Another example of the lack of understanding around who is responsible for the health care needs of aged care residents – and the consequences of inadequate clinical care.
60-year-old Kristine (Kris) Stevens (pictured above) has told the Commission how her mother was left with a life-threatening pressure wound after information about the wound was not passed on when she moved her parents Nena, 81, and Albert Stevens, 84 (both pictured below in December 2017) to a new facility in Dubbo, NSW.
Over 40 minutes, Ms Stevens – one of three children – said she had moved from Newcastle to Dubbo in 2010 after her father suffered a heart attack to help her mother care for him. In 2011, her father was also diagnosed with both Parkinson’s Disease and Lewy Body dementia.
In January 2016, Ms Stevens had moved her parents into a retirement village in an effort to keep them living at home together for longer but her father’s health continued to deteriorate and in May 2016, he was moved into a locked dementia unit at the village’s co-located aged care facility.
With both her parents going downhill, Ms Stevens then opted to move both her parents into a second facility in July 2017 where they were initially happy, but their daughter said the care gradually declined.
In December 2017 after having symptoms of confusion for five days, Mrs Stevens was sent to hospital where a neurologist suggested she also had Parkinson’s Disease and Lewy Body dementia and put her on medication that led to a bad reaction (she actually had a UTI).
“She has never been the same since that incident,” she told Counsel Assisting Brooke Hutchins. “After that, she became fragile, unsteady on her feet, her capacity to communicate was diminished and she just continues, it was like she’d jumped off a cliff in terms of her wellbeing.”
Ms Stevens says this unsteadiness resulted in a series of falls, the last of which resulted in a gash to her mother’s head that has left her bedbound and unable to communicate.
While the facility had an on-site physiotherapist, they did not offer Mrs Stevens rehabilitation so Ms Stevens hired her own physio to visit her parents.
“My expectation was that the facility was going to deal with it,” she stated. “They had the professionals on site, but it didn’t.”
While her parents have maintained the same GP since 2010, he is popular and because of the lack of GPs in regional areas, he is often unavailable immediately.
Relocating her parents to a third facility in August 2018, Ms Steven said staff there struggled to cope with a pressure wound that her mother developed after becoming bedridden because she was responsible for passing on her mother’s care plans and medications and was unaware of how serious the wound was.
It was only when the GP called and told her he had scheduled a visit with the palliative care nurse that Ms Stevens realised that her mother was in danger.
“I thought well, that doesn’t sound like we’re going to try and deal with this, and see if we can heal this wound. It sounds like we’re accepting that this wound is going to really result in the death of my Mum.”
Asking the RN daughter of a friend to give a second opinion, Ms Stevens said the RN was shocked by the state of the wound (pictures were not made available) and told her that an ambulance needed to be called immediately.
The wound is now being treated by the third facility’s wound care specialist (who was on leave when her mother was admitted) and Ms Stevens says she has great faith in the new care manager who has put a number of new procedures in place.
However, Ms Stevens is critical of the information exchange between facilities, hospitals and GPs, noting when her parents moved from the second to the third facility, their advanced care plans could not be located and the staff at the third facility could not administer her parents’ medication until the GP visited the facility to sign off on their medication charts (the old ‘bureaucratic spaghetti’).
She also blames the staffing levels at the facility, saying her mother’s injuries were preventable.
“They are a result of neglect and that neglect is directly related to staffing levels. The fact that they don’t have time, the caring staff don’t have time to spend any more than a few minutes with each resident every day, and facilities are reluctant to tell family members what the staffing ratios are. They actually can’t tell you what the staffing ratios are, so you don’t know.”
Yet again, we return to the issue of staffing.
