Sydney hearing – dementia care week 1
From 6-17 May the Royal Commission heard evidence in Sydney from families, carers and people living with dementia in residential care. The evidence was presented through a range of case studies, telling the stories of individuals with dementia from the perspective of the person, their loved ones, carers and providers.
The stories included that of a wife who admitted her husband for 60 days of respite care only to find his condition had significantly deteriorated at the end of the period of care – including a loss of speech and continence. The evidence pointed to questionable use of chemical and physical restraint. Another case study highlighted the dilemma of balancing dignity of risk with safety through the story of a resident being injured while in respite care.
One of the most emotional stories concerned the death of Mrs DE four weeks after entering permanent care at BUPA’s Willoughby facility with declining health and dementia. Mrs DE’s daughters described being concerned their mother was not being fed properly, her glasses and hearing aids going missing and that they were not adequately informed of their mother’s deteriorating health. Senior Counsel assisting the Commission put that the evidence supported a finding that Mrs DE’s care fell short of an acceptable standard across a range of areas, including failing to have an end of life plan in place.
The second week featured a panel of aged care workers answering questions about the daily challenges providing care in RACFs. On the panel were three ANMF members, a nurse and two AINs. Other witnesses included Professor Joseph Ibrahim who gave extensive and forceful evidence about the shortcomings of the aged care system, particularly for those people with dementia. He told the Commission that there is widespread lack of care, lack of oversight, inappropriate use of chemical and physical restraint and inadequate training of staff delivering dementia care.
ANMF dementia care submission
The ANMF provided a submission which drew on the ANMF National Aged Care Survey 2019. Members told us about their feelings of frustration and sadness about not having enough time to provide the care they would like. Others told of their distress about not having adequate resources available to support residents – such as poor quality continence pads.
The ANMF submission addresses the problems faced in providing dementia care in RACF’s including the lack of mandated staffing levels and skills mix, lack of training, workforce challenges, issues with occupational violence and aggression, understanding the complexity of health issues associated with dementia and the use of chemical and physical restraint. The submission then sets out what the ANMF considers are the features of best practice dementia care. These include providing a trained, stable workforce, nurse-led practice, purpose built dementia care facilities and person-centred care that acknowledges diversity and individual needs.
Next round of hearings
The next hearings will take place in Broome between 17-19 June focussing on care in remote areas and the unique care needs of Indigenous Australians and then move to Perth between 24-28 June when the Commission will inquire into advanced care planning and palliative care services. A Community Forum will be held on 19 June in Broome.
You can contact ANMF (Vic Branch) confidentially for urgent issues in relation to the Royal Commission.