterioration in a bid for more funding.

Overuse of medication for dementia patients emerged as a significant issue.

“A national study found nearly two-thirds of aged care residents were being given psychiatric drugs,” said reporter Anne Connolly.

“This includes anti-psychotic medications which are principally used for mental illnesses like schizophrenia.”

She interviewed Dr Juanita Westbury, Senior Lecturer, Wicking Dementia Research and Education Centre, University of Tasmania, who said that doctors are often asked for these medications by staff.

“They should only be used as the last resort, but I think more often, and from the usage rates that we’re seeing, they’re really reaching for them first.” AJP looks more closely at the issue of inappropriate medication here.

The report told of one woman with visual and hearing impairments whose food would be taken away before she could eat it, and who due to her disabilities was unable to tell whether her meals were still there.

Around half of nursing home residents have malnutrition, the report highlighted.

“There were people that were in bed that needed to be fully fed, they couldn’t feed themselves at all,” said one carer, Rebecca De Haan.

“And you’d see staff members just quickly go in, offer the resident a bit of food. And if they didn’t take immediately, just go out and ditch the lunch. You can see these people are so hungry.”

Another said that “Some people get really depressed and you have a resident saying, ‘Can you give me a pill to kill me?’

“They just wanna die and you don’t have five minutes to spend sitting there with them.”

Other workers told of being given an allocation of three incontinence pads for their patients.

“I definitely recall them saying not to use more than three continence pads and I have to say, I ignored that directive because in my view, if there’s faeces on a continence pad, I’m not putting it back on another human being,” said carer Tanya Bosch.

Prime Minister Scott Morrison announced a Royal Commission into the aged care sector, which will primarily look at the quality of care provided in Residential and Home Aged Care to senior Australians, but also include Young Australians with disabilities living in Residential Aged Care settings.

“Our aged care sector in Australia provides some of the best care in the world,” the PM said. “And we are looked to as a leader in the field.

“But the best teams will always want to do better, and will always want to be honest about the performance of the sector as a whole. If you care about aged care, which those who work in the sector do, you will want it to be at its very best.”

He cited recent efforts to improve the system and said that when he became Prime Minister just over three weeks ago, he was advised that as a result of increased audit work, the Department of Health has closed almost one aged care service per month since the Oakden nursing home abuse scandal, with an increasing number under sanction to improve their care.

“However, incidences of older people being hurt by failures of care simply cannot be explained or excused. We must be assured about how widespread these cases are.”

Health reacts

A number of stakeholders have spoken out about the report, including the PSA, which welcomed the Royal Commission and said that pharmacists should be embedded in aged care to improve medication use.

“Research shows positive health outcomes are delivered in models where pharmacists and pharmacy services are embedded and integrated within aged care facilities,” said national president Dr Shane Jackson.

The AMA’s national president, Dr Tony Bartone, said the organisation has been concerned about the care being given to older Australians for “many years” and highlighted that many doctors have been pulling back from the sector.

“There is a serious lack of resources. There is a serious lack of staff. And there is a serious lack of coordination between all the sectors involved in caring for older Australians,” Dr Bartone said.

“We know that this Royal Commission will uncover uncomfortable and distressing stories, and systemic failures.

“The AMA has made consistent and repeated approaches to Government about the need for better resourcing and regulation of the aged care sector.

“The most recent AMA Aged Care Survey found that one in three doctors plan to cut back on or completely end their visits to patients in residential aged care facilities over the next two years. The Survey also found there are not enough suitably trained and experienced nurses in aged care.

“There must be proper planning to ensure that medical, nursing, and other specialised care are built into the design and operation of aged care facilities.”

The Australian Nursing and Midwifery Federation and Dementia Australia also welcomed the Royal Commission.

“Our members have long-been raising their concerns about dangerously low staffing levels in nursing homes, as well as practices uncovered by tonight’s program, such as restriction of continence pads and appallingly unhealthy food. The revelations from the program are beyond distressing, they are intolerable,” ANMF Federal Secretary Annie Butler said.

“As a society, we have a moral obligation to stop this neglect and abuse of the elderly, we cannot allow it to continue, not for one single day longer.”

Related: Aged care failings: are RMMRs a solution?

Watch the full Who Cares? report here.

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