Aged Care Insite Issue 113 | Jun-Jul 2019 | Page 10

industry & reform Merle Mitchell gives evidence via video. Photo: AAP/ Royal Commission No voice, no choice A summary of the third round of the aged care royal commission’s hearings in Sydney, which focused on dementia. By Conor Burke D arryl Hilda Melchhart, a sharp- minded 90-year-old who has lived in residential aged care since 2014, was the first to take the stand in Sydney at the hearings of the Royal Commission into Aged Care Quality and Safety. Inside a small courtroom, she spoke to the many problems within residential care as she sees it, from rationed incontinence pads, to bland food, to loneliness. Melchhart groaned when prompted to talk about the problems she faces when asking nurses for simple things such as getting her medical paperwork ready for the cardiologist. More shocking were her recollections of the violence she faced at the hands of other residents on the ward, where, in her estimate, only 10 of the 90 residents have their full faculties. One incident saw a resident come into Melchhart’s room to steal her jewellery box. When confronted, the resident attacked her with a mug. Melchhart has spoken to staff about all of these issues, she said, but she feels as if she has “no voice”. When she alerted a nurse to her expiring GTN spray, which she needs for a heart condition, she said the nurse refused to grant her a new one and took the depleted spray away. This left her without this potential life-saver for nearly four days, until her doctor intervened. 8 agedcareinsite.com.au Another aged care resident, Merle Mitchell, AM, gave evidence via a pre- recorded video. She told the court of the “terrible” time she had transitioning from an independent life to an “institution”. She felt she had “no choice” but to conform to the strict schedules imposed upon her. Like Melchhart, Mitchell recounted her own near-death experience. “Three senior people” ignored Mitchell’s complaints of pain, telling her “it is all in your head”. Only when a fellow resident warned nurses that they were at risk of committing elder abuse was Mitchell taken to hospital, she said. She was found to have a crushed disc and broken back. When asked whether she felt that staff are adequately trained to provide care, Mitchell gave a blunt “no”. And if she could nominate one thing to change in the sector? “Ratios, ratios, ratios. Everybody will tell you that.” ‘NO LONGER THE MAN HE WAS’ Drugged without family consent and strapped to a chair for hours on end, Terrence Reeves spent a hellish 60 days in Garden View aged care facility, the royal commission was told. Wife Lillian and daughters Michelle McCulla and Natalie Smith recounted how an otherwise fit Reeves entered the Garden View facility on a short respite with dementia, and at that point was still able to shower himself and get around with Lillian’s help. Lillian and her daughters were approached by staff about signing a restraint form for Reeves for short periods, as they “felt that during changeover shift there weren’t a lot of people that would be watching him, and that it would be for his own safety”. However, in McCulla’s testimony, the court heard that on nearly 30 occasions family members turned up to find Reeves restrained, sometimes in a secure dementia wing with many other patients strapped to chairs in a small room. On nearly every other visit to the facility, McCulla or other family members found Reeves tied down, she said, and in one instance found him “drooling” and “shivering”, barefoot and wearing only a singlet wet with saliva. Reeves was also wet from incontinence that day, and McCulla recounts hearing his screams as he was changed by six nurses all pulling at separate limbs trying to undress him. “Dad grabbed my arm and said, ‘How would you like it?’” McCulla said. Lillian told the commission that at no point did she mention to Garden View staff that she ever gave her husband risperidone, nor did she ever consent to him being administered the drug by Garden View staff. However, the women were convinced that their father was being medicated. McCulla remembered an occasion when the whole family brought a home- cooked lunch to Reeves. They found him unconscious, she said, but were told he was asleep. As they tried to rouse him, he started to gag. McCulla found a piece of meat lodged in his throat. She cleared the obstruction and lifted him up to continue rousing him, only to find he had faeces smeared all along his back. There was then a disagreement between the family and Garden View as to whether Reeves had been medicated. According to notes presented to the commission, Reeves was regularly given a dose of risperidone, which staff say had been approved by Lilian. However, the family say this is not the case, and when they confronted staff that day, they were told Reeves had not been given the drug in about a month. “They said, ‘No, no, look at his charts.’ I was convinced that it was risperidone,” McCulla said. An RN from Garden View gave evidence that she was told by Lillian Reeves that it