Nursing Home care in Qld fails basic standards

The Courier Mail today ran a story about the poor standards of some nursing homes in Queensland - I am sure the same could be said for nursing homes across Australia.  It is appalling.  I have been incensed that our governments spend so much money on education, and totally neglect the older members of our communities.    It has been something that I have been talking about for a long time - it is hard.  It is hard because one doesn't know that the conditions of your family member is mirrored elsewhere.


Someone suggested we move our mother.  What?  Despite what we see as her neglect, SHE is somewhat happy and doesn't want another move.  We have already moved her in a failed attempt to find better.  It was better - but that was in the early days.  Family members do fear speaking up lest their relative is badly treated as a result.  Staff often do their best - but there is often a lack of training, a lack of staff, a lack of good direction from their superiors and cutting costs at all levels.


Read the article here.

http://www.couriermail.com.au/news/how-aged-care-fails-the-test/comments-e6freon6-1226212749037

Mixed Emotions

We are so proud of our parents (my sister and I) as they have had (until recent times) a good long life.  Certainly had its challenges at times, but they are stoic and determined and have done pretty well.

But in their declining years, the challenges really make life difficult.  Mum is physically fit, but dementia has claimed her.  She now lives in a nursing home, completely happy as all is done for her, and she lives our days out doing very little, but considering herself very busy working for the government.  She told me a few days ago that she was at the races at nearby Seacliff racetrack (there may have been a racetrack there, but it would have been 70 years ago), and that she was telling someone (her grand daughter) that she was pregnant. (We've had a good laugh at that - even she thought it was funny.)

Dad on the other hand, who was until a few weeks ago living in their unit right next door to the nursing home, was mentally alert, but physically going down hill.  He's weathered cancer and complications from the medication, but in the end it was more depression, and his heart that made it impossible to continue living at home.

He has had several 'heart attacks' and is clearly depressed - and other than make him as comfortable as possible, there is little else that can be done.  He is 92 in a couple of weeks time.

He has been in and out of hospital for the last three weeks and keen to go to a nursing home - though not to the one where mother is.  There was a vacant bed next to mum, but we knew that constant bickering would get them both 'down'.  Dad always argues with mum - as he contradicts her, and tell her that the stories she relates are not true.  Result?  Massive tension between the two.

While many who know dad consider that mentally he is ok - well, he is to some degree, and you can have a more sensible conversation with him, than with mum, but he repeats himself over and over and over, and is in denial about his situation.  Despite the advice he's been given he can never allow mum to talk about the fantasy life she is living.  The disputes are uncomfortable to witness.

His preferred aged care home has no vacancy, and he had to be discharged from the hospital, so after much 'mucking around' we found a bed for him, quite close to where he has lived most of his life, and consequently not far from his shrinking circle of friends.

When I saw it the other day I saw quite a few reasonable alert people around, and was assured that the were some guys who were mentally alert, but he's already depressed about the place.  He saw all the 'oldies' sitting in their wheelchairs watching television, and he and my sister have agreed that it is not suitable for him.

OMG!  As one that has been frequently in these places as a visitor and as an aged care trainer in the past, I saw the establishment as one of the best I have seen.  It was relatively new, open and clean and surrounded by gardens.

All Dad and my sister have seen is the old people - and dad doesn't want to associate with them.  In fact he doesn't have to but he might be there for several weeks, or even months until there is a vacancy.

The reality is that dad is declining, and fairly fast if he does not manage to 'pull himself out of it' - and the depression is what is causing the problem. 

He cannot accept that his longevity, along with his health issues, renders him pretty much like the others in such places.  He sees himself (and it is not snobbery as such) as being better than the others.  He doesn't see the old man that he is.

Well, I am back in Brisbane.  I did all I could do in the five days I had in Adelaide, and I'd love to have done more but it was a rush to do everything as it was.

I am sure the fear of his days ending sometime soon, is what is behind the depression, and he worries about our mother, who is incredibly comfortable where she is.  Family members will continue to keep visiting them. 

We will try to do the best for them both.  It is hard on everyone - and especially them, although mum worries not about it.  Dad is (and always has been) the worrier.

Fear of Ageing

I am sure we all fear the last few years of our lives - fear of the unknown really as we don't know how our own bodies and minds are going to behave in our twilight years. 

My father, at almost 92, is an independent cuss, whose live nearly ended 12 years ago when he was given 24 hours to live - and somehow miraculoulsy survived, for which we are very grateful.  I remember at the time my mother's reaction as he lay dying - she really had had enough I think.  He was typical male - and made most decisions - often wisely, but she had lost her own independence many years before.  He berated her frequently, and I suspect his behaviour contrinuted to her downward spiral mentally.

