The Royal Commission

The Royal Commission into Aged Care Quality and Safety released an interim report yesterday. The document is a sad reflection of the horrific evidence of cruelty and incompetence presented to that inquiry since its establishment by Scott Morrison last September. This is the most important royal commission to have been called for decades and credit must be given to the ABC for exposés that gave the Prime Minister no choice but to act. Over the past two years, I did read about but couldn’t bring myself to watch any of the undercover footage that has been broadcast proving abuse at various “homes.” The thoughts of everyone who did watch or learn about such assaults turned instinctively to their own beloved elderly. That substitution made it heartbreaking and enraging. But when the commission condemns “the system” for having been so demonstrably “unkind and uncaring,” I fear it veers disturbingly close to saying – in unison with Theodore Dalrymple’s infamous murderer patient – “The Knife Went In.” A “system” is not responsible for anything. It cannot be kind and caring. Or are the commissioners prescinding from a more confronting morality to let us all off the hook?

Pointing the finger is usually discouraged during a ‘national conversation’ of this kind but provided you’re pointing at the actual problem and not trying to make somebody else feel guilty, there is no reason to holster it. The truth is we have grown less and less personally committed to the care of the elderly. Anglophones are a rarity in some of these institutions. Prestige-wise, it’s fair to say most native-born Australians do not value the work at all. There can be selfishness behind putting a loved one “into care” – our “lifestyle” comes first – but mostly it’s a pragmatic decision or a medically necessary one. We’re busy, after all, and looking after the old – to a generation that has never known an extended family – is one of the things the state is ‘supposed’ to do. This morning’s press coverage on the commission report emphasises increased funding (of course), better training and more rigorous accountability. These might even do a lot of good but I doubt they will do much to salve the unmeasurable despondency to be found in these “homes” that aren’t.

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28 Responses to The Royal Commission

  1. stackja

    Funding is needed to bring all ‘homes’ to an ‘acceptable’ standard.
    Families if can they can, should provide some help.
    If a company offers something they should deliver.
    Overworked staff need support.
    The whole sector has been neglected.

  2. Youngster

    My thoughts exactly. The first thought is for the “system”, but what of the responsibility of children to care for their parents? Decades of conditioning Australians to think that the state can solve all our problems is coming home to roost.

  3. Pyrmonter

    ‘Beds’ (the right to receive and support inmates) change hand at a premium. Does that not suggest that ‘resources’ and ‘funding’ are available, but they simply aren’t being used as expected?

  4. Pyrmonter

    @ Youngster

    Time was, households (‘families’): grew their own food; cooked for themselves (from scratch; none of this soft stuff about bouillon cubes or tetra-pack stock;) built their own houses; raised, slaughtered and butchered their own meat; wove their own textiles, to make their own clothes. Are there any other areas of economic activity you think should be removed from the market?

  5. Gerry

    I feel confident that the issues plaguing nurses trying to work at aged care facilities will not be addressed. The ANMF says it’s all about pay and staffing levels. It’s not the number of nurses only but the skill and experience and qualifications of the nurses, it’s about the lack of innovation in providing platforms of care, the bureaucratisation of aged care, the increase in level of needs of residents coinciding with the lowering of the level of skills of the staff.

    In the community, RDNS in Victoria has been taken over by Bolton Clarke and RNs are being replaced by SENs and PCAs – cheaper and less skilled. Wound care, incontinence care, colostomy care, dementia care are all being compromised. Keeping people at home requires nurses with qualifications in aged care, a higher level of skill and a commitment to excellent care. What will happen is more money will be allocated and more bureaucrats will get hired and more money will be wasted.

  6. Bruce of Newcastle

    I have a sneaking feeling that the horrors and abuse the staff are undergoing is not being addressed.

    Dementia is a terrible thing, but to ignore the effects it has upon those trying to give care is unfair.

  7. Pyrmonter

    @ Bruce

    Indeed. One reason I think ‘in the household’ care ideas, as if it were simply a matter of pulling together Charlie’s grandparents in Charlie and the Chocolate Factory all to live upstairs from adults of capacity are, at best, naive.

  8. Shy Ted

    Dementia facilities have the highest rates of assault on care providers. The do-gooders and uninitiated talk about chemical restraint with the implication it’s a bad thing but it’s very expensive medication for completely different conditions which is used with the hope of reducing difficult and dangerous behavior. The sad truth is that for many sufferers care becomes impossible. Trying to clean someone’ teeth when they are biting down on the toothbrush for example. The “granny grip” where some poor old dear in her confusion grabs what you have failed to protect and holds on for dear life. Crushing medications that shouldn’t be crushed but the only method of administration. 5 care providers to shower the behaviourally disturbed. The commissioners need to go and work a shift or 2 as do the politicians.

