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Reform in uncaring aged care is needed

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Elderly residents in aged care facilities are suffering from neglect and ill treatment (Image via Pixabay)

The Federal Government isn't doing enough to adequately look after our elderly and reform in aged care is urgently needed, writes Lyn Bender.

‘Any man's death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee.’ ~ John Donne.

Ageism, ableism and the callous market economy have brought the perfect storm to bear on a global pandemic.

In March 2020, my mother’s aged care facility locked down even before the full implications of the global pandemic became apparent in Australia.

It is a traditional response that the institutions set up for aged care shut out visitors if an influenza or gastro outbreak occurs in the vulnerable elderly. So when the global pandemic began to menace Australia, the gate shut on all visitors with a resounding emotional crash. The elderly and infirm were now on their own.

Left to the mercy and the scant care of minimally trained workers and without any mandated ratio of staff carers to residents, the elderly as commodities received the bare minimum of attention.

The Royal Commission had warned us with its Interim Report titled Neglect:

‘The Royal Commission into Aged Care Quality and Safety’s Interim Report has found the aged care system fails to meet the needs of its older, vulnerable, citizens. It does not deliver uniformly safe and quality care, is unkind and uncaring towards older people and, in too many instances, it neglects them.’

But their recommendations have not been heeded or implemented. It can be difficult to prove that neglect may have contributed to an earlier death of those in ‘God’s Waiting Room’.

By definition, they are at the end of the line. As dementia reduces their capacity to be enticed by food and fluids, their slow decline can be attributed to their age. Overmedicated and unattended, they are subject to falls. The food that is frequently unsuitable and unappetising may be delivered on a tray at their bedside or laid on the table before them. The small number of staff have little or no time to encourage eating and drinking or to even check on the resident’s capacity to swallow. The plates, often barely touched, will be hastily collected to facilitate other staff duties.

I am intimately aware of the shortcomings of this care as I and my siblings visited my mother in a daily roster over six years. I was a desperate advocate and an observer of a system of deficits and sometimes cruel indifference.

It is easy to dismiss the complaints of cognitively and physically challenged “consumers”. When they complain that no one has answered their bell, this is denied. If they call repeatedly their bell may be switched off. “I switched off her bell,” a care attendant bragged, smiling.

When they stare blankly at the plate or swirl the mush around with their spoon, the residents may be seen as children not wanting their dinner, despite it being common with dementia to not be able to identify what they are seeing on the plate.

It is only since the pandemic that the full extent of the disaster that is aged care has been exposed. People are abandoned and isolated in their rooms with no attention to their emotional needs. There is little to stimulate them other than a television, the content of which is too fast and incomprehensible. They are left to die alone. Doctors are using telehealth to diagnose and treat the sight and hearing-impaired patients who can’t relate to a FaceTime call.

I and many of the relatives – perhaps our whole society – are left with unresolvable grief. Like Shakespeare’s Lady Macbeth, we cannot wash our hands clean of guilt.

This is how we treat our vulnerable people. We shut them away.

 We are rightly recognising the impact of isolation and loneliness in the general community. Attention is being given to those who live alone. I am fortunate. At 72, I am still able and mobile, but the joy of being able to see one of my children as a bubble person has been priceless.

We don’t price love into institutionalised aged care.

As reported by Ray Bricknell in ‘Pearls and Irritations’: ‘Aged care has become a property play’. The lucrative residents’ bonds, worth millions, are invested in property, not in patient care.

When I was allowed to visit my dying mother for 30 minutes in April, I noted that no staff wore masks. One of the attendants said that she had been infected by the coronavirus. As far as I could tell, social distancing amongst staff was haphazard.

I was lucky. I was able to say goodbye. My mother was in a morphine fog but I saw her body relax and exhale as I spoke to her. I am grateful for the years of unrestricted time I was able to have with her.

My plea is for visits for all aged care residents.

The easing of restrictions in Melbourne allows two hours a day for family, but will aged care comply?

The residents are dying broken-hearted. The elderly are not being emotionally supported in these institutions that have always regarded them as a commodity and sources of profit. I have witnessed inappropriate medication being used to deal with “behavioural issues”. It is a substitute for appropriately skilled staff. 

Thanks to the deregulation of aged care under the Howard Government’s Aged Care Act 1997, there are no mandated nursing or staff ratios.

There is much that needs to happen in terms of reform. But as I write this, the elderly languish in their confusion and abandonment. Has anyone asked the aged, “R U OK”?

Over the years, I got to know many residents. They remain frozen images in my memory. How are they surviving in this uncaring emotional desert? Who is even listening or talking to them? They each have names. They are not just the room numbers stitched to their clothing. They each have stories. They each long for emotional connection. They have feelings. They suffer.

But who even knows them in these ironically named “homes” as they struggle to know and hold onto who they are?

Aged care providers could enable family visits immediately.

But perhaps they prefer the invisibility and lack of accountability that lockdown affords them. I am fully in favour of the current lockdown in my city of Melbourne and state of Victoria. The global pandemic raging in Britain and America confirms the wisdom of our State Government’s plan. However, aged care has been a profit-driven debacle and tragedy that has evolved into a catastrophe. It has failed to do its job of providing care. There was no COVID-19 plan for aged care. The Royal Commission Interim Report cited aged care as ‘a shocking tale of neglect’.

My mother fled Poland and Nazi persecution. She did not deserve to live her last three weeks alone.

I hoped that the lockdown in aged care would keep her and other residents safe. But the high COVID-19 death toll in aged care tells another story. Aged care in Australia has incurred most of the deaths. It is a federal responsibility and a Federal Government horror. They are failing to protect our elders.

It is literally a crying shame.

Lyn Bender is a professional psychologist. You can follow Lyn on Twitter @Lynestel.

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