The trials of finding a good nursing home

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Until recently, I was your typical, middle-aged Aussie who spent very little time thinking about the quality of nursing home care. I'm a member of the generation that thinks of ourselves as the centre of the public universe. We are the workforce. We are the parents of kids in school. We are peak-hour public transport users. We are the ones who pay full price. So, we don't think about nursing homes much, until it's something a loved one needs.

Holding the hand of an old personIt happened to me back in 2013. My dad, who had been diagnosed with prostate cancer some six years earlier, was not coping well with chemotherapy. He'd managed to maintain his independence through six years of treatments and a bout of skin cancer. But now he needed chemo.

I scheduled a flight back to Australia timed to celebrate the end of the last dose, but Mum called to say he wasn't doing so good. 'He can't walk up the stairs, Rachel.' He needed 24-hour care, and Mum — who worked full-time and was half his size — just wasn't able to be his nurse, no matter how much she wished she could.

So he went into hospital and we started to think about nursing homes. I had visions of him in a nice room he could call his own, where he could receive visitors and play bingo in the afternoons. In hindsight, I can't believe I didn't realise how close he was to the end — he could barely lift himself up into a sitting position in bed. But when you are losing a parent your brain doesn't work rationally. 

Because my dad was eligible for fully subsidised care, we were given a list of potential nursing homes that took people like him. While we worked to find him a permanent place, he was put in a temporary one, unfortunately far away from us. The decision-makers gave no thought to my mum's battling public transport and the traffic, but it seemed like a nice place. We thought Dad was just being difficult when he begged us to take him home.

After having no joy convincing my mum, he rang and begged me. Startled, I explained he was just too sick. He angrily hung up on me, very out of character for my normally jovial dad. When we visited, we'd find him lying there with his beanie pulled low, covering his eyes, shutting out the world. Later, he quietly told us that while some of the staff were good, one fella was very rough, yanking and yelling at him. I still shudder to think.

We needed to find a permanent place, so I began to do the tours. I remember someone telling me to ignore the chandeliers and smell the couch cushions. One place had a million things you couldn't do for 'health and safety' reasons. No, we wouldn't be able to bring in his favourite Indonesian food. No, his pet dog wasn't allowed to visit. It seemed more like a prison than a home, so that was scratched off the list.

 

"It didn't take much to provide dad with good care. What he needed — and got — was good food; kind and gentle interactions with appropriately-trained staff; and a can-do attitude from the higher-ups."

 

Another place seemed very posh. I was given an appointment and tour. But then the next week I dropped in without announcing myself, and found a mattress in the hallway and a woman, who seemed to be in some distress, calling out without being answered. The third place gave me a generous tour of their lovely facilities but when I explained dad was fully subsidised I was told that he wouldn't be allowed in the home I'd just toured, they had a different home for government-funded care. I didn't ask about that one.

Finally, I went and looked at the local council-run home. It was like we had stumbled on the promised land. Nothing was too difficult, no request too odd. When I explained about dad's need for Indonesian food, the manager told me they even had Indonesian nursing staff who would probably be able to cook him something authentic themselves! This was the home for us.

Fate must have been smiling on us, because a place opened up almost straight away. Dad transformed from an angry, difficult patient, into a happy and contented soul who knew he was about to make the greatest journey of all. He kept telling us how good it was in the new place, how kind the staff were. We started to realise that what we'd dismissed as 'Dad being difficult' was more likely due to a darker cause.

Dad died two weeks later, never even eating a bite of nasi goreng. His cancer had progressed too far. The night before he died, the nurses asked if I'd like to stay over, and arranged for a camp-bed for me to sleep in next to his bed. They were angels, the staff at that home. 

It didn't take much to provide dad with good care. What he needed — and got — was (at least the offer of) good food; kind and gentle interactions with appropriately-trained staff; and a can-do attitude from the higher-ups. It's the type of care I wish for all residents of nursing homes all over Australia. Unfortunately, it seems this is very far from the case for many.

 

 

Rachel WoodlockDr Rachel Woodlock is an expat Australian academic and writer living in Ireland.

Topic tags: Rachel Woodlock, aged care

 

 

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Unfortunately, Rachel, in our enlightenment we have, in the main, handed aged care over to the private entrepreneurial provider, dedicated to share-holder profit, executive salaries and "good boy/girl" bonuses to those who minimise cost to the company. With the abandonment of belief in a god and in the dignity and sanctity of human life, we have lost the dedicated personnel (eg members of religious orders and those who saw the care of the elderly as a privileged calling to service rather than a money earner) who used to offer themselves willingly to the care of the disadvantaged for little monetary return. A Nobel Laureate whom I once knew and admired said in his acceptance speech for the prize, "Service to others is the rent we pay for living on this planet." The corporate sector pays as little rent as possible. We the landlords should boot them out! It was not surprising that when you eventually found a humane institution it was run, presumably on the public purse, by the local council, something which highlights the destructive outcomes when public sector responsibility for essential human services (which is also required of us to "live on this planet") is farmed out to serve the greed of free enterprise.
john frawley | 20 September 2018


The Australian Government are organising a Royal Commission to look into aged care here, but that will take time. Immediate needs are a much better staffing ratio, better pay for the carers, and many more well-trained staff. Governments must act immediately on these issues as so many of our elderly citizens are being neglected in their time of need.
Grant Allen | 21 September 2018


What a lovely account Rachel, the search for a comfortable place for your dad was worth it in the end. My wife and I are 70.I am retired as I am in ill health , she is still working as she is healthy and loves her work. We watched the 4 Corners programme on Monday night with concern and some anxiety as we hope very much we can avoid ending up in a nursing home. I have vivid memories of one of my aunts ending up in a nursing home in the 1970's- needless to say she did not last long. It was a most depressing place. Obviously things have not changed since then! Maybe a Royal Commission is needed to shake up a damaged system.
Gavin O'Brien | 21 September 2018


Rachel Thank you for describing the nursing home your father went in. As a one time worker in a nursing home, cost in was the big thing. We have more than 70 beds and 3 staff were considered sufficient to look after each resident and have the shower quota met and all residents fully dressed and sitting at the dining room by 8 am for breakfast. There was another problem management rostered the 3 males on at the one shift and many of the ladies did not like to be showered by a male, which resulted with careres who were going the extra mile to give residents a shower on their day and not the rostered day. Result castigation for the carer who did extra but not the males who did less. The pay rate is appalling, but the privilege of caring for the elderly is a great gift.
Gabrielle | 21 September 2018


We were fortunate, when my father needed to go into care, to get a bed for him in a not for profit nursing home where the staff were very caring for the brief time he was in their care. However, some of the nursing homes and special accoms that I have visited over the last 25 years have been appalling. Beware the places with flash furnishings and signs that suggest that this establishment is for "discerning or refined gentlewomen and gentlemen" or the like. This usually signals lovely surroundings but little else. A friend who was in one such place told me that her Sunday night dinner consisted of 2 cocktail frankfurts, half a slice of bread and butter, a slice each of tomato and beetroot and one lettuce leaf. This place also turned on Devonshire teas on nice china for prospective residents and their families but biscuits in packets the rest of the time! Please be like Rachel and look at places after hours and make unexpected visits, including at meal times, if you ever have to find an age care home. And check staff qualifications and ratios, meals, laundry, activities and diversional therapy, and access to medical care.
Sandra Houghton | 21 September 2018


Care for the aged, who are particularly vulnerable in a world that increasingly places only utilitarian value on human life, is especially incumbent on members of a society that would qualify as civilised.
John | 24 September 2018


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