  9. Percy Popinjay

    This is way too complex an issue to be summarised in a few soundbites or seemingly damning gotcha statements attempting to assign guilt.

    As one would expect, “the state” is utterly incapable of being able to ensure an adequate level of care for the elderly, which is why aged care is largely provided by service providers such as the big charitable organisations, with a government overseen QA system that often (again, as you would expect) veers into the realms of dangerous expediency.

    Then there is the issue of the “obligations” of those people who were unfortunate enough to be cursed with hopeless/evil/vindictive parents.

    Finally, I’m not convinced that this monumental waste of taxpayers’ dollars (the royal commission) has uncovered anything that wasn’t already known. In addition, not a single aged person in the country is going to end up better off, or receiving a higher standard of care, as a result of this royal commission. The equally unnecessary and destructive disability royal commission will also demonstrate this.

    Just wait the for sanctimonious, obnoxious and seemingly unending cavalcade of intolerable narcissism and destructive “outcomes” that taxpayer bonfire will enable.

    You ain’t seen nothing yet.

  10. Tintarella di Luna

    The Royal Commissions are just a stalling tactic – nothing but nothing ever changes because those who are in charge at the moment will have been covering the arses of those who came before them and the current arse-coverers will expect those who come after to continue the arse-covering ad infinitum.

    “It is hard to imagine a more stupid or more dangerous way of making decisions than by putting those decisions in the hands of people who pay no price for being wrong.” Thomas Sowell

    Dangerous Stupidity thy name is Government-Bureaucracy.

  11. My 90 year old mother with onset of dementia is in one of those aged care homes. She had to pay a hefty bond because she had finances, but that aged care facility takes very good care of her. They have an imperative to do so as the longer she lives the more they earn interest from that bond, adding to what they get from her pension.

    It should be noted that all the care staff I believe are Filipino and they seem to have a completely different attitude towards care of the elderly than what I’ve heard do Anglo staff. I’m glad that she’s not in our local aged care facility, as there’s nary a good word been said of that place.

  12. Gerry

    Shy Ted – you are spot on – the toll on carers of working with dementia patients – who may be at home with a son or daughter doing the caring – is huge. It is exhausting, relentless, and can go on for weeks and months without a rest.

  13. Tezza

    Good comments. People are living longer and dying more sadly from diseases requiring more palliative care. We no longer live in extended families, and don’t/can’t/won’t take care of our own frail elderly family members.

    So we have socialised the problem. We spend heaps of money directly, and through government subsidies. We heavily regulate the aged care workplaces. Unsurprisingly, this works about as badly as socialised government solutions to tricky problems or dilemmas usually do.

    So, unsurprisingly, a royal commission recommends more government spending, and morons criticise the aged care staff and make arguments for easier euthanasia as the final solution to the problem.

    We are about to see some of the moral implications of the glib and morally unmoored debate we have been having on all manner of moral issues.

  14. Ceres

    Aged care facilities also need to have cameras everywhere.

  15. Roger

    My wife’s uncle died recently in a nursing home. He had dementia but he was not violent; he was mainly a danger to himself by falling and had to wear a soft helmet to prevent head injuries. His wife, a lovely and devout woman, visited him every day to feed him because if she didn’t experience showed he wouldn’t get adequate food or hydration. That is not good enough. Pity the residents who have nobody to visit them.

  16. Squirrel

    There may be some extra public money to address the problems identified, but this will probably end up meaning that nursing home bonds will become larger, and refunds of such will be smaller and less common.

    The impact on family dynamics is going to be interesting, as will the surrounding public debate and commentary from groups who are noisily keen on “progressive” tax changes, except when such changes might threaten their anticipated inheritances…..

  17. Perfidious Albino

    Not to query the underlying point, but Bolton Clarke IS the RDNS, they just adopted a different name when they merged with RSL Care. Bolton and Clarke were the surnames of the founders of those organisations apparently. (Dad has been a client of Bolton Clarke recently, no complaints).

  18. Scott Osmond

    We are also seeing one of the consiquences of fewer kids. Fewer kids mean that the burden falls on 1 offspring or the state if the elderly hasn’t reproduced. Throw in a lower tax base for extra fun.