She had some 15 years ago wanted to move into a 'retirement facility' - just a small unit, similar to what they were living in, but with support and people around.  Mum had no where to go, no one to talk to, unless Dad took her, and he was such a nice guy to everyone else that he was always made a fuss of, and often stayed at the events that Mum had thought she could get some peace away from him.  These occurrences continually aggravated here.

He dominated her life in every way.  Mentally she went downhill quickly and he beratd her more.  He cared for her though - and it was he who cooked the meals and did much of the housework.  Last year, he became ill (though we know now that it was more 'panic attack' than anything as he was suddenly overwhelmed by all he had to do - and the continual bickering (often instigated by him) got him down and he was taken to hospital.  It was clear he was unable to manage our mother, so she went to a nursing home.

As it was right next door to their unit - he felt it was the right thing to stay there.  He was still driving though didn't go far.  I could never understand how his doctor would see him as still fit to drive, but he managed without any accidents. 

Clearly though in the last year, he was failing.  It came to a head recently when he 'collapsed' - actually another panic attack, and he was hospitalised.  He was discharged - and on talking to him I deduced that he really was not fit to beon his own, but he had rejected all support except regular home visits by an aged care organisation.

My sister took time off work to keep an eye on him, but she was looking after her daughters home and animals on the other side of the city, and I was in Brisbane - not easily able to go to Adelaide.  (Even if I had wanted to go - the volcanic ash from Chile would have interrupted any travel plans)

My sister called to make sure he ate properly, and she gave him his medication.  He was so confused he needed someone to do this for him.  So this man thinks he can now live alone???

My sister had been with him most of yesterday and, according to his wishes arranged for home help, - someone to visit every day - check that he had meals, and that he was taking his medication.  I spoke with him about 1 pm - he was feeling fine, he said.  In fact he sounded quite bright and confident everything would work out.  (His breathing bothered me - there were signs of breathlessness I could hear).  My sister left for a short time to do some shopping for him, but while he was away the home care folk to confirm arrangements and Dad broke down.  He told the lady that he could not manage and could not breathe properly, so she called the ambulance and then contacted my sister.

He was taken to Ashford Hospital in Adelaide, but a few hours later he was transferred to Glenelg Hospital.  He has now accepted that he will never go home and that he will have to go to some aged care facility.  He refuses to go to the same place Mum is - creating quite a dilemma for us - my sister will now have two places to visit on a regular basis.

I can understand how he was reluctant to go to a facility - my experience is that they are unhappy places - God's waiting rooms - and I have no doubt that he will go downhill quickly.

Meanwhile my mother is oblivous to all that is going on.  She doesn't seem to notice that she has not seen Bob for a while. She will be 96 this year and physically is ok. 

I don't know the answer, but I know that as a community we are not providing well for our ageing population.  I know it is often a finance issue, and I know older people are pigheaded and won't make the changes that they need to.  If Mum and Dad had moved when she wanted to, into a facility that had a nursing home attached/associated with it, they would both have had more peace of mind.

It is hard.  I wonder how I will react as I get older?

Who Cares?

The Courier Mail (Wednesday December 15th) front page covers the story with graphic photograph of the 70 year old father, and the 36 year old Downs syndrome daughter, and his search for full time appropriate care for his daughter who cannot manage alone.  His wife, who died in September was her carer, but now it is left to this 70 year old man, who knows that he cannot continue for ever.

There is a huge shortage of housing for ageing people, and especially those with a disability.  There are over 14,000 on a waiting list in Queensland alone, with little hope of receiving the appropriate accommodation and care for them.

It appears the government is not doing enough about it - and the not-for-profit organisations are lagging, in part because it is a high cost service.  As well, there are few carers available - a great shortage of them.

Sad but true.  When will our governments and spend more money on such things rather than sports and casinos??

The elders in China.

I read this on the website for China Daily.

"Elderly entering old age without support of kids

GUANGZHOU - A recent study of the elderly in parts of Guangdong province, in southern China, has shown that the tradition of children supporting their aged parents is slowly fading away.

The survey of nearly 1,300 people aged 60 or above, living in urban areas, found that, more and more, the elderly are living by themselves and are instead providing financial support to their adult children."

You can read the full article here. China Daily Report 

In old China where there were big families, often the oldest daughter looked after the parents, and her siblings helped support them.  But now with only small families, themselves struggling in a very competitive world, the parents are left to fend for themselves, or as I saw when in China, the grandparents have become full time carers for their children.

Having parents and grandparents in charge of their discipline has interesting consequences, and often the grandparents are blamed if the child becomes spoiled and demanding.

