Category: Diary Blog

Complaints with Aged Care?…Here’s What You Can Do.

Brett0 comment

Often people do not know what their options are when it comes to a complaint, or even where to start. I have decided to try and make things a bit clearer and easier for you.

Complaints are often considered negative in our society, but if you have an ongoing unresolved concern, you may need an avenue to voice this. If a resolution can be made,care services improve, or something change for the better as a result of your complaint this can only be a positive thing.

I find overcoming problems in general to be more successful if I communicate respectfully and through the right channels to receive the desired results. I would hope that most complaints and concerns should be able to be sorted by the aged care provider in the first instance and is always best to give them the time and opportunity to resolve the concern.

HOW TO FIND OUT MORE INFORMATION BEFORE MAKING A COMPLAINT?

You can contact the relevant advocacy service in your relevant state. Below is a link to the contact details:

http://www.myagedcare.gov.au/how-make-complaint/advocacy-services

WHAT CAN YOU COMPLAIN ABOUT?

You can make a complaint about any area of the care and services you receive from an Australian Government-subsidised service provider.This might include areas such as:

• quality of care
• choice of activities
• personal care
• meals
• communication between you and staff
• physical environment.

WHO DO YOU COMPLAIN TO?

If you feel comfortable, the first thing you should do is let your service provider know about your concerns. Most of the time, your service provider is best placed to resolve complaints and alleviate your concerns. This can be the quickest and most effective way to find a solution.

However, if you don’t feel comfortable speaking with your service provider, or if your complaint hasn’t be resolved, you can contact the Aged Care Complaints Commissioner.

HOW TO MAKE A COMPLAINT:

https://www.agedcarecomplaints.gov.au/raising-a-complaint/…/

If they are unable to help you, they will tell you why and either suggest who you can contact or refer you to other organisations such as a state-based Health Care Complaints Commission or the Australian Health Practitioner Regulation Agency.

WHO CAN MAKE A COMPLAINT?:

Anyone can make a complaint, including:

• you (the person receiving care)
• your family members
• your friends
• your representatives
• aged care staff
• volunteers
• health professionals.

WHAT HAPPENS AFTER YOU LODGE A COMPLAINT?:

When you lodge a complaint with the Complaints Commissioner, the process will be explained to you, including your options. You may be asked for more details and what your expectations are.

The more information you provide when you lodge your complaint, the better – it will help the Complaints Commissioner understand all the issues and determine the best way to resolve your concerns.

Visit the Aged Care Complaints Commissioner website for more information about how the Complaints Commissioner can help you resolve your complaint.

https://www.agedcarecomplaints.gov.au/raising-a-complaint/…/

YOUR REVIEW RIGHTS:

If you have lodged a complaint with the Aged Care Complaints Commissioner and are not happy with a decision or the complaints process, you can provide feedback and ask the Complaints Commissioner to review the decision.

You can also ask for a review of our complaints process by the Commonwealth Ombudsman.

HOW TO SEEK A REVIEW BY THE COMPLAINTS COMMISSIONER:

A ‘Your review rights‘ fact sheet on the Complaint Commissioner’s website outlines options to seek review of the Aged Care Complaints Commissioner’s decisions or process.

If you’re still unsure about your review rights call the Complaints Commissioner on 1800 550 552 and ask to speak to a complaints manager in your state or territory.

HOW TO SEEK A REVIEW BY THE COMMONWEALTH OMBUDSMEN

The Commonwealth Ombudsman can investigate complaints about the actions and decisions of Australian Government agencies, including those of the Aged Care Complaints Commissioner, to see if they are wrong, unjust, unlawful, discriminatory or unfair.

If you are not satisfied with an outcome offered by the Aged Care Complaints Commissioner, you can contact the Ombudsman’s office through the Commonwealth Ombudsman websitehttp://www.ombudsman.gov.au/ or by phoning 1300 362 072.

*Disclaimer – Please note any opinions are my own and you should seek your own professional legal advice or contact the relevant organizations to resolve your concerns.This post is to simply assist and help connect people with the channels they may require in regard to complaints.The information above has been extracted from the www.agedcarecomplaints.gov.au &http://www.myagedcare.gov.au/ websites.

Time For Change

Brett4 Comments

After the recent publicity on the alleged abuse of an elderly man in an Adelaide nursing home I felt it was important to address some issues in regard to aged care.

The following opinions are my own and I just want to clarify that I am a family carer and not employed in the industry. I have however spent many days inside nursing homes as a family member and volunteer.

