"Lack of care"

My parent recently attended Maroondah Hospital in the morning.

I’m writing this complaint as within a 2 week period I feel that our family has encountered neglect, lack of empathy, something else in here too, with 2 hospitals located in the eastern suburbs.

Our parent has been diagnosed with Alzheimer’s and is recovering from a broken wrist which required plates and screws a few months ago. Due to the location of the plate, they have very minimal use of their hand. Recently, my parent was taken to Maroondah hospital by ambulance after a bad fall at home.

Upon arrival at the hospital, the nurses would not allow me through emergency to be with my parent for over 45 minutes. I did advise them of my parent's Alzheimer’s but it seemed this obviously was not relevant to them. I was extremely unsettled knowing my parent has Alzheimer's and they would be asking them lots of questions. My parent gets extremely confused and anxious when they're being asked questions that may not be answered correctly.

After finally being let through on numerous occasions, we still had staff members asking my parent if they have had pain relief and various other questions. I would have thought this is something that would have been documented in the nurse's notes on their file, rather than needing to ask the patient if they have had pain relief.  

When my parent came back and they confirmed a fracture in the humerus of the left arm, I asked about my parent's hip. They weren’t aware of the sore hip as my parent had forgotten to tell them in Emergency. If I was allowed in, I believe they would have known this. When they took my parent for the x-ray of their hip, I mentioned to the nurse that was looking after my parent at the time if they were considerate of people with Alzheimer's. I said that I didn't want to keep bringing it to the attention of everyone in front of my parent every time they asked a question that they weren't able to answer. It can be degrading and makes them feel uncomfortable that they actually have this disease. The reply I received was, the reality is they do have the disease and there's no point not talking about it in front of them and pretending it's not real. I found this to be very insensitive to the situation, in my opinion.

A couple of days later, I spoke with a nurse regarding my parent getting in and out of their bed and asked for a triangle for them to be able to pull themselves back into the bed. The nurse explained they couldn't give them one because it was an orthopaedic ward. This was fair enough, but I expressed my concerns about what happens when my parent needs to go to the toilet as I was assisting them while I was there. I was unsure as to what was happening when I wasn't there as I believe nurses didn’t come in to offer their assistance even if they saw my parent struggling to get back into bed properly.

I felt this nurse offered some unthought out & unrealistic options in regards to using the controls on the right-hand side of the bed to lay the bed back for my parent to adjust themselves, but in my opinion, my parent would have to be a contortionist to use their right hand for the controls on the right-hand side of the bed! So then the nurse said maybe my parent could use the controls on the left-hand side of the bed, then demonstrated lifting up the side rail to show us where the controls were on that side. I explained that my parent wouldn't be able to get out of the bed if the side rails are up for them to use the controls. The nurse kind of scratched their head and didn't really know what to do or what to offer. This, again, left me feeling very unsettled, knowing this is the quality of care I was leaving my parent in.

It was at the end of this nurse's shift I believe, when they were doing handover with the next nurse when I was just about to leave as visiting hours had ended. The nurse looked over to me whilst doing hand over and asked if my parent's arm actually fractured? I couldn’t believe it; this nurse had been on duty 8 or 9 hours caring for our parent! In disbelief, I said excuse me? They again asked is it actually fractured and I questioned if they mean my parent's arm. The nurse said "yes" and I confirmed they have a fractured humerus bone. In my opinion, how could they not have known this? Is it not documented on the patient file? Do they look at the file?

The next day, I asked for an appointment with the NUM. I addressed the issues above as well as that my parent had not been showered, washed, teeth brushed, or had clothes/underwear changed in 3 days and was no sign of it happening in the near future. The NUM (whose name escapes me) expressed that he was sorry for this happening and explained that both of the nurses looking after my parent were Grad nurses and only 3 months out of their time, so still learning, he was going to assign my parent different nurses, with over 20 years experience.

