AGED CARE CRISIS: Beloved mum suffers in agony
JANICE Williams will never forget Valentine's Day 2018.
It's the day she tearfully sat and watched her family tell her Mum they loved her.
It's the day she watched her 87-year-old Mum die from sepsis.
But it's also the day she vowed to never let what happened to her family happen to anyone else.
Early warning signs
Mrs Williams entered her Mum into the Bundaberg Blue Care Pioneer Lodge on November 3, 2016.
Mrs Williams, a registered nurse, initially had no concerns but then she started to notice things.
"On numerous occasions, I found staff to be scarce throughout the nursing home," she said.
"I often walked corridors for some time before I found a staff member and most of the time they would be very stressed and tired."
"There was a lack of communication from shift to shift that concerned me."
Within a few short months, Mrs Williams became concerned about the care her Mum was receiving after she had two falls in one day on February 28, 2017.
About 6am her mum fell and hit the top of her nose.
Her mum was not made a high falls risk after the first fall.
Mrs Williams' father was contacted and advised that she had had a fall and was OK.
Then about 3pm, Pioneer phoned Mrs Williams and told her that her Mum had been found face down in the shower covered in faeces and she was being sent to hospital.
"Hospital admission notes a state of increased confusion, febrile, erythematous on the right leg and foul-smelling urine," she said.
"They should have called me as I was the first contact," she said.
Mrs Williams spoke to a manager and two senior nurses to discuss her Mum's health.
"We were met with the most hostile reception from that manager in the first meeting," she said.
"She denied my mother had an infection.
"From that moment on I knew I would have problems."
A fortnight later Mrs Williams said she walked into her Mum's room to find her vomiting into a bag with three personal care workers.
"A personal carer said to me that your mum has been like this for an hour and a half," she said.
"The RN gave her a cold glass of water."
"I had to demand that they call an ambulance as my mother again was showing clear signs that she was very unwell," she said
"The registered nurse was very junior and clearly out of her scope of practice."
In early 2017, Mrs Williams said an anonymous personal care worker phoned her to say her Mum had not been showered for a week.
Previously, Mrs Williams had found out her Mum was being dragged out of bed around 3am to be showered.
Mrs Williams spoke to Pioneer staff and asked to have showers done at a reasonable hour.
Mrs Williams said the personal care worker told her there were not enough personal carers during the day to shower her Mum so the night staff had taken over.
According to Mrs Williams, the PCW said because Mrs Williams had put a stop to showering her Mum between 3am to 6am, she had not been showered for a week.
"I was devastated," Mrs William said.
"While visiting my mother with my Dad, the stench of urine that come off my mother nearly made us physically ill."
When I discussed this with the clinical nurse in charge of mum, she advised me that it was because I had stopped the night staff showering her.
In May last year, Mrs Williams noticed her Mum's toenails were starting to get long.
She advised staff that her Mum was in danger of getting an infection if the toenails were not clipped.
Every Friday, Mrs Williams would visit her Mum with her father to and raised the issue,
Four days before Christmas, she received a call from her Mum's GP who said her Mum's toenail had become infected and she had to have a course of antibiotics.
Mrs Williams confronted Pioneer staff.
"What is wrong with you people, why are you not doing something about this?" she asked.
"It needs to be cut because my mother can't stand to have a shoe on her foot or a sheet on her toe."
Pioneer said the contracted podiatrist had rescheduled and they could not call another podiatrist.
"I was working at the hospital Saturday and"I went down town and bought an expensive pair of cutters," she said.
"I went there and had to cut my mother's toenails and release the pressure and pus."
"My mother screamed because of the pain and then she looked at me and said, 'oh my God, that feels so much better'."
Lead-up to Valentine's Day
When Mrs Williams returned from a week-long work trip at Rockhampton on January 19, her husband had visited her Mum with her Dad.
He told her that her Mum was looking unwell.
She picked up her phone to ring Pioneer but before she could dial a number the phone rang.
It was her Mum's GP.
"He said he had just told the staff to get an ambulance to take her to hospital,"
"She was hyperkalemic, my mother's potassium level was 6.5 mEq/L, which can be critical.
"She had an acute kidney injury from dehydration, a systolic blood pressure of 80 and was short of breath".
Worse was that her doctor said he believed she had been like this for days.
Frustrated, Mrs Williams rang Pioneer to demand why they had let her Mum's health decline.
Mrs Williams said during many meetings with senior nursing staff and management she was promised each time that they would put new processes in place to prevent another repeat of their failure to act in relation to her mother's care.
"They constantly broke their promise and agreement, and I was forced to lodge several complaints with the Aged Care Complaints Commissioner," she said.
"I had a simple request that the nursing staff phone me at any time to let me know when my mother was not well as I did not trust them to recognise signs of an infection in an aged person and this they regularly failed to do."
Soon after Mrs Williams received a phone call from a junior registered nurse.
The nurse said she had seen her Mum's pathology report two days ago and knew her mother's potassium levels were 6.5 and had forgotten about it.
The nurse begged Mrs Williams for forgiveness and not to blame Blue Care.
"I said 'yes, I forgive you, I know at the end of the day you're human, but this is my mother's life you are dealing with'," she said."But you just told me you knew about this two days ago that my mother's potassium level was 6.5 that's lethal for an old person."
