Monday 1 June 2009 at 8.30pm on ABC1
“And the nurse came around. And I said you know my mum’s not well, we need to get a doctor, and her comment to me was, isn’t she always like that? And I said no, she’s not near dying.” Son of aged care resident
It’s a difficult decision for any family to make: what to do when Mum or Dad can’t look after themselves and they need around-the-clock care. Most families make that decision accepting assurances from the government that Australia’s system is the best money can buy.
Right now across Australia there are 170,000 people in aged care nursing homes. By 2030 that number will be closer to half a million. Those institutions are heavily subsidised by the Federal Government and their performance is scrutinised by the Federal Department of Health and Ageing and the Commissioner for Aged Care.
“I certainly have seen nursing homes right around this country in every state and territory, and I have seen many first class nursing homes.” Justine Elliot, Minister for Ageing
But for many families the performance of nursing homes falls a long way short of the ideal.
Take 87 year old Eddy, confined to a nursing home with limited mobility. Last October he fell and fractured his hip. An eye-witness to the event tells Four Corners that Eddy was yelled at by staff before they bundled him into a chair, unaware he had a serious injury.
Over time, the elderly man developed serious leg ulcers and ultimately died. No one is quite sure how his treatment in the home affected him. When his family asked for his medical records they were told they must make a Freedom of Information request. A complaint alleging abuse by the staff against Eddy was investigated, but a key witness was not interviewed. The family is left bewildered.
Reporter Wendy Carlisle talks to another family who placed their 86 year old mother, Thelma, in care. They tell how staff washed her with a dish cloth, ignored filthy bedding and ultimately failed to realise she had pneumonia.
“I think everything was done cheaply, like there wasn’t enough linen. One time she was sick on a Sunday, and they had washed up, well, there was no towels to dry her, they did it with chux cloths, and another time there was all faeces on her sheets.” Thelma’s daughter
Thelma’s doctor tells Four Corners he was not called to attend her and 19 days after she first moved into the nursing home, Thelma died in a public hospital.
Significantly, an investigation by the Department’s Complaints Investigation Scheme into her case shows the nursing home did ignore Thelma’s condition. Alone, this would be of real concern. However the investigators failed to speak to her doctor to understand the full extent of the nursing home’s problems. Four Corners has discovered these kinds of oversights by investigators are not uncommon, as a former panel member of the Aged Care Complaints Resolution Scheme says:
“I would describe it as a very flawed system.”
Four Corners reports that the Aged Care Commissioner found serious deficiencies in the way the department investigates cases. Of the 139 cases the Commissioner reviewed, she found that half of them were seriously flawed.
The inability to investigate complaints properly isn’t the only problem though. Last year there were 7,500 complaints to the Department of Health. In the vast majority of cases, no matter how serious the complaint was, there is no public record made of the complaint, even if it’s proved correct.
Nursing homes can avoid being named and shamed by simply agreeing to improve their standard of care. In order to be named the home must be sanctioned by the Department. In 2008 that happened just 14 times. That means, for the general public, there is no comprehensive way to check the number of complaints made against an individual nursing home.
There is little doubt that with an ageing population, the care system is under enormous strain. It’s also true it can only be kept up to the mark by a powerful system of regulation. Right now, if you believe the experts and the families who’ve used it, there are serious flaws.
“End of the Line” is a program that no child of an ageing parent should miss. It goes to air on Monday 1 June, at 8.30 pm on ABC1. The program is replayed on 2 June at 11.35pm.