Firstly, ‘Dementia Downunder’(DD) is a positive dementia based forum & environment. The majority of topics and posts are discussion points for positive change and improvements to the way we care for the elderly, as well as providing support for families.

I have left the recent news footage post on the DD Facebook site (refer link below) on this occasion as it is a very ‘public conversation’ that is being beamed across Australia via news services and across the globe via the internet (so is widely viewed regardless). It is important that we remain informed and also have balanced views when it comes to forming opinions and subsequently airing responses. We do not want to display outrage by attacking people, organizations and industries with nasty comments and bullying via social media.

I would hope that we do not become disrespectful to our many wonderful carers and nurses based on this news article/report of an individual case. I see first-hand the challenges faced by carers and nurses across a day and it is simply not easy. Whilst there will always be a minority of people not doing the right thing it is imperative that we value our aged care workers and as family members continue to work together to provide great care outcomes for our loved ones. People with dementia are really vulnerable and may struggle to make the most simple of decisions or perform everyday tasks, and it is these people that we need to ensure are our highest priority.

This recent nursing home incident on the news is extremely traumatic and very confronting. The story is probably not an isolated incident, and the general public will want to express anger, however I am more interested in what we can learn from this situation and what we can do to create culture change?

What I learnt:

• It highlights how vulnerable our senior citizens are when placed in care.
• It illustrates the desperate measures taken by a family to protect their loved ones.
• It shows that some people should not be working in aged care.
• We need to have measures in place to attract the ‘right people’ into aged care both financially and with their working conditions.
• Training is vital and so is monitoring and auditing the systems.
• Are our current models of care based on old information and techniques from decades gone by?
• When we use the overused buzz word ‘person centred’ should it be used if the person is not the single prime focus of the task or environment?
• Do we always consider the person’s feelings and well being when aged care decisions are made?
• Budget cutting ultimately impacts on the person receiving the care.
• Australia needs to lead the way in aged care with our ageing population and be proactive, innovative and do so with a genuine desire to look after our elderly .

It is time for change – and we need to place a priority on our aged community and ensure they live out their lives on their terms and with dignity.

http://www.adelaidenow.com.au/news/south-australia/hidden-camera-captures-abuse-suffocation-attempt-of-elderly-man-in-adelaide-nursing-home/news-story/4c3c440a0ead0440207dcd1a04f14993

 

 

Get A Grip

Brett0 comment

I went to the nursing home last night and sat with an 84 yo man sitting in a chair by himself, and he was crying. I knelt down and asked him “what’s wrong Daryl?”.. He said “I can’t stop shaking and I don’t know what to do?”. His hands were really trembling ( a bit like Parkinson’s) and he was concerned.

I then remembered my ‘Teepa Grip’ ( refer pic) and I just held one of his hands and gave him firm palm pressure from me. I rubbed the top of his hand ( with my other hand) to create some warmth and re-assured him verbally everything will be ok.

Blow me down …Two minutes later… He stopped shaking!!!… He calmed down and started bantering with me.

Seriously, the more I interact with people the more I believe that ‘reassurance’ could be the best medicine moreso than anything else.

Another lesson in ‘natural’ dementia care from the nursing home …magic!

Dementia Care Matters – ‘A Lesson on Being Human’

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Yesterday I was fortunate to be asked to a lunch meeting with one of the leading international dementia care trailblazers in the world, David Sheard.

David is the Founder of the UK based ‘Dementia Care Matters’ which is a company that is offering a different way to caring for people with dementia in nursing homes.

Amazingly, he is considered controversial and ‘out there’ by many in the aged care industry, but when you sit with the man and just listen to him talk he is simply passionate about people and how they are treated. This really resonated with me and together we talked dementia for two hours without hardly taking a breath. (We almost forgot to eat our delicious meal at ‘Sean’s Kitchen’ Adelaide Casino).

Our meeting was simply a lesson in life and stripping things back to the core values of all that is good about being a person. I hung off every word that was said hoping to absorb more knowledge and learn from one of the best in the world. We talked about environment, feelings, living in the moment and so much more. I feel really privileged to be given an insight into an alternative way of doing dementia care…..but should it be the new mainstream, and is it the new ‘black’?

Key aspects of the care model include:

• Developing small household living for people with dementia in a family-like environment

• Removing institutional features such as staff wearing uniforms, medicine trolleys, and rigid ‘task-based’ routines

• Enabling greater freedom for people living in the home to do more for themselves and feel less restricted.