Like Australia, the large number of elderly people are causing the government concern.

Get me out of here!!!

Mum had been very happy for four or five days and Dad was feeling less guilty about it all - but today when he called to see her, she had all her belongings in plastic bags and was sitting waiting to be taken home and was very cranky when she learned that she would not be going home.  Dad had to get help from the sister in charge, who put her arm around Mum's shoulder and lead her back to her room.  

Sadly Mum's room mate is a lady who is unable to communicate - she lies in bed and does not talk and needs someone to feed and do everything for her.  If only Mum had some company in her room - but that is not to be at the moment.

Dad speaks very highly of the staff - in fact  says their care is 200% - he is very happy with the way Mum is being cared for, but always when I speak with him expresses his feelings of guilt at having to leave her in care. 

Mum's Story continued

Following the ACAT assessment, which classified my mother as needing full time dementia care, we set about finding a suitable aged care facility. It was not easy. There was an "offer" by a "professional" aged care facility seeker, but it was going to cost $600. Perhaps ideal for someone who did not have the time/expertise to do the research, but I had the time, and set about the search via the Internet. I was in Queensland and my parents in South Australia, but thanks to the Internet it was not terribly difficult to access a number of sites. As it turns out, I could not proceed until I had the ACAT report, and we did not have it at the time.

Luckily Mum was found a "respite" place at a home around Morphetville, and with the aid of a cousin and her husband, Mum was taken. We knew it would be too difficult for Dad to do it, and Mum was not willing to go, so an "independent" was needed and Mum went for a holiday. The dementia increased, she hated it there, and my sister was not happy with it either, even though she had been to see the place before Mum was placed there.

One problem was that we were all having difficulties facing the fact that Mum needed this type of care, that she was no longer able to remain in her own home, and we all felt guilty. It was easier for me - as I was in Brisbane, but my sister and Dad had to deal with Mum's anger on a daily basis when they visited. In the end the hunt was on for somewhere else.

Initially Dad had indicated that he too would like to go into care too - but in the end the ACAT assessment did not indicate that he needed care. I sent off many requests for information/application, and my sister and I spent ages trying to sort through the myriads of information that came our way, and then Dad suddenly realised that as HE did not need care, perhaps Mum could go to the aged care facility right next door to where they lived. It did help that Mum and Dad had been good neighbours and Dad was quite well known to them.

And so it was that he orchestrated the move to the home right next door - though Mum does not know it.

She is settled some days, and others she is quite off the mark. When I phoned one day she told me she couldn't speak to me as she was in the city waiting for a taxi. Clearly not the case as we were speaking on the nursing home phone. I have spoken to her several times and she seems lucid, but then will say something that is clearly not true.

Dad is managing on his own - and Mum says he "walks all the way" to see her, not realizing that it is right next door.

She does go on outings with the nursing home and loves it.

Dad on the other hand is very lonely. Despite her dementia she was company for him.

In retrospect, we wish our parents were not so keen to remain in their own home for so long.  Mum had wanted to go to a retirement village setting a long time ago, but Dad did not want to give up his own home.   It was a dividing issue for them for a long time.  Mum did not drive and where they lived was not convenient to public transport and Mum became quite isolated - if she wanted to go somewhere, she had to get Dad to take her, and pick her up. She lost her independence, and the issue of transport/access to social activities for her was one that raised its ugly head from time to time.

Dad continued to play bowls with his mates (although they were dwindling) until the last year or so, when I could not leave Mum alone.  Luckily he was able to meet with his mates occasionally, but Mum no longer found anything she wanted to do.  Her friends were all departing this world too.

I have got to think there must be a better aged care model that we have right now.  As we are all ageing, we need to look closely at the alternatives for care for us in the future.

Tribute to my parents

My parents have outlived all their family members - my mother is almost 95, and probably has a sister still alive, though she is younger than my mother and has been in a nursing home in Western Australia for many years.  My father is 91, and until recently was my mother's carer.  They both enjoy pretty good physical health, but in recent years dementia has claimed my mother.  She is amazing really, and despite being rather strange most of the time, can pull herself out of it.  I've taken her to the doctor at a time when she was completely "strange" and she's sat in front of him and virtually convinced him that it was everyone else.  (It turns out that he had a major health problem that we suspect made him unable to see what was going on!)

My father has remained somewhat active - he still drives a car, though most of the family think he should have given that up a long time ago.  (riding in the car with his is scary!)  He still likes to play bowls, though, due to his care commitments with our mother, he's had very little opportunity to particpate in bowls.  Until recent years he'd been an active member of Lions International.  He still likes to read, but he's been quite confined to home for some time as my mother found it difficult to go out.

