Commission hears of resident’s decline after failing to get home care

The royal commission has heard how an elderly woman who had to enter residential care after being told she would have a 12 month wait for home care died of infected ulcers three months later.

The royal commission has heard how an elderly woman who walked into a Victorian aged care facility after being told she would have a 12 month wait for home care died of infected ulcers three months later.

Johanna Aalberts-Henderson told the Royal Commission into Aged Care Quality and Safety on sitting in Cairns on Monday that her mother, Bertha Aalberts, who was born in Holland in 1930, had been living at home by herself since the death of her husband in 2015.

Ms Aalberts-Henderson, who described Ms Aalberts as a “neat freak” who loved cleanliness and order, said her mother wanted to remain at home but had  begun to suffer from a range of health issues including heart problems, back pain and macular degeneration which left her legally blind, and she had become increasingly frail.

She was assisted in staying at home by her family and a carer who helped out with shopping and cleaning once a week under a level 2 home care package.

By March 2018 Ms Aalberts had been assessed for a level 4 home care package, but relief quickly turned to despair when it became evident that the package wouldn’t be available for 12 months.

“We were delighted but the case worker said ‘the money isn’t available in the government funds to provide those extra hour’, so we went from joy to sadness very quickly,” Ms Aalberts Henderson said.

Johanna Aalberts-Henderson

Rapid deterioration

The family then made a decision to put Ms Aalberts into residential at care at Avondrust, a Victorian aged care facility operated by MiCare.

Ms Aalberts said her mother was not happy about moving from the family home but she realised it was necessary. She says Ms Aalberts walked into the facility unassisted, “cogniscent and continent” on 24 May.

Just weeks later Ms Aalberts had become bedridden with a broken wrist she had suffered in one of a series of falls, had lost seven kilos and developed a series of pressure ulcers. She also said her preference for vegetarian meals wasn’t respected and she was encouraged to defecate in adult nappies even though she was continent.

Three months later Ms Aalberts transferred to an acute care hospital with severely infected pressure ulcers, where she died.

Ms Aalberts Henderson told the commission she believed her mother did not receive appropriate physiotherapy to help her rehabilitate after her fall, wasn’t turned frequently enough to prevent pressure ulcers developing and was not given assistance to get out of bed or move around.

“We kept saying to the physio, ‘mum needs to stand, she needs to have some mobility, some leg exercises or arm exercises’,” Ms Aalberts-Henderson, a former nurse, told the commission.

“I often saw her in wheelchair crying … No one was walking her so the capacity to walk went very quickly.”

Reactive care

She also said the care her mother received was reactive rather than proactive.

“Everything seemed to be done after the fact,” she said. “We have the fall, then we’ll fix it. We have something else go wrong and then we fix it. There was no proactivity in mum’s care. It was reactive.”

She said she was eventually left in the position where “I was no longer a daughter but a supervisor.”

The first time Ms Aalberts-Henderson became aware of the seriousness of her mother’s wounds was when in August 7 when she was present as they where being examined at the acute care hospital.

Among the wounds was one on her 87-year-old mother’s right shin that was 14 centimetres long, turning green and down to the bone.

“They pulled the gauze out of it and every body in the room (gasped),” she said. “It was unbelievable to see.

“I was in an icy cold rage. How dare they?”

Ms Aalberts’ family decided she would not return to Avondrust but the doctor took them to a room and told them “I think your mother is dying”.

She died in hospital on 19 August.

MiCare CEO and executive director Petronella Neeleman acknowledged there had been cultural and leadership issues in the organisation.

“Unfortunately, what we weren’t hearing until probably some time in February, were that there were issues between staff…. The clinical staff and management staff at the time were having differing opinions on how care should be delivered,” Ms Neeleman said.

She said there were no excuses for the delivery of inadequate care to Mrs Aalberts.

“No excuses can be made that will ever make up for the pain and suffering experienced by Mrs Aalberts and because of this, her family,” Mrs Neeleman said in her witness statement.

The hearings continue this week.

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