54-year-old Canberra local Jennifer Walton (pictured above) has told the Commission that the aged care and health system failed to provide her mother Avril Walton (pictured below inset) – who died on 19 May this year aged 84 – with adequate access to primary care and rehabilitation services.
For a little over half an hour, the retired public servant – who spent 30 years in the public service including time in the Department of Health in its aged care section – detailed how her mother – who had dementia and a previous hip replacement – had entered residential care in July 2015 but experienced six falls resulting in hospital transfers between November 2016 and August 2017 – a period of 10 months.
Unlike yesterday’s two direct evidence witnesses, Ms Walton was not so much critical of her mother’s facility but the interface between the home and hospital and the lack of understanding among hospital and allied health staff in how to speak to people with dementia.
While her mother suffered some injuries from these falls – including pelvic fractures, a dislocation of her left prosthetic hip and a broken right hip – Ms Walton maintained some of these transfers were unnecessary and caused her mother – who was often unaware of where she was – undue distress.
In one instance after a fall in January 2017, Ms Walton said both staff and herself had checked on her mother and found her to be uninjured, but the facility’s physiotherapist insisted that Mrs Walton be taken to hospital where no injury was found.
Ms Walton put this down to the physiotherapist’s inability to properly communicate with her mother.
“We just had all that time in there that was completely unnecessary, and I did complain to the facility that … they should not have allowed that to happen,” she told Counsel Assisting Brooke Hutchins.
Another time her mother was transferred to hospital by an after-hours GP (her own GP was unavailable).
“I did observe them, after-hours GPs coming into the room and not really addressing Mum,” she said. “So, I would step in and say … Mum has dementia and this is what might happen and wanted to try and frame it for them.”
Ms Walton was also critical of the lack of services in the hospital for people with dementia. After her mother’s fifth fall in March 2017 where she dislocated her left hip, Mrs Walton was finally offered rehabilitation and spent six weeks in a regular rehabilitation unit which improved her health but left her distressed.
In contrast, after the sixth fall in August 2017 where her mother broke her right hip, Mrs Walton was placed in a four-bed orthopaedic unit specifically for people with cognitive problems which Ms Walton said kept her mother calmer and happier.
The Counsel Assisting’s line of questioning also gave insight into where the Commission is heading in its thinking – namely, that hospital-like services should be offered in aged care facilities.
“If there had have been the availability of say an X-ray service to have come and seen your Mum in the facility, do you think that that would have, you know, been a preferable option for her?” Ms Hutchins asked.
“Absolutely,” replied Ms Walton. “And especially, like, you know, because of the environment she’s still in a similar environment with similar people, the people around her, then she would be left agitated by that. You would think that’s a better use of money as well, especially in the situation where you don’t need to go to hospital, because then you don’t go.”
Ms Walton also noted that her mother’s GP would need to write notes and leave prescriptions in her mother’s file because the facility relied on a paper-based system – she wants providers to have electronic systems.
“It’s just logic in this day and age,” she concluded. “It’s beyond my comprehension why they didn’t just have a computer-based system from the start.”
Another ‘vote’ for facilities to have digital record systems in place.