Jun 11, 2020

Medication Cowboys: A Law Unto Themselves


The topic of unqualified personal care workers administering medication has made headlines for all the wrong reasons in recent weeks, and it appears that this issue may be far more widespread than many are willing to imagine.

HelloCare were inundated with stories from families and staff members who wished to share their own personal experiences regarding this issue, one of which was a registered nurse by the name of Carol* wanted to illustrate the lack of effective safeguards for elderly people who don’t have family members advocating for their wellbeing.

“I worked as a hospital-in-the-home-nurse, and one of my patients happened to be an elderly woman who lived in Melbourne,”

“This woman was very frail and had no living family following the death of her husband, she also happened to be very wealthy. There was a Guardian appointed to manage her funds from a distance and they had organised for this woman to receive 24-hour care, seven days a week, through a private agency.”

Carol revealed that as well as living with dementia, the woman was also a diabetic who was “supposed to be” responsible for assessing her own blood-sugar levels and administering her own insulin.

A rotating roster of personal care workers was assigned to care for this woman’s day-to-day needs, but none of them had the authority or qualifications to administer her medication or insulin.

The personal care workers were originally hired to just observe the patient whilst she managed her medication and insulin herself.

The home care agency had been caring for this lady for many years and admittedly they were very familiar with her care needs.

But, maybe a little too familiar.

Upon arriving at the patient’s home one day, Carol was shocked to find the patient barely conscious. She then turned her attention to one of her patient’s personal care workers and was horrified at what she learned.

“I was trying to figure out what the hell was going on. The poor woman’s blood-sugar levels were so low they were basically in her boots,” said Carol.

“Looking at her, I knew there was no way that she was safely drawing her own insulin or checking her own levels, so I approached the carer that was there at the time and I began asking some questions.”

“After talking in circles for a while, the carer revealed that because of the patient’s deterioration she and her fellow personal care workers had taken over the role of checking her blood sugar levels now, and they had also started administering her insulin injections.”

“Instead of notifying the home care agency they worked for that the patient was getting worse and that she could no longer manage the insulin herself, the personal carer workers started administering the injections for her. Which was totally outside their scope of practice.”

According to Carol, some home and community care providers are a “law unto themselves” with minimal clinical oversight of their teams going out into the community caring for the vulnerable elderly. 

There is a concerning lack of accountability from some home-care providers and case managers who are increasingly willing to fulfill the demand for services but take on minimal accountability and oversight for the quality of their workforce.

“This company would have been receiving somewhere around $160k per year to care for this woman. Yet despite having multiple people specifically assigned to protect this woman’s wellbeing they still couldn’t do it.”

Many people who have loved ones that require care believe that their continued presence is one of the only ways to ensure that their family member receives the care that they need.

Sadly, a significant portion of older Australians who are utilising aged care services don’t have a family member present in their lives. This means that their quality of life hinges on the success of an aged care system that is currently in the midst of a Royal Commission.

“Had I not been assigned to this patient through the hospital, nobody would have known what was going on,” said Carol.

“The biggest issues arise when there is no family to pay attention because they are the most effective safeguard. In this instance, we had a very wealthy woman with no family, and to me, it felt like the provider was just taking advantage of her.”

“Home care is like the wild west in this country. This industry is crawling with cowboys who are looking to make a fast buck and take no responsibility for the quality of their services. You need to weed the good out from the bad. Because there are some good – you just need to find them.”

“When all the money in the world fails to purchase quality care, it becomes pretty damn clear that this system needs a total and complete overhaul.”



Photo Credit – iStock – Daniel Chetroni

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