This is how we care for the aged

Aged care residents living in hell ... at Sydney nursing homes. Source: The Sunday Telegraph
A woman in her late 70s lies awake on her bed. She is calling for the lost love she has not seen in years and her cotton tracksuit pants are soaked in urine.
It has been an hour since she wet herself, and it will be another hour before a junior nurse comes to clean her up.
Upstairs, a former boxer is screaming like a wailing baby. Residents and workers try not to notice.
In the recreational area, a room full of men and women in their 70s, 80s and 90s gather around a piano and happily sing tunes.
Later, another group cheerfully lift their arms and raise smiles during their exercise routine to music.
Down the hall, a frail woman desperate to use the toilet strains to reach a call button. The button has been placed deliberately out of reach, twisted over a light fitting above her bed.
This is a typical day in a Sydney nursing home: sometimes inspiring, at times heartbreaking, often tragic.
I worked as a volunteer for three weeks in two homes: one operated by the Domain Principal Group, Australia's largest privately owned aged care provider, and another owned by a British-based Bupa Aged Care. I kept a detailed diary each day.
The experience was gut-wrenching.
I witnessed well-intentioned but under-resourced nurses and other workers tirelessly caring for the aged, infirm and mentally ill, young and old. I also saw hopelessness on a scale that would shock and sadden most Australians.
The nursing homes The Sunday Telegraph worked in have never failed an inspection. They have a clean record from the national accreditation body, overseen by the Federal Government.
Yet what was staggeringly clear is that both - through lack of resources, and too few nurses and staff - were failing our elderly.
Our most vulnerable - some suffering dementia and others clear of mind simply unable to move freely - live in a culture of passive neglect.
Some are subject to clear examples of bullying, and abuse - sometimes physical, other times mental. Almost all of them suffer from severe loneliness.
"I hate it here, I'm not eating again, I want to die," one elderly lady says.
And it is not just the residents who are dispirited: "We are understaffed - it's not the facility's fault, it's the government's. There is no incentive to get into this work, the pay isn't high enough," a nurse confides.
W orking as a volunteer in two aged care facilities, I saw residents underfed. I saw residents who had injured themselves in falls left without medical attention. Ridiculed. "I can't sit up. My ribs are aching and my head hurts because I fell over," one lady tells me, "I fell over on Sunday and now it's Tuesday, and I need a doctor."

I also saw nurses and other staff who deeply care about the residents, and look after them as best they can, considering the conditions.
I saw loving family members visiting - some every day, helping to feed, wash and look after parents (or children).
I also talked to residents who rarely see family, some maybe once a year.And as a worker I was told to keep family members in the dark.
"Everything you see in here is confidential, even from the families. If they ask you 'why is he like that' you say 'I'm sorry it is confidential, you need to talk to management'."
One man, visiting his father, is resigned to the conditions.
Another home is an option, but it's run by the same mob, he says.
"It could be a lot better. I like most of the nurses except one. If I had my way I would throw her over that balcony.
"I was here with my dad and his dinner arrived - no cutlery. So he asks the nurse for cutlery. "After an hour of waiting she says to him: 'this is not a hotel, eat with your hands'.
"I went straight to the manager. He says she must have been kidding, but I knew she wasn't."

As a volunteer I was also told to perform tasks - feed, help move and assist residents - for which I had no qualifications. This is in clear breach of guidelines.In their "mission statements" the aged care operators boast respect, understanding and kindness.
What they deliver at times is distinctly different.
At a DPG-owned nursing home, residents are left unsupervised in front of the television for hours at a time, and rarely exercise.
Often miserable residents are unsupervised during meals. Those who cannot feed themselves go hungry.
The Sunday Telegraph witnessed one dreadfully frail lady spilling food down her clothing three days in a row while attempting to eat unassisted.
Nurses must spoon-feed pureed meals to those who can no longer chew and some residents wait up to an hour while their meals get cold before any staff can help them.
At times I was left with no choice but to help feed residents, which is strictly against the volunteer code of conduct.
When one 83-year-old woman tried to explain to the kitchen staff she couldn't eat grilled sausages or vegetable rissoles because of her allergies, the young Chinese worker yelled at her: "Well, what do you want?"
She came back half an hour later with two slices of white bread and two sachets of plum jam. She dropped them on the table and stormed out.
"The food was better at war," the lady, an ex-army nurse, says.
Working in a nursing home is difficult.
Walking through the sterile corridors a Bupa-owned facility, I hear them echoing with the sound of residents calling for help.
"Nurse, can I have a second blanket?". "I need to make a phone call." "I need my pan changed."

