Australia: Lack of staff behind chemical sedation of patients in aged care facilities, royal commission hears - PressFrom - Australia
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AustraliaLack of staff behind chemical sedation of patients in aged care facilities, royal commission hears

13:56  15 may  2019
13:56  15 may  2019 Source:   abc.net.au

Staff ignored requests for heart medicine, aged-care commission hears

Staff ignored requests for heart medicine, aged-care commission hears Darryl Hilda Melchhart, 90, says she faces a "never-ending battle" to be seen as a fully competent adult at the aged-care home where she lives in Melbourne. The former bookkeeper told the Royal Commission into Aged Care Quality and Safety in Sydney on Monday that she was regarded as incompetent and unable to make her own decisions. "My thoughts and wishes are mostly disregarded by some of the staff. And I am treated by some of the staff as if I am a child or have dementia," she said.

Retention and turnover in aged care has been a significant and longstanding problem in the sector, with estimates pegging average annual A lack of career opportunities was also consistently rated by employees in the study as a factor that would make We need a royal commission into Aged care .

The Royal Commission into Aged Care Quality and Safety is a royal commission established on 8 October 2018 by the Australian government pursuant to the Royal Commissions Act 1902. The Honourable Richard Tracey AM RFD QC and Ms Lynelle Briggs AO currently serve as Royal

A nurse has told the Royal Commission into Aged Care, there is no excuse for chemically sedating people and it is often done only because of a lack of staff.

A panel of three nurses and a diversional therapist gave evidence to the commission today, saying their roles were plagued by understaffing and that regularly had to do unpaid overtime.

In answer to a question from counsel assisting Paul Bolster about why chemical restraints were used, registered nurse Elizabeth* said it ultimately came down to not having enough staff.

Dementia patient restrained for '14 hours a day'

Dementia patient restrained for '14 hours a day' An emotional daughter down in tears as she revealed the neglect her father suffered while in a Sydney aged-care facility. Speaking at day two of the Royal Commission into Aged Care in Sydney, Michelle McCulla told how her father Terry Reeve was restrained for up to 14 hours a day. The 72-year-old, who suffers from dementia, deteriorated dramatically during his two-month stay in an aged-care facility, losing weight and becoming incontinent, she said. © 9news Terry Reeve was left restrained for up to 14 hours a day his family have told a Royal Commission into Aged Care.

Commissioners warn nursing homes and government not to try and deter whistleblowers.

Persistent pain is prevalent in aged care facilities and there are a number of barriers that make effective pain management more difficult to achieve Early studies showed a lack of analgesic use in practice, particularly for those with dementia,3 though more recent work suggests this trend may have

Lack of staff behind chemical sedation of patients in aged care facilities, royal commission hears© Provided by ABC News Nurses told the royal commission their roles are plagued by understaffing. "It's really confronting and unsavoury to physically restrain people and I can't think of a time where it should be happening at all," she said.

"Rather than give proper care you sedate people so they're not annoying you and it's not acceptable."

"Chemical restraint ... is an anonymous way of doing it because people come in and everyone looks fine, they're all clean and tidy and they're not crying out, but they're not actually getting the care they need."

Maggie Bain, a diversional therapist, said she had seen daily instances of residents being physically restrained.

'He was drooling ... it wasn't normal': residents strapped to a chair

'He was drooling ... it wasn't normal': residents strapped to a chair The hearings this week are concentrating on residents living with dementia, and to illustrate the widespread use of physical restraints and pharmacological restraints. Ms McCulla and her sister, Natalie Sonya Smith, said they'd seen their father restrained before they signed an authorisation form. They said they found him tied into his chair in a lap belt every time they visited him. © ABC 7.30 Report Terry Reeves was restrained, via blue straps around his waist, in a nursing home for hours. Speaking to the ABC's 7.

The royal commission will not complete its investigation or release its findings until after the For example, there are no enforceable staff -to- patient ratios and aged care facilities receive The crisis in aged care has been further exacerbated by ongoing government funding cuts. Lack of access to critical medical treatment and inadequate levels of care has had devastating consequences.

As GPs our challenge is to provide appropriate care of the highest quality to older people regardless of where they are living. GPs working collaboratively with other health providers play a key role in delivering high quality primary care to older people living in residential aged care settings.

The nurses spoke of shifts where they were run off their feet and doing unpaid overtime — sometimes on a daily basis.

"I was working in an aged care facility where we'd work half an hour unpaid overtime every day and that was so we could have the handover," Elizabeth said.

"We would be doing up to four hours overtime a day just trying to manage the care for people.

"This is when you're doing one [nurse] to 60 [patients] and you've got people with high needs — so people that are dying for example."

Relatives not consulted about medication

A number of the nurses voiced their support for mandated nurse-to-patient ratios.

"If you've got a person [who's fallen], you're completely taken off the floor with that person," assistant in nursing Susan Walton said.

"So your other 39 [residents] ... you don't know if they're wandering, there's people at risk that you're supposed to check, and you can't get to them physically."

Aged residents 'given psychotropic drugs'

Aged residents 'given psychotropic drugs' A resident at an aged care facility in Sydney's northwest was given anti-depressants without being tested for depression, an inquiry has heard.

Outbreaks can occur in aged - care facilities , childcare centres, restaurants and hotels. PDF printable version of Figure 4: Flow chart to guide aged - care facilities actions for managing All staff handling or cleaning soiled linen during an outbreak should use protective equipment to prevent infection.

Other considerations when caring for the sedated patient are the competency and availability of the practitioner The Joint Commission Hospital Anesthesia Care Standards require that the individuals who are Minimal to moderate sedation is a continuum and patient response can be unpredictable.

The commission also heard from pharmacist Dr Juanita Westbury from the Wicking Dementia Research and Education Centre.

Dr Westbury said many relatives she had spoken to were not consulted before their loved one was prescribed a psychotropic medication.

"A lot of them said the first time they found out their relative or their mum or their dad was taking these medications was when they received their pharmacy bill," Dr Westbury said.

"Pharmacists who worked in the sector often said they encountered real resistance to reduce the overall use because a lot of the staff were quite concerned behaviours would return or be escalated if the use was reduced."

The commission has heard numerous stories of over-prescribing of psychotropic or anti-anxiety medications in aged care homes.

Never return home: rise in palliative care patients dying in hospital.
Palliative care-related hospitalisations rose by over 25.6 per cent, between 2012-2013 and 2016-2017, the 'Palliative Care Services in Australia' report found. Over the same period, hospitalisations overall rose by 17.6 per cent. Dying is increasingly becoming institutionalised, with more than half of palliative care hospitalisations ending with the patient’s death in 2017-2018 (51.6 per cent) - up from 42.1 per cent in 2012-2013. Yet surveys have consistently shown the majority of Australians want to die at home.

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