It has been running for over 20 years and it all made sense to me and with over 100 care homes adopting his ‘Butterfly House’ model of care (including 3 sites in Australia) it is obviously working and really needs to be given strong consideration. I worry that mainstream aged care is doing things the same way they always have, and possibly using methods that were developed many decades ago.

Love him or loathe him, David Sheard is a passionate ‘down to earth’ guy that actually CARES…..isn’t that what we all want in a nursing home?…genuine care?….certainly worth consideration.

It was also an absolute pleasure to meet Peter Priednieks (Director of Learning) and spend time with Andrew Ramsey (CEO Hands On SA). A great time was had by all.

 

Hanging on the Telephone

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This dementia journey has produced some magical moments for me over the last 5 years. I want to share a small but powerful moment that happened at a recent dementia workshop I was presenting at last week.

One of the staff from Alzheimer’s Australia/DBMAS was in the audience listening to me speak about a story involving my night in the Emergency Department (ED)of the hospital with Dad being restrained by the security guards many years ago.

I told the audience I was in a really distressed state and was traumatized at what had just happened and had no idea what I was going to do next (I knew zero about dementia back then). I explained how I went into a corner of the room in the ED and called the help line. The voice on the end of that line was very comforting and it was one of the most amazing calls I have ever made.

This person came up to me after the presentation and said “Brett, After hearing you tell that story about your Dad in the ED, I had to let you know that I was the first person on the other end of the line that night when you called. I will never forget that call as long as I live….you sounded so distressed and emotional.”

Wow!…I am without words….

Breaking The Shackles

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I want to share something that is very personal to me, but also very public.

As many of you know, when I do a dementia presentation I leave nothing in the tank. I bare my soul and give you a ‘warts and all’ insight into a situation that is playing out all over the world many times over. I try and influence people to understand that there are millions of people battling with dementia, but there are millions more caring for these people. This is global…..

For some bizarre reason I want to share what it is like to stand in front of a group of strangers, tell my story then watch positive change happen in front of me. It is terrifying, exhilarating, emotional, therapeutic and powerful all at the same. I spend hours and hours preparing and practicing to the point of having the speech content spinning in my head out of control, and even getting upset on occasions when things hit too close to home. I have so much to say but have to find the most influential bits and try and remember them….This is the stressful part. The first 2 minutes of a presentation you are being looked at by strangers and being judged, you feel vulnerable but this goes away very soon. I choose to have a ‘this is me…and I am what I am” attitude. I try and deliver honesty and brutal reality in a sincere & authentic package and I can feel some people in the room squirm. I realise this is my speaking style and is not for everyone.

The key to public speaking is to ‘push on’ no matter what happens, as this is not about me, it is about the audience and what’s important is what they take away from the presentation. Can they be better carers and nurses with more information and real stories?…I hope so.

After the speech I love it when people come up and tell me their stories. This inspires me and gives me new ideas to create change. To give you an example I recently had a lady come up to me and tell me her heartbreaking story about her husband with Alzheimers who had trouble with anti-psychotics at age 57 and took his own life 3 weeks later. Another lady shared with me some amazing and unique ways to create engagement in the nursing home she works at, someone else talked about acute care issues in the country, others just say ‘thank you’. I feel so privileged to be exposed to the private lives and thoughts of others without even knowing them. I encourage these people to join ‘Dementia Downunder’ to share their thoughts and ideas with all of you. We can get to know them and deal with dementia as a community….there is strength in numbers.

I try and chip away with ‘taboo’ subjects and I brought up a new one yesterday…incontinence & toileting issues. This is happening in every aged care home, and hospital in the world and it is difficult to deal with, and our amazing carers and nurses are dealing with this many times per day. If people are struggling with an aspect of a disease we need to bring it out in the open, discuss it and then deal with it. No more restriction , no more stigma, this dementia story needs to be told ‘loud and proud’ without judgement. Let’s just have the conversation and work out the solutions. A positive and collaborative mindset is what we need without politics, excuses and old fashioned thinking….this is simply about PEOPLE, and they ALL matter irrespective of their race, gender, financial status, social problems, sexual orientation or anything else.

I leave the dementia workshop and visit my Dad which keeps me grounded as it reminds me what I am fighting for. I go back to being a son again and just sitting with him hoping for a smile. I banter with the residents and we talk about ‘nothing!’ and laugh. My sister helps me get Dad ready for bed and does a great job, as this is not easy when the person no longer knows how. I go home to my family, only to once again fall asleep on the couch exhausted with a headache from my exciting ‘rollercoaster’ day.