Mrs Williams' Mum returned to Pioneer on February 5.
Knowing her clinical history from her last hospital admission, Mrs Williams knew that her Mum would need to be monitored carefully.
"I met with Aged Care Complaints Commission investigators and Pioneer management on February 6," she said.
"I left that meeting sick to my guts."
On Friday February 9 Mrs Williams visited her Mum and asked how she was.
"I asked my mum if she was OK, she didn't respond and said, 'I can't hear you'," she said.
"My husband and I searched the room for her hearing aid."
Mrs Williams went to speak with the clinical nurse and asked where the hearing aid was.
"She handed it to me and said a personal carer had put it through the wash and dryer," she said.
"It was absolutely stuffed."
About 9pm, Mrs Williams received a call from a Pioneer registered nurse to say her mum was sick and an ambulance was required.
Her mum was aggressive and confused.
When she arrived at Pioneer and Mrs Williams put an oxygen saturation probe on her mother's finger to read how much oxygen was in her blood
Mrs Williams said it was at 87 per cent on room air and anything below 94 per cent starved a brain of oxygen and organs started shutting down.
Mrs Williams' Mum was taken to hospital and put on a fluid bolus, given intravenous antibiotics and then transferred to the Friendly Society Private Hospital.
A day or two later, Mrs Williams was told her mum was severely septic.
"I said take her off the meds, no more tests and palliate her because I now know what's going to happen."
"If they didn't palliate her, she would die a very slow and miserable death."
On Valentine's Day this year, Mrs Williams' family gathered around the family matriarch to comfort her.
Because of the morphine, Mrs Williams' Mum couldn't open her eyes 24 hours before her death and was unable to hear without her hearing aid.
"She kept saying 'I'm scared, I can't hear you, I love you, are you all here?'," Mrs Williams said.
"We just had to rub her hand on our faces to let her know who was there.
"We wanted to say so much to her and Pioneer took that away from us.
"She died not hearing our voices."
ACCC is investigating the circumstances which led to Mrs Williams' Mum's death.
Mrs William has chosen to channel her anger, sadness and frustration into advocating for better aged care.
She wants better nurse to patient ratios, so experienced nurses can spend more time on the floor.
She wants targeted education and training for nurses in aged care to be able to recognise symptoms found in older people.
Most importantly, she wants the community to stand and demand action.
"I urge any person that has a family member or friend in an aged care facility to lodge a complaint with the ACCC if they have concerns that are not being addressed by management,' she said
"As a community we have a responsibility to stand up for those that can't.
"The government will bow to community pressure if enough people stand up and fight together to push the government into action."
An aged care crisis meeting is scheduled to be held in Bundaberg on Thursday, March 15 at 6.30pm at the Bundaberg Bowls Club.
Blue Care issued the following response
"BLUE Care is committed to providing high quality care in a safe environment for residents.
An assessment of our records has identified a number of inaccuracies with the claims put forward and cannot be substantiated based on the information provided by the NewsMail.
Staffing levels at Pioneer have always been either above or in-line with Australian residential aged care facility averages.
We can confirm our team have been working with the daughter of our former resident for some time.
We appreciate this is a sensitive time for her and we will continue to provide assistance wherever possible to address these concerns."
Nurses union call for staffing level transparency
THE Queensland Nurses and Midwives' Union is calling on Blue Care to reveal its staff numbers and rosters statewide.
Queensland Nurses and Midwives' Union secretary Beth Mohle said elderly Australians in aged care facilities were regularly experiencing pain and premature death.
Ms Mohle said Australia's 260,000-plus nurses and midwives called on Prime Minister Malcolm Turnbull to acknowledge and address chronic understaffing and neglect in Australian aged care.
She said nurses and midwives from every state and territory had joined forces to fight for federal legislative change to improve conditions in aged care.
"Australia is in the midst of an aged care crisis," Ms Mohle said.
"I ask Malcolm Turnbull, how many elderly Australians must die painfully and unnecessarily before he acts?"
The Federal Government is responsible for overseeing conditions in Australia's 2400-plus privately-run facilities.
Aged care providers are currently responsible for deciding how they staff each facility.
Ms Mohle said chronic understaffing meant elderly residents did not receive the level of care they needed and simple medical conditions could cost them their lives.
Currently there are no laws that state even a single registered nurse must be on site in an aged care facility at any time.
"When on staff, it is not unheard of for a single Registered Nurse to be left with up to 200 residents," Ms Mohle said.
Aged care providers do not have to make their staff levels public.
Aged care nurses and support staff have repeatedly told the QNMU chronic understaffing means they can't properly feed or wash residents.
Ms Mohle called on all aged care providers, including Queensland's largest provider BlueCare which is part of UnitingCare Queensland, to reveal their staff numbers and rosters statewide.
"Issues at BlueCare facilities are a direct result of a corporate cost-cutting initiative that saw around 11 of 17 enrolled nurses cut across three facilities in August last year," Ms Mohle said.
"Aged care staff that remain have desperately tried to provide care.
"However, due to chronic understaffing and poor skill mix this is increasingly difficult.
"We fear elderly residents are still suffering and this issue is very much ongoing."
According to Ms Mohles, Blue Care cut an estimated 60 per cent of enrolled nurses at Pioneer Lodge and two sister facilities in Bundaberg in August.