"Mum's traumatic brain injury"

Our story starts a few months back when my mum suffered a subdural haematoma after a fall. She was transferred to Royal Perth Hospital where she underwent emergency surgery to save her life. The post-operative care provided by the staff at the Intensive Care Unit - particularly the nurses - was outstanding, and I can't thank them enough for their hard work and their compassion. 

She was moved from ICU to Ward 5H, the neurosurgery ward at Royal Perth. Again, we had a good experience with the nurses and also the neurosurgical team. The main blip was the communication which could be patchy. For example, we arrived to find my mum being prepped for surgery and no-one had confirmed with us that this was taking place. I also found that communication between disciplines, for example speech therapy and nurses, could be improved. The nurses noticed that my mum had word finding difficulty but this information did not get passed on to a speech therapist. There was also a lack of appreciation for the impact that a traumatic brain injury can have on a person's mental health and overall well-being. I had to justify a request for a clinical psychologist to speak with my mum to both a nurse and a neurosurgeon before the request would be actioned.  However, apart from this, the overall experience was ok. The food could be improved though! 

The month after mum's admission, she was transferred to the aged care rehabilitation unit at Rockingham General Hospital and unfortunately that's where our experience changed. Within days of her arrival, she was dropped by a nurse who did not follow the correct manual handling procedure which was displayed above mum's bed.  It was up to my dad and myself to get back into her wheelchair as the nurses went into panic mode. My mum has no skull on her left-hand side and any fall could pose a significant risk to her life. This affected her trust in the nurses at the hospital and I don't think this has recovered.  

Other issues:

We discovered she was only getting showered every second or third day. Mum is incontinent and in pads and I think a lack of showering is unhygienic, plus could potentially contribute to the recurring UTI's she has had since being at the hospital. Not to mention the fact that a person feels better in themselves if they can maintain their personal hygiene.   

Call bell wait times are long and again mum's trust and belief in the nurses to respond to her needs have been affected and she is reluctant to press the call bell as a result. The unit is significantly under-resourced given that the majority of patients have high care needs and require two staff for manual handling.

I find staff aren't proactive in responding to requests. We asked if it was possible for my mum to have additional physio and this took weeks to action - funnily enough it was implemented a day before our family meeting.   

I also feel that they won't act unless the family complains or consistently makes noise about an issue. Again, mum has had word finding difficulty for some time and I have expressed concern about her cognitive ability, which I believe has declined since being at Rockingham General Hospital. It took a family meeting for the doctor to say they should get the speech therapist to re-assess mum and look at strategies to help her.   

Care is linear and lacks creativity. Suggestions by family to introduce additional therapies, such as music and arts therapy, at our own cost have been met with reluctance. I've been asked to put my request in writing and I will do this, but I find it amazing that a rehabilitation unit does not consider the use of arts and music therapy generally.  There is a vast amount of research that proves the benefits of taking part in arts and music therapy for people who have suffered a traumatic brain injury, as well as stroke survivors who make up a large number of patients at the unit. I also think social isolation could be addressed if there were arts therapy activities that people could participate in a group.

To be honest, my overall impression of the unit is that it is used as a holding pen for patients before they either a) enter residential aged care or b) return there.  If you want your loved one to return home, I think it's probably best to transfer them elsewhere.