I want to be free when I speak and I am going to continue to ‘break the shackles’ and talk about this disease and all that comes with it. I hope I can encourage others to speak up as we need more people to share their story, we need more caring people in our aged care homes, we need to create dignity for all, the clock is ticking…..tick…tick…tick…

The Power of Touch

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Once again I received another ‘on the job’ lesson in how to care for people via the nursing home today. I was visiting Bob (Dad) as he had been striking out at a carer, and I was in ‘re-direction mode’ and we were heading for the sanctuary of his room to calm things down. On the way I heard a scream from a nurse as a glass and bowl broke in the dining room. I looked across to see some broken crockery and glass on the floor. A few seconds later I heard another scream from the nurse and she turned to find a very frail female resident had fallen and her head had hit a sharp ledge on a window frame.

The scene was really traumatic and I heard the lady hit the floor so I decided to leave Dad and try and help out. I felt quite useless as I have no medical background so I decided to concentrate solely on the resident’s well being & state of mind. I ran around to get wet flannels and some pillows for the nurse then simply comforted the lady by holding her hand (using the Teepa Snow grip) which I had recently learnt about. The nursing staff arranged for a lifter to get her into a wheelchair, and some bandaging for the lady’s head which was bleeding quite badly. I simply tried to keep out of the way whilst just trying to re-assure the resident that “Everything will be ok”. Right in the middle of all the panic another female resident yells out to me from her table “Excuse me..Excuse me….Can you get me a biscuit?”. I put on my most patient voice and said “no problem…I won’t be long”.🙂

The injured lady was ever so polite and was constantly talking to me and thanking me for holding her hand. I applied some palm pressure throughout (as I was told this is comforting) and I was amazed when she then said to me “Thank you ever so much for being with me, the way you are placing gentle pressure on my hand is making me feel very re-assured”.

are you serious?………

Here is this poor woman in complete shock and pain, verbalizing how she felt about the ‘hand holding’ as though she was giving me a live tutorial on how to comfort someone who has fallen. I stayed with her until we had her back in her bed and I just sat with her (still holding her hand) and watched her go off to sleep, then left the room.

I am sharing this story as I continue to be involved in these incidents and be taught so many valuable practical lessons as though it is meant to be…..bizarre. It taught me that having a re-assuring voice amongst the mayhem can soothe the injured person and sometimes ‘little things matter’, and that the power of touch is very powerful indeed.

As I walked back to Dad (who was asleep in a chair) another female resident came up to me with a look of horror on her face. I said to her “Tell me what’s wrong Mavis?” She couldn’t speak and was shaking her head…..Then from her body language I could tell she was in shock from witnessing the other lady fall. She was worried about her and was reacting to the situation. I reassured her that the lady who fell will be ok and the doctor is checking on her. I then asked her if she would like to have some ‘quiet time’ and have a rest, and she said “yes please” and I walked her back to her room. She also was really appreciative that her concerns were re-assured.

Once again another valuable lesson in human behaviour…when someone falls we need to check on ALL the residents to make sure they are ok (and not in shock) as well.
After all the excitement & life lessons – I went home and fell asleep..ZZZZZZZZZZ

‘Wee’ Need To Give People With Dementia Some ‘Relief’ From Loo Confusion

Brett0 comment

When you next visit the bathroom at a pub, restaurant or cafe check out the creativity and design of the toilets signs on the doors. I know I personally have trouble sometimes working out which toilet door to enter (even more trouble after a few beers), so imagine if you have dementia as well? Your next move could be very embarrassing indeed.

I love a laugh and some fun, so I have attached a few crazy toilet signs to this post for your amusement. But also on a serious note I just wanted to point out how difficult going to the toilet in a public place must be for people with dementia (especially in early stages without a carer).

Our environments are really confusing and we need to be mindful of people with dementia, just like we make allowances for people in wheelchairs etc. Just because the symptoms of dementia are not always physically visible does not mean they are less important and should not be considered.

PS – The taps in bathrooms are also getting really confusing these days- I often end up standing at the basin waving at the spout, or vigorously rubbing my hands with no water coming out….how embarrassing!!! 🙂

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Spotlight on Family Members

Brett1 Comment

As a ‘family member’ I believe to present a balanced view I should highlight some of the shortfalls in our role within the world of aged care and hospitals. Quite simply….on occasions, we get it wrong! Sure …”we are the family and we know best” is what many of us believe, and is often the family member mantra as we strut around the nursing home looking for any evidence of mistreatment.

Sometimes we don’t know best and we have to trust the staff and management of the aged care facility or hospital.