A few days after that my parent arrived in the afternoon to the Angliss Rehab facility. They were placed on to Ward 1 North. My parent had a room with a beautiful view and this was extremely comforting to us as a family, as it brought a spark back to their eye. I believe it reminded my parent of where they used to live. I believe it was keeping their mind active with everything that was outside; the train, the people walking by, the birds, the mountains and lots of different things.

Everything seems to be going well.

After a few days, my parent was asked if they would move to another room so another patient could take their room. Unfortunately for my parent, they did agree. They were then placed in a horrible room (in my opinion), tucked around a corner with no window and just four walls to stare at.

As you walk along the corridors there are plenty of people that seem to not give two hoots about their window, yet my parent sat there all day, every day, staring out of it. It was occupying their mind. It was a real shame for this to happen, not only because it was keeping my parent's mind very active but it is very unsettling and confusing for someone with Alzheimer's with all of these changes. In my opinion, my parent's Alzheimer’s was not taken into consideration whatsoever with this move and how it would affect them.

I arrived that morning to visit my parent who was desperate to have a shower. My parent showed me the towels that the nurse had left on the chair along with some face washers and bath mats. They were told those are there for a shower, but I believe no one came back to offer them one so asked me to do it. Obviously I assisted my parent as they were unable to bathe themselves with broken bones. I brushed their teeth, got them dressed and put the sling back on.

I was very surprised that this enormous bathroom had no shelf to put any clothes or toiletry bags on. I had to dry the hand basin and put everything in the hand basin so they wouldn’t get wet on the floor. The shower is right beside the toilet and all of the toilet paper gets soaked. This is a very poor design for a rehabilitation bathroom, in my opinion, it's not user-friendly and I believe it's unsafe.

Whilst my parent was sitting back in their chair beside the bed I noticed their feet dangling away and nowhere near touching the floor. Once again, I believe this is extremely dangerous as they're already at high risk of a fall, they certainly should have both feet flat on the floor while in a seated position. I had to assist my parent to get off the chair while I adjusted all four legs down two notches. Of all places, in my opinion, a rehab facility should be looking at these things when either admitting or moving a patient.  

On the same day, my parent had no meal delivered. I went to find the lunch person who was up the other end of the corridor to ask if they had my parent's lunch. They went and checked the other trolley and said it's being delivered just now, so I walked all the way back down to my parent's room thinking it was delivered while I was gone. No, my parent still had no lunch. I then had to go out to the nurse's station and enquire there. They found that it had been delivered to the wrong room and the nurse scurried off to go find my parent lunch and deliver it to their room.

Once again, I was alarmed as my parent had a note on their wall that they need assistance with cutting their food up, yet I believe no nurse came into the room to offer any assistance cutting up the meal. If the nurse had come to check and offer assistance, as noted on the wall, they would have found that my parent hadn't even been given a meal! I was very thankful that I was there at the time or else my parent would have gone hungry. Since this day they now have their meal delivered already cut up.

As I was leaving, I asked my parent for the changes of clothes that needed to be washed and said they didn't have any. I checked the cupboards and drawers in case they had forgotten, but there were none and the same amount of clean underwear that I had packed for them to take in. At this stage, my parent had been at the Angliss for 4 days and had not had their underwear changed and, to the best of my knowledge, had not had a shower until that morning when I came and gave them one. Also, had not been wearing the disposable underwear that the hospital can sometimes supply as they were wearing their own when I undressed them for the shower.

I left the hospital feeling very upset and disheartened with the lack of care our parent was receiving. So I called to speak to the NUM. When I explained that my parent hadn't been showered for 4 days, they went to check my parent's chart, came back and explained to me that they had a shower that morning, to which I agreed (as I had actually given my parent that shower). They seemed somewhat apologetic and offered no explanation as to why these things have been happening, nor did they give me confidence that this type of thing wouldn't happen again. So I requested to speak to their superior who they arranged to give me a call the following day.

