I was pleased to see your article in Senior News and hope I can contribute something to help solve the problems you obviously know exist.
My wife has been confined to a wheelchair for almost 5 years in the high care section of our Gold Coast retirement village.
During those years I have visited her each afternoon, for about 3 hours, with few missed days. This has enabled me to gain some insight into the management of, as well as the shortcomings of, this care institution.
I have no reason to believe it is exceptional, other than the fact that it did earn itself a period of sanctions imposed by AACQA. A very enlightening time, of which more follows.
I attempted to handle the shortcomings progressively, firstly by complaints to EENs, RNs, etc., then through QADA (now ADA Australia) to AACQA, also through the local Federal member to MHR Ken Wyatt. A fruitless approach was also made to Senator Derryn Hinch.
It was all frustrating, despite leading, I truly believe – along with other residents’ actions – to sanctions being imposed about 2 years ago.
There was much activity – inspectors galore, dining room furniture changed to most residents’ dissatisfactions, crockery changed, much painting and other minor infrastructure alterations. None of which really altered the nursing care shortcomings, although there were probably improvements in record keeping and other administrative matters that I knew nothing about.
From all this I learned something which I consider is at the base of all that is wrong with aged care: there is nothing or no one able to ensure adequate staffing levels. I did not realise this until discussing with the AACQQA inspectors and ADA Australia.
The problem my wife encounters daily in getting transferred between toilet or bed is that this requires two nursing assistants to be available. There are periods during the day at shift changes and rest breaks when only one is free. This means a wait of 30 or 40 minutes on many occasions. I was told they had no authority to question staffing. And I can’t find anyone who has!
Leaving my wife’s problem aside; it seems to me that most of the problems I have heard raised at resident and relatives meetings are justified but when “solved” it has been a case of “shifting the deck chairs on the Titanic” and never – as far as I can tell – involved additional staff.
The ultimate result is that the AINs have to virtually run between rooms at times, or choose to let some aspect of care lapse. This is not fair for them or the residents, yet it is difficult, maybe impossible, to collect the evidence on each occasion to show that more staff was needed, and to repeat it enough times to enable government agencies to question the complaints. And then they cannot enforce a change.
Such situations bring into focus the area of aged care nursing which is most in need of legislated inspection, with sanctions imposed when necessary – the loss of income from empty beds is a wonderful way of getting the owner’s attention.
They also need to have a rigid, structured, legally enforceable, national method of collecting complaints data.
Care is intangible, unlike infrastructure which can be easily specified and examined. It seems to me care is best measured by its absence and that lack of care needs capturing on record as it occurs or it remains intangible too.
A job for the digital world when asked by the Department of Health.
In today’s world of computerisation and programming, this is not difficult but obviously needs a high degree of consultation with all stakeholders and initiation at Federal level.
I have made overtures to ADA who, while liking the idea of data collection, seemed to baulk at selling it. I will keep trying.