Example 1: I often demonstrate to nurses how to get dad to take medications and I was offended when a nurse questioned whether dad had swallowed his tablet. I said “once he swallows, he has definitely taken it, and it is his routine”. But the nurse persisted and wanted to check under dad’s tongue to be 100% sure. It was a couple of minutes or so later and I was really mad that the nurse questioned it. But as she checked under his tongue, there was his little yellow Oxazepam tablet hidden there like a prisoner in jail would do. I was staggered and embarrassed but most importantly said to the nurse “sorry…you were right”. Once again I learnt valuable lessons in that you have to be thorough at all times, follow procedure and be ready for a change of routine, as the dementia journey is ever-changing.

I also learnt to get off my ‘high horse’ and allow people to do their jobs without constant badgering. The nurses and carers have a tough job to do and they are forever under scrutiny. We need to treat care staff and nurses with respect and allow them to teach us some things as well. There will always be the odd person that is not doing the right thing or may just do their job for the money. But we must be mindful not to punish the thousands of other fabulous carers, nurses and doctors that are committed to patient care.

At the end of the day – when we visit our loved ones with dementia in a nursing home or hospital we only see a ‘snapshot’ of their life in care. In that 15-30 minutes of visiting time do we really know what is happening across the other 10,050 minutes???

If this worries you at all – then you could visit more often, meet the other residents and families, create relationships with care staff and nurses and discuss how your loved one is coping and interacting. Perhaps visit regularly every day for a week or so and turn up at different times including meal times. You will see the pressures, the system cracks and you may even get to know other people with dementia a little bit better. You will learn how to care for your family member and be more tolerant of others. Most importantly you will have a more informed understanding of dementia and all that comes with it and you may think twice before you go off at staff demanding ” I want better care for my mum or dad”.

This is dementia….

Do We Really Have A Clue?….The Pressure Is On.

Brett0 comment

 

This post may be one of my more challenging ones but I believe this is a conversation that needs to be had…..Do we really know what care our loved ones are receiving? I visit the aged care facility every day pretty much (and we are in one of the best) and am fairly intuitive when it comes to people, but sometimes I question what can happen to a person with dementia when we are not there?

I am concerned about night time shifts when care staff are stretched and often filled by agency carers or staff not known to the person with dementia. This is the ‘key ingredient’ for trouble to occur. If I put myself in the person with dementia’s shoes , I wake up unsettled at night and set off the motion detector in my room, as I walk around lost. A carer comes in to investigate and they tell me to “get back into bed” . I am shocked as the tall figure in the shadows barks the order (with no-one else to be accountable to), the carer is a complete stranger treating me like a child and they don’t even know me or may not want to know me. They may talk down to me sternly to evoke a quick response to avoid waking other residents. The carer may be no-nonsense, they may be empathic, they may be from a different culture, they may be understanding. Whoever that single carer is, and what they know and what they stand for, will potentially determine my future.

Even though we protect our loved one across most of the day, you can never protect them 24/7 and we are subject to the ‘system’. If the care staff deem the person with dementia difficult or is seen to display ‘difficult or aggressive behaviours’ an ambulance or police could be called at their discretion. Everyone has a different tolerance and we all have different ‘tipping points’. The result is potentially a life changing scenario that can rip families apart and send the person with dementia deep into the mental health system, which could be avoided with more intensive staff training and strategic rostering. The costs blow out everywhere as the work is loaded onto emergency services, security staff, extra nurses, doctors and carers who are all required to deal with the aftermath.

My point is this – aged care facilities need to invest deeper into their dementia training and focus on the key elements such as ‘tone of voice’ , the ‘power of touch & body language’ and diversionary tactics. When words are no longer effective and the person with dementia simply does not understand anymore, you are simply wasting your breath…..Perhaps roster key staff on at night with advanced dementia training so that good decisions can be made and create an accountability that keeps everyone safe and sound. It may take the courage to actually add a person to a shift in the short term or invest some more training dollars, but the long term cost savings and resident safety and happiness is paramount. The families will be happier and the pressure valve released off a system that could potentially blow.

PS – The role of the agency carer or nurse is often not understood or valued by people, and can sometimes be given the ‘cold shoulder’ by regular staff who may treat them as the ‘enemy’. I actually believe agency carers and nurses are vital and courageous ,and under the most pressure, as they continually walk into potentially dangerous situations with very little resident knowledge or background (let alone facility procedures). Perhaps developing a team of agency based ‘dementia champions’ is the way to go? …Is this possible?