I received a phone call from the nursing unit manager. I explained this lengthy situation to them also, who said they've been in and checked my parent's notes and it said they had washes and also had a shower with the OT on a few days earlier to see how they would go showering themselves. I asked that if that was the case and they had a shower with the OT, then where was their change of underwear and Pyjamas? The staff member said they had no idea, so I asked if I could speak to the Occupational Therapist. So they arranged for the OT to give me a call back either later that day or the following morning. I received a call back from an OT 2 days later, but I believe this was not the OT that had showered my parent, so was unable to answer any of my concerns. The OT I was needing to speak to, I believe was now on leave.

I expressed to the NUM that maybe it was extremely busy and they didn’t have enough nurses to get around to everybody, to which it seemed they snapped that they have all of the right numbers for the patients to nurses ratio, so I said that makes this situation even worse. If you do have enough staff to patient ratios, then why are all of these mistakes happening and jeopardising the safety of my parent.

They apologised and said that none of this happened on their shift which made me quite frustrated and left me feeling that I just needed to accept the apology and move on.

The day after the phone call, I visited my parent in the morning. During my visit, a nurse popped into the room looking for my parent's chart on numerous occasions and could not find it. They came back about an hour later with the doctor, both looking for it and eventually found it hanging over the back of one of the chairs, underneath some towels. As they grabbed it off, they flicked off the towel and face washer that was sitting on top of it onto the floor with neither of them picking it up, they walked out of the room with the chart to discuss what they needed to.

Not long after, the nurse came back in and I asked how my parent's physio and occupational therapy were going. They told me they didn't know that information and turned to ask my parent have they had physiotherapy? I said to the nurse I think they're asking the wrong person as my parent would not be able to recall that kind of information.

Not long after, the doctor came into my parent's room, not introducing themselves at all and explained that the x-ray had come back and it looks like the bone is healing, not sure when you're going home. In my opinion, they were dismissive of any questions that I had regarding the muscle potentially tearing off the bone and just told me that x-rays don't show that. We still don’t know if the muscle is attached or not. I felt this doctor has no bedside manner whatsoever, they couldn't even look at us when they were giving us this information. They seemed to cut my parent off at every question they asked and had no patience. They didn't allow us the time to ask any questions and rushed out of the room still speaking to my parent on the way out.

Once again, leaving feeling very frustrated and disheartened at the lack of care my parent was receiving. I stopped at the nurse's station when I was leaving and waited for 2 minutes for all of the nurse's commotions to calm down and for someone to recognise that I was standing there. I then got the attention of the NUM and asked if I could have a moment of their time. They took me into their office where I expressed all of my concerns to them again. I felt they seemed quite annoyed at the concerns that I had and said they were doing the best they could do. I told them, in my opinion, it is not good enough, as all of these little problems are how big accidents happen, and we know this first hand as we lost our other parent due to a hospital not following orders in a chart.

Upon leaving the hospital, I asked the staff at the main desk for the Director of Nursing's contact details. I have since been in contact, I gave the person on the phone a brief overview of my concerns and is arranging for someone to call me back.

Someone from the phone number on the brochure I have called me back, they noticed a missed call from my number. They asked for details surrounding my complaint and said that someone like the Director of Nursing would call me, if not that afternoon, but most likely would be the next day. I've still heard nothing.

I believe hospitals and rehabilitation facilities are to assist those in need. They have a duty of care to look after their patients to ensure their recovery and safety. Surely, there are basic guidelines such as file notes on medications, injuries, treatments and diagnosed illnesses! I believe these would be mandatory for health and safety purposes; and what about basic hygiene of patients? 4 days without a shower or a wash is totally unacceptable, in my opinion. All medical staff, I feel, whether they are nurses or doctors surely know how to deal with a patient with Alzheimer’s.

Our parent is only one person in this facility. If our parent is receiving this substandard treatment, how many others are in the same situation in the Eastern Health care system.