The Royal Commission into Aged Care Quality and Safety touched down in Cairns on Monday providing those in Far North Queensland with the chance to share their stories and offer possible solutions to a number of the issues currently being faced in the Australian aged care sector.
Unfortunately, the vast majority of Aged Care Royal Commission hearings have been littered with harrowing personal stories of elderly neglect, and yesterday proved to be no different as Johanna Aalberts-Henderson, a nurse of 30 years, gave a very sad and graphic account of her mother’s rapid decline in residential aged care.
Johanna’s 87-year-old mother, Bertha Aalberts, entered a culturally specific Dutch styled aged care facility in May 2018 after learning that the current home-care waiting list could leave her without care for up to a year.
Despite being mentally cognisant and physically continent, only three months after initially entering aged care Bertha Aalberts was dead, and her daughter Johanna believes that her death was the result of a series of failures regarding her mother’s wound care, staff training, and nutrition.
Within two-days of first moving into her aged care facility, Mrs. Aalberts had the first of three serious falls, the last of which resulted in a broken arm and a large haematoma on her right shin.
Sadly, these injuries marked the beginning of a rapid health decline for Mrs. Aalberts as the following months saw her develop a series of pressure ulcers, and a lack of staffing forced the 87-year-old to have to defecate in adult nappies because there was often no one to take her to the toilet.
Eventually, Mrs. Aalberts was moved to a hospital where the staff were shocked to see that a horrific 14-centimeter leg wound on her shin was still stuffed with gauze as they removed the dressing from her leg.
The family of Bertha Aalberts made the decision not to return their mother to the aged care facility, but sadly, only 12 days later, on August 19, 2018, she died in hospital as a result of her untreated ulcers and skin infections.
The Avondrust Village aged-care facility where Mrs. Aalberts lived was also home to 65 other high-needs aged care residents, but there was only one registered nurse actually on site at the home for 7 hours a day, and rosters showed that registered nurses were actually on-call, rather than on-site for the majority of the day.
Despite the severity of Mrs. Aalberts injuries, the nursing home had no record of the wounds sustained during her fall even though documentation was sent through to the facility from doctors and the hospital itself.
The residential services general manager representing the Avondrust facility at the Royal Commission, Robert Van Durren, conceded that a wound specialist should have been engaged earlier and could not offer any explanation as to why this did not happen.
Mr. Van Durren also failed to explain why personal carers were left to monitor and apply pressure bandaging to the wound instead of registered nurses when the severity and increasing volume of the injury called for more clinical expertise.
Mrs. Aalberts lost seven kilograms in her short stay in the Avondrust aged care home and was unable to feed herself due to the broken arm that she suffered from one of her initial falls. It was also reported that staff failed to provide her with the nutritional supplements that had been recommended as well as failing to respect her wishes regarding a vegetarian diet.
Robert van Duuren said that notes indicate that staff had tried to assist Mrs. Aalberts to eat, although he acknowledged that the facility could have charted what “she did and did not eat”.
Senior counsel assisting the commission, Peter Rozen, said that the Avondrust facility had passed all 44 quality outcomes in an audit performed only one month before Mrs Aalberts arrival, but only 10 days after her death, the facility was sanctioned by the federal department of Health for placing the health of Mrs. Aalberts and 13 other residents at risk.
Johanna Aalberts-Henderson’s statements regarding the abhorrent treatment and neglect that resulted in the death of her mother served as a stark reminder of how completely shambolic the process of delivering care can be when hard working-staff are forced to deliver care while facing inadequate time constraints
“My anger and sorrow is in the manner of her death,” Ms. Aalberts-Henderson said.
“In the days leading up to her death, she was in pain every time she moved her legs, I can’t unhear her cries and unsee what I saw.”
“She would be crying, saying, ‘My back is so sore, my bottom is so sore.”
In addition to dealing with the circumstances that directly resulted in her mother’s death, Johanna also highlighted a number of other issues affected her health and her personal dignity.
“How you feed someone that food and expect them to get sustenance out of it I just don’t know,” Ms. Aalberts-Henderson said.
“Mum was put into an adult diaper and one nurse said, ‘Just poo in your pants’, which was just very undignified for my dignified mother, and in a way putting a continent person into diapers infantilises them. For what purpose? It’s inhumane.”