Until recently they would go on a monthly bus tour around Adelaide, but Mum was unable to get into a bus easily.  She found it hard to get into a car too, and did so with difficulty.  Eventually Mum found it just too hard to do, so one of their regular outings was eliminated from their activities - anyway Dad found it challenging as often he was the only male on the bus - and while he has been always good with the ladies, he rather enjoyed the company of guys.  

They have lived for the last 20 + years in their little unit in the southern suburbs of Adelaide.  Mum until recently had been involved with the local church, but her enthusiasm faded when the new rector introduced the modern singing in the church, and the old traditional ways of the Anglican Church were traded for the new trendy mode of attracting folk to the church.  Mum was not impressed.

Their neighbours have been OK - but only one in those years have they found to be very friendly with - a single lady who eventually moved into other care as her eye sight diminished.  In any case Mum and Dad would have liked friends their own age - but in the end they spent their days saying good bye at funerals as others left this world.  

Mum and Dad didn't like going to the movies.  I remember taking them to see "Australia" with Nicole Kidman and Hugh Jackman, which they did enjoy, but the audio was too loud for them.  Something that a lot of older people complain about at the movies, I've found.  Actually even I have often found the sound too loud.  Do movie theatres know they do that?

For the last two years my father has been my mother's full time carer.  He's done all the cooking, much of the washing, and they've had a lady come in to do the housework and take Mum out for a few hours so that Dad could do a few things alone.  Mum thought she did it all - how else would it all be done?  She'd talk about how busy she had been cooking and cleaning, but the reality is that she did none of it.  Dad was amazing.

Mum liked her wine - and Dad found it easy to indulge her.  Even drinking in the morning.  If Mum was "thirsty" she'd look for wine.  Coffee or tea no longer quenched her thirst, and we'd laugh as she'd have a glass of wine for morning tea, then lunch, and to Dad's joy would doze off in her armchair for much of the afternoon, and he could read or watch TV or doze off himself.  Mum insisted on going to bed early - and Dad went too - but he would lay in bed awake or read.  He valued his radio and would listen to the ABC all through the night sometimes.

Two or three days a week they would go out to lunch - Warradale Hotel, or Morphett Arms Hotel were their favourites.  Mum would always complain, but then say she enjoyed it.  Pretty hard to deal with on a daily basis, but that's the way it was.

Dad had already told my sister and I that he was finding it difficult to manage with Mum, and we'd set about finding her care, knowing that she flatly refused to leave home.  It was very hard to do - to get her out of the house, but in the end, with some trickery it was done.

The first step was an assessment by the ACAT team.  It is normally an annual event, and she was due around the end of October, but we managed to get them to reconsider and make it earlier.

Inspired by Sir Michael Parkinson

I've been reading Parky, the autobiography of Sr Michael Parkinson, and towards the end of his book he talks about ageing, and his work with a program called Ageing with Dignity in the UK.  I've done quite a bit of research on my own, as the topic has been of interest to me for many years.

I remember that in my nursing days (when I was a teenager training in Mt Gambier, South Australia) how concerned I was about ageing.  At the time we had many "patients" in residence in the hospital, as there was limited aged care outside of this establishment, and there were many folk there for the duration of the rest of their lives.  It certainly was not a good place for aged care, they were fed, washed, and kept as comfortable as we could make them, but it was a pretty awful existence for them.

I recall stating that I would "do away with myself" when I reached 40 - that seemed a good age to me, and so, so far away from my tender years.  Clearly by the time I reached 40, I had changed my mind, but it has always had an impact on me, that older people were not cared for very well.

Some years ago, a friend was "graced" with government housing - and she is still there, in a pokey little house that is dark, too small even for one person, and very gloomy.  Not only is it small and miserable, but there is no on-site care, and my friend, despite her disability, has often been called upon to help residents there, as she is more able than many of the residents there.  The establishment is a block of pokey 'units' on a busy street corner, with low fences and prone to unwelcome visits by drunks and other low life, and hardly comfortable and secure for the residents.  I have always been appalled at the treatment of our elderly by our government, but unless and until, younger people seek better accommodation and services for the senior members of our community, we will all find ourselves living in such situations.

And if you have every tried to find aged care accommodation for a family member, or care for a younger member of the family who is/has become frail and needing care, you will see how disadvantaged this group of people are.  You will learn how difficult it is to find one's way through the maze of red tape and garbage.  Very frustrating and long winded.  And to find the in the end the accommodation is pretty basic. 


Here is the video with Sir Michael Parkinson.