Aged care royal commission this week hears of patients evacuated from loved ones due to lack of local resources

This article is more than 1 year old

This article is more than 1 year old

Indigenous elders whose childhoods were torn apart as part of the stolen generation are now facing a second round of heartbreaking separation from loved ones in their old age, the aged care royal commission heard this week. .

As aged care and health systems are failing to adequately look after them in remote outback communities, many are medically evacuated to cities and die hundreds of kilometres from their homes.

Aboriginal elder Mildred Numamurdirdi is from Numbulwar in the Northern Territory – a small community on the Gulf of Carpentaria.

Since March last year, she has been 800 kilometres away at the Royal Darwin Hospital and remains unable to return home because of ongoing ill health.

“I am myself sad, far away from my family,” she said from her portable hospital bed.

“My heart is crying. We can hardly stand to be away from our children and grandchildren.

Facebook Twitter Pinterest Mildred Numamurdirdi and GP Meredith Hanson-Knarhol at the royal commission hearings in Darwin. Photograph: Greg Roberts/AAP

“If I pass away here, it is far for me to get to my spirit, my culture, my ceremony.”

Central Australian Aboriginal congress chief medical officer John Boffa was damning of the health and aged care systems’ lack of reach.

“We have had 28 years of sustained economic growth and we can’t even make sure that old people can be cared for close to home in communities of very considerable size,” Dr Boffa said.

The commission was told of the huge scope to train Indigenous people to be aged care workers in remote communities.

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Failing on wounds

The commission, which held hearings in Darwin this week, also heard stories of multiple failures across the sector and the rest of the country.

The late Italian migrant Annunziata “Nancy” Santoro was a hard-working seamstress and a keen gardener. A foot infection contributed to her death at the age of 94 last October.

Santoro had dementia and a year earlier had entered the Assisi nursing home at Rosanna in Melbourne which cares for Italian-speaking elderly people.

Facebook Twitter Pinterest Italian migrant Annunziata (Nancy) Santoro died in 2018 Photograph: Supplied

On Wednesday, her daughter, Anamaria Ng, cried as she told the commission her mother would still be alive if she had received proper treatment for the wound on her foot, which became infected and had maggots.

For two months, the wound deteriorated, and weight-bearing exercise recommended by a physiotherapist made the pain worse.

The ward manager, Jumuna Jacob, had tried to stop Santoro’s GP, Eric Tay, telling Ng and her brothers about the maggots, according to the doctor.

Tay told the hearing Jacob was “tense” and “anxious” about disclosing the maggots to the family and was worried about getting into trouble.

I can watch my mum on my phone from anywhere at any time of day Lisa Backhouse

The hearing was told a fly would have had to have landed on the wound to lay eggs for a maggot infestation to occur.

Ng said Jacob told her that “maggots are used in modern medicine” and was “trying to downplay the significance of the whole thing”.

The Aged Care Quality and Safety Commission had investigated Ng’s complaint and found significant gaps in Santoro’s care.

The hearing was told that within a month of Santoro’s death, the former agency responsible for nursing home audits had assessed that Assisi had met all 44 quality standards. No sanctions were imposed on the nursing home.

Assisi’s interim chief executive officer Paul Cohen told the hearing a “root cause analysis” was being undertaken into the case and that the former chief executive, who cannot be legally named, had recently been sacked.

Cohen agreed there had been “systemic failures” around Santoro’s care.

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In a separate case, examined on Tuesday, the commission heard about feet pressure ulcers on a elderly Wollongong woman which were missed by poorly trained staff.

One foot was so damaged that bone was exposed.

Shirley Fowler, 92, had dementia but had been physically mobile when she moved into residential care at the IRT William Beach Gardens nursing home south of Wollongong in 2013.

Fowler developed contractures in her leg, which resulted in the “freezing” of a limb in a crooked position due to the atrophy of muscles. A lack of exercise had contributed to this condition. Contractures cannot be reversed.

Her daughter, Lyndall Fowler, a former nurse, said her mother could no longer move any part of her body except for her eyes.

“It’s very stressful to not only have to witness her deterioration and loss of independence and dignity but to have to time and again bring things up that shouldn’t have been my role,” her daughter said.

Her mother required hand-feeding and a lactose-free diet but this wasn’t always available, and the hearing was told that Fowler often had food spilled all over her clothes.

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Lyndall Fowler called for increased pay for aged care staff to improve quality.

“If the pay of people doing the important and challenging work of caring for the most vulnerable people in society like my mother ... is less than someone serving hamburgers at McDonald’s, what does that say about our society?”

Kristy Taylor, the IRT William Beach Gardens care manager, rejected claims of inadequate staff training.

Counsel assisting Peter Gray QC asked her if staff had “slipped back into mistakes from time to time”.

“I wouldn’t say ‘slipped back into’. We get different staff, new staff, that then require education and training, and then we provide that to them, to make sure they’re up to date with the requirements of residents,” Taylor said.

Failing on safety and comfort

Lisa Backhouse told the commission on Thursday she was forced to install video surveillance in her mother Christine Weightman’s nursing home room following a series of unwitnessed falls and two reported assaults.

“I can watch my mum on my phone from anywhere at any time of day and I can be involved in her care doing that, ” Backhouse said.

“Short of moving in and sleeping by her bedside, I don’t know what else to do.”

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Weightman, who has dementia, had been left undiscovered for hours with a broken leg which resembled a “snapped tree branch” in 2017 the commission heard.

The commission heard that after three months at a new Brisbane nursing home, the centre manager phoned Backhouse to say that her mother had been hit by one of the carers.

The worker was stood down but the investigation concluded there were “mitigating circumstances”.

Backhouse told the hearing few weeks later, the manager phoned her again to say: “I’m so sorry to have to call you about another incident. I’m afraid your mum has been hit again”.

Facebook Twitter Pinterest Lisa Backhouse installed a surveillance camera in the nursing home room of her mother Christine Weightman Photograph: Supplied

The second carer had “hit with intent and force, twice on her upper leg”. She was sacked and police have charged her with one count of serious assault.

The hearing was told the surveillance camera revealed neglect, including Weightman being left waiting on a floor for 43 minutes after a fall in May as she tried to get up to go to the toilet.

Backhouse believes low staff ratios and a lack of resources devoted to regularly toileting her mother contributed to her falls.

Weightman, a former nurse, was also left shivering without blankets for 10 hours during a cold winter’s night after they fell off her bed.

“We need a strong policeman on the beat,” Backhouse said. “A regulator must be given punitive powers in order to be able to fine and penalise nursing homes that fail in their duty of care.”

Hearings continue next week in Cairns.

Sudden closure

Meanwhile, families and authorities in Queensland are grappling with the sudden closure of a Gold Coast nursing home.

Seventy residents were evacuated on Thursday night from Earle Haven Retirement Village, following a commercial dispute between the owner and medical contractor.

The residents have been transferred to a nearby facility.

The federal government has vowed to investigate.

Leading Age Services Australia, the peak aged care industry body, described the situation as appalling.

“Our first concern is for the welfare of the residents and our thoughts are with them and their loved ones,” chief executive Sean Rooney said.

Aged care minister Richard Colbeck says it appeared the subcontractor withdrew all services without notice.

“I will be looking to bring the full force possible of action onto those who put residents of Earle Haven in such a terrible position – it is simply unacceptable,” Colbeck said on Friday.