I am a volunteer.
Yet I am kept busy with demands from patients who need help. I can't help but wonder what the residents would do if I wasn't there seeking out nurses, smuggling blankets from the laundry or straws from the kitchen so residents can drink.
Assistants in nursing look after the personal hygiene within the homes. Most of the assistants The Sunday Telegraph saw were migrants with varying standards of English. Communication is sometimes difficult.Each nursing assistant is responsible for up to eight residents - showering, dressing, feeding and helping them to the toilets throughout the day.
Nurses save time and resources by leaving residents in wet pads for hours and The Sunday Telegraph saw nurses, in their haste to get through their tasks, forget to wash their hands toileting one patient before feeding another.
At the DPG nursing home, staff left the call button out of reach forcing frail residents to yell for assistance.
One cold afternoon, I sat for one hour with an elderly woman who suffers from Parkinson's while she repeatedly pressed the nurses' call button. She needed a pad change.
"I'll get to you sweetie," the nurse said before disappearing out the door.
"That's just what it's like in this place, nothing gets done when you ask for it," the lady says simply.
The following morning while massaging sorbolene cream into 92-year-old's soft and wrinkly feet, I noticed, like those of many other residents, her toenails were overgrown and a rotten yellow colour.
Soon an entertainer arrived who sang wartime classics for an hour to lift the mood. While she sung the staff took the chance to duck outside for a cigarette, leaving the entertainer in charge.
Outside, overworked and emotionally drained nurses complained they smoke to calm their nerves.
"Jenny tried to bite me this morning. I almost dropped her," laughed one.
Then another said: "I will trade you Bobby for Jenny" - a dementia sufferer who is known to defecate in the shower.
"Nah, I'll stick to Jenny," the woman said.
Earlier that morning an 84-year-old lady had been begging to go to the toilet from the confines of her wheelchair.
She is recovering from a stroke and needs assistance walking, but it takes 20 minutes to rally up two staff to help her.
They want to take her to a bathroom on the top floor but before they arrive she let out a cry. She had soiled herself.
Tears welled in her eyes as she recalled the incident.
"I have never done that before and it really upset me. They said don't worry we have seen worse, but I am worried, it's my dignity I am trying to keep." She told The Sunday Telegraph she was depressed by her surroundings.
"I am too well to be here," she said.
Nurses at the DPG-run home at times brushed off medical complaints.
When a 52-year-old, who suffers from Down syndrome, repeatedly asks for a doctor to look at her sore ribs she was ignored.
"I fell over yesterday," she says. "I hurt my head and my ribs are aching. I fell over just near the phone. I'm always falling over. Will you help me walk?"
She was interrupted by a nurse who said: "No, she is a young girl she doesn't want to hear that sort of nonsense from you. Don't tell her these bad things."
The nurse turned to me and said simply: "(She) exaggerates illness."
For six days the resident complained about her aching head and ribs. Eventually she was given Panadol.
"(She) is hard work, always wanting attention," said one nurse as we served hot pancakes to residents in the recreation room. "If she is not getting attention she will throw herself at the ground or trip on the stairs. We can't dedicate all our time to one resident."
B oth nursing home facilities were caring for mentally ill patients as well as ageing grandparents. At the Bupa-owned facility, a 34-year-old woman suffers from a hypoxic brain injury caused by drugs.
She has been at the facility for a decade. Many residents complain they are scared of her violent outbursts.
She is visited three times a week by paid carers, but no family come to visit.
Nurses say her condition has deteriorated, and she is often uncontrollable. Nurses complained of being abused by residents who hit and spit on them, and some even suggested putting them on "calming medication".
Over the three weeks The Sunday Telegraph learnt many of the residents were miserable and lonely. Often they said they are "waiting to die." After reading a magazine to an elderly resident one day she was distressed when I tried to leave the room. "Don't leave me darling, I am so lonely, please don't go," she said.
The staff are not fazed by death.
When an elderly woman died in her sleep, staff chatted about her for 10 minutes before the conversation turned to what they were having for lunch.
A dark, locked room called the "Holding Cell" at the DPG nursing home is where dead bodies are kept until they are sent to the morgue.
And the belongings of the deceased are kept in a large storeroom for families to collect.
For those who do not have any family, their clothing is washed and redistributed among residents.
One nurse said she never went to the funerals even if she knew the resident for years. "This place has changed me. I remember the first time I saw one of the residents die I did not sleep for three days. But they are still warm, they just stop breathing. Now I am used to it, it is just part of it," she said.
On my final day, an hour after lunch was served I noticed one frail 73-year-old had not touched her food.
The woman who was clearing away told me the lady never eats. A poster on the wall informed me she used to be a medical specialist who ran her practice before suffering a stroke in her 50s. I sat with her and coaxed her into eating about six cold mouthfuls. She could not speak but she took my hand and nodded. I almost cried.