  19. Dr Fred Lenin

    Like most goverment involved things the input is from people who dont really know what they are talking about ,because you have read a few books by theoretical experts doesnt qualify you as knowlegable about any subject ,the world is full of book experts who know little about the subject . If you need surgery get the person who does isurgery , dont ask them to fix your plumbing .

  20. herodotus

    They are not all as bad as made out. Check before going in.
    (comment shortened due to connection issues)

  21. John Dee

    I have first-hand knowledge of the neglect and what I have always regarded as criminal behavior when accompanying a friend of mine visiting his elderly father – a retired surgeon – at what was supposed to be a top of the line, much sought after elderly “care” establishment.
    The father’s sons were a mixed crew.
    My friend would do anything for his father but his employment involved extensive travel.
    Another son was quite ambivalent about the whole matter, whilst the third could not have cared less if his father passed the night in a pool of his own urine – or worse.
    And this type of abuse in that “care ” establishment happened frequently.
    But the sons all chipped in equally – financially.
    And the cost was staggering.
    I challenged the friend – would it not be possible to buy a small cottage or build a granny flat on one of their expansive properties (one a vineyard) and privately hire a full-time carer who could be readily supervised?
    I proposed that the savings would be substantial – that his dad would lead a dignified existence yet would be no real imposition on the uncaring side of the family.
    They had the wherewithal – they had the property area – they could easily afford to pay more where in all probability they would collectively pay much less – and the cottage would be an asset.
    He always refused to answer and my questioning upset him greatly.
    I realized that such an easy answer required some kind of joint effort that would not be forthcoming.
    Scum.
    Some people are utter scum.
    It is not only the establishments.

  22. Percy

    My main man you are on fire boy.

    He always refused to answer and my questioning upset him greatly.

    Pretty much the same with people that encourage their offspring to take welfare but won’t support them or those who want big government but want to get rich.

  23. struth

    See what happens when the government starts a war on smoking?
    People live longer and boy aren’t they having fun.
    It’s worth giving up the fags for those extra 10 years frolicking in the Nursing home.

  24. Paul

    “Anglophones are a rarity in some of these institutions.”

    Thank you. A very large part of the problem stems from this, but it remains unmentionable. This and the abandonment of the most basic qualifications as a criteria for entry to the “profession”.

    If this inquiry were honest it would say that everyone wants Rolls-Royce care for their loved ones, but no-one wants to sell the grand inheritance that would pay for it.

  25. Win

    A follow on to this enquiry elderly and the disabled should be the hospitals. With a Cerebral Palsy brother who instead of working now has to live in a high care Bolton Clark establishment I am qualified to comment. He is there because a consultant surgeon ,her off kick and an X-ray technician diagnosed bowel obstruction for constipation ,inhalation ,pneumonia even after 12 days sedation in an IC unit for clear lungs But failed to diagnose global oedema for which his employer had sent him home from work and kidney stones only found when there was frank blood in the catheter. After his unnecessary surgery the consultant surgeon and off kick sent him to IC the bed having been pre booked and with his stomach open and not fully closed ,ready presumably for the organ donor removals.
    The point is the ease with which these doctors none of whom had English as a first language could convince a disabled person with private health insurance to forgo private hospital treatment and a second opinion to give work experience to grossly incompetent and or criminally motivated doctors that ruined his life completely.

  26. Percy Popinjay

    Win – that is monstrous. Have the individuals concerned suffered any adverse consequences?

    If not, they certainly deserve to.

  27. Botswana O'Hooligan

    Throwing money at the problem won’t fix it, the amount thrown at the aboriginals over the years proves that, it’s a people problem and not all the people being blamed, the poorly skilled immigrants are quoted as a problem and yet in their societies old folk are looked after very well. The old folks homes are money making concerns just as kindergartens are so the idea is to maximise profits by cutting expenses to a minimum and no Royal commission is ever going to stop that just as no Royal commission will ever resolve the aboriginal problem. My mother was parked in a home and basically abandoned by a family member who had her enduring power of attorney so we shifted across the country to keep an eye on her and from day one I informed the facility care manager that I would monitor her welfare closely indeed and I did. That is probably the only answer, someone has to monitor the welfare of each and every patient daily for it is primarily a people problem. No one wants to look after someone with dementia who is constantly violent or keeps on and on over and over again or is incontinent but it has to be done. We in our socialistic system expect the government to resolve our problems, new start, dole, allowances for teenaged pregnancies, single mothers, the retarded, old folks etc. when in fact these are family problems and should be resolved by the family and not the taxpayer.

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