Aged care didn’t need another expensive inquiry to detail its faults

This week Crikey readers wrote to the letters about two major issues facing Australia: the country’s fraught aged care sector — including the greater issues in health legislation for elderly Australians — and allegations of sexual abuse permeating Australia’s political sector.

On aged care and health

Chris Kemp writes: I was an aged care worker for about two years in 2009-10 — sometimes as a personal care worker or assistant, sometimes a nursing assistant. Unable to secure full-time work in my usual employment, my job network provider offered a free “introduction to aged care” course, and I found myself working night shifts in a secure unit in a not-for-profit residential facility.

I would have about 20 residents to care for in a seven-and-a-half-hour shift. All had varying degrees of dementia, many with high-care requirements. Duties included toileting, assisting with meals, changing linen, dressings and continence aids, cleaning, assistance with walking, responding to emergency calls, dispensing medications … the list was long, all the while ensuring the resident’s personal care plan was adhered to.

I was able to contact a registered or endorsed enrolled nurse via phone if required. I found the work to be challenging, emotionally rewarding, and exhausting.

I felt privileged to work with many wonderful carers and nurses. I did, however, always feel vulnerable to criticism as the list of duties was impossible to accomplish. I was to learn that the toxic culture of blame-shifting was pervasive and came at the cost of the residents’ health and well-being.

I might add that the need for higher staff-to-resident ratios, better remuneration and more funding should not require an expensive inquiry.

Jacqueline Wilson-Wilde writes: A recent illness found me in the Frankston Hospital. It’s short-staffed and none too clean, so I’m lucky I’m a fit and independent 75-year-old.

I observed a great deal of cruel and harsh treatment of the elderly. Only one example: an elderly ESL (English as a second language) woman being bullied over bedpans and her screaming during attempts to find a good vein for blood tests. She was told she must get up to move her bowels (she had a blocked bowel and serious infection). It’s uncertain she understood — but nobody cared.

At the shift change I pointed out to the new nurse that if someone could sit and hold her hand while trying to take blood I’m sure she would be calmer. The nurse listened and did as I suggested (just once). It was a success. The lady remained calm and cooperative instead of screaming and refusing.
Time spent: five minutes. Dealing with ESL, loneliness, feelings of helplessness and pain requires very little time and is at the heart of good age care.

I also experienced impatience and rough handling. But I’m lucky. I can firmly point out that they must stop, listen, and point out that a particular procedure was hurting me. Had I not been fit, strong-willed and confident I could have finished up like the ESL lady: helpless and frightened.

We don’t need to throw more and more money at age care. We need a culture change where staff are constant and familiar face. Empathy and understanding is essential for those who are weaker or vulnerable.

Julanne Sweeney writes: I live in Adelaide and I support a change in law for voluntary assisted dying which we hope will be debated early in 2021.

Dying with dignity is another expression for the end of life. Some achieve this through palliative care which is a good choice for them. But politicians who want perfection should accept that intolerable suffering against a dying patient’s expressed wishes should not enter their opposing plan.

In 2005 I witnessed the undignified death of my 94-year-old mother, feisty and independent until her stroke. She had been a registered nurse and had trusted her advance health directive (now voluntary assisted dying) would protect her from a humiliating death. However, due to the existing law she had to decline slowly with no hope of recovery after a massive stroke. By the time she died she could not speak or know her family, who had to return to their distant homes.

I have learnt that Oregon has had assisted dying choice working well for more than 20 years. California and a number of other US states now have much the same legislation. Adults in Canada have this choice in very restricted circumstances. This shows that safeguards are possible and work well.

We see reports of other Australians with money going to Europe to use legally assisted death. Victoria has a voluntary assisted dying law which became operational 18 months ago, as has WA, so the people of South Australia should not be denied the same compassionate choice.

On parliamentary culture

Bob Weis writes: It is not acceptable to just have Scott Morrison and co wring their hands and tut tut while having no intention of dealing with the issues confronting them and the nation. The Trumpian tactic of saying “look over there” that ScoMo has used for dealing with problems is once again on full display.

Any decent leader would tell his minister to go to the backbench or to leave the parliament until all is clear. This is not just an issue for him and parliament. It points to the toxic environment that women have to deal with, in a place which should be a leader to the nation in workplace safety and respect for all. Sadly it is not, and until it is we must call it out in every sphere in which we have a voice.

Claudia Witton: As a formers ministerial staffer for eight or nine years I am well aware of the appalling behaviour of those we elect. I never heard of anyone being sexually assaulted but I am very aware of the bullying and verbal abuse of public servants some politicians engage in, and these are not isolated incidents.

Our biggest problem, as is the case currently, is that people are too scared to come forward. This can be for many reasons including fear of the complaint not being taken seriously, impact on career or loss of employment.

It is also important to acknowledge that it is not only male ministers who bully, abuse and belittle. Female ministers can be just as bad in their interactions with public servants.

Miriam Germein writes: Amber Schultz’s analysis of this case is particularly effective in revealing how sexism and a power imbalance can combine to arm a perpetrator in playing out his fantasies. She reveals the reasons why such behaviours must be called out before young people leave school. No student should leave school without this knowledge — essentially about what constitutes a respectful relationship and how to negotiate that.

With respect to the current case, the PM must act but be closely guided by the law and ensure a respectful process addresses the immediate problem.

Whatever the allegations and however compelling the detail, the accused will be immediately and forever tarnished, as will everyone closely associated with him — most of all his family.

In this instance, justice for the deceased is a long bow to draw. The best outcome would be a radical overhaul of parliamentary culture and national initiatives to address the systemic problem of abusive behaviours in relationships — personal and at work.

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