Aged Care Insite Issue 113 | Jun-Jul 2019 | Page 11

industry & reform was fine to administer risperidone up to three times daily. “Well, if they’re saying that we informed them that that’s something that we would do at home, it’s 100 per cent incorrect,” McCulla said. Remembering an interaction with the nurses who questioned McCulla and her sister as to what was wrong with their father, she recalled replying, “You tell us. He is no longer the man he [was when he] came in.” INNOVATIVE SOLUTIONS “We’re not funded for how happy a resident is.” That’s one of the ways in which the aged care system fails to incentivise good practice, the royal commission heard. Lucy O’Flaherty, who heads Glenview Community Services in Tasmania and will oversee the development of its Korongee dementia village, said: “If we look at the way the industry is structured, we are … funded for the amount of medications we’re giving, how many times we shower someone and what meals we provide.” Tamar Krebs, co-chief executive of Group Homes Australia, said she would like to see a voucher system that would fund community or residential aged care as soon as a consumer needs it. Commissioner Richard Tracey welcomed the change of tone for the hearings after the weeks of harrowing testimony. “It has been refreshing to hear how a bit of innovative thinking can produce good outcomes,” he said. BUPA UNDER THE SPOTLIGHT The second week of Sydney’s commission hearings heard testimony detailing the death of an aged care resident at a Bupa facility in late 2017. Two daughters recounted walking into the building and hearing “this loud rumbling that was so disconcerting and scary I think that as soon as my sister heard this, we ran”. The sound was their mother (DE), struggling for breath in her final hours. DE died four weeks after she was admitted to the Bupa facility in Willoughby, Sydney, aged 70. DE’s daughters outlined the poor care their mother had received, which included bed sores, malnutrition and poor upkeep of her hearing aids and glasses, leaving her, at times, essentially deaf and blind. DE had no communication abilities and was unable to feed herself, and the daughters were soon worried that she was not being fed properly by staff. “Every time we would go, Mum’s face was more sunken and she was becoming a lot more unwell.” The daughters tried bringing this up with staff, but say their concerns fell on deaf ears. The daughters told the commission that they and other family members could successfully feed their mother when they visited. They say other health professionals who visited Bupa knew it was an issue as well. They recalled an incident with a speech pathologist who tried to teach them how to successfully feed their mother to avoid dysphagia. “And she said to me, ‘Now I’m going to show you a 3.5-minute video on how to feed your mother so that there is no risk.’ “And I said to her, ‘Shouldn’t you be showing this to the nurses here, because I’m not here every day.’ “ When asked whether she felt that staff are adequately trained to provide care, Mitchell gave a blunt “no”. “She said to me, under her breath, ‘There’s not a lot of point in that, and that’s why I show the family members who are here, because they’re usually the ones that end up feeding them.’” The commission also heard how DE, who was originally moved to aged care after a series of falls, was admitted to hospital after only 36 hours spent in the Bupa home, diagnosed with aspirant pneumonia. When talking to witness Maureen Mary Berry – formerly the interim chief operating officer of Bupa at the time DE lived at the Willoughby facility – counsel assisting Peter Gray discovered that although the pneumonia was said by Bupa staff to be the result of a pre-existing condition, poor practice in that short 36- hour period could have been to blame. Gray read hospital notes from DE’s discharge that explicitly state that DE should be monitored “for signs of aspiration/penetration, coughing, wet gurgly voice with oral intake, reduced chest health, and refer to medical/speech pathologist”. Berry admitted that BUPA had failed to follow this advice. On the day of her death, DE’s daughters rushed to the facility after receiving a confusing phone call from staff. They found their mother breathing heavily and in clear discomfort. It took 30 minutes for a GP to appear, they say. He stayed in the room for about a minute, before saying, “This isn’t really my area of expertise,” and leaving. Before coming to the commission, DE’s daughters took their grievances to the Australian Aged Care Complaints Commissioner. BUPA has been dogged by negative headlines since the Four Corners investigations. As of March, nine BUPA facilities were under sanction for failing to meet compliance benchmarks set out by the Australian Aged Care Quality Agency. YOUNG ONSET DEMENTIA The Sydney hearings ended with testimony from witnesses with young onset dementia. Trevor Crosby was diagnosed with Lewy body dementia four years ago at age 65. Crosby lamented the lack of support people like he and his wife, Jill, are afforded once they receive a diagnosis. He told the commission about the Living with Dementia program he undertook with Dementia Australia, which he described as a “real turning point” for him and Jill. However, after the eight-week course, he felt cut adrift. “I felt cheated. The course was so good, but there was no follow-up,” he said. The last witness was the chief executive of Dementia Alliance International, Kate Swaffer. She was diagnosed with a rare form of younger onset dementia 10 years ago, aged just 49. She told the commission that it wasn’t until 12 months into her diagnosis that she was referred to support services, which in her words “set us up to fail”. People diagnosed with dementia need “intensive brain injury rehabilitation”, she said, and called for people of her age to be “supported to stay at work with reasonable accommodations”, just as if she had suffered an accident causing brain injury. ■ agedcareinsite.com.au 9