A former rest home manager is calling for better care for the elderly after her father was "starved of food and fluid" in a Whakatane centre.
Donna Barraclough's father, retired farm manager Des Barraclough, lost 13kg in 16 days in Whakatane's Sheaffs Rest Home and died six days later from heart and kidney failure.
Health and Disability Deputy Commissioner Theo Baker found that the rest home and its owner/manager Jenny Lepper failed to provide services of an appropriate standard and that Mr Barraclough's care by Mrs Lepper's daughter Lorene Armitstead, the home's sole registered nurse, fell "below expected standards".
But Mrs Lepper said Mr Barraclough had already suffered dehydration multiple times before going to the rest home.
"Mr Barraclough does have a right to refuse his food, although we did everything in our power to encourage him to eat," she said.
Mr Barraclough's daughter Donna, a senior nurse at Waikato Hospital who managed two rest homes in Te Awamutu between 2002 and 2004, has spoken out in response to a Herald rest home investigation this week.
"There should be an awareness that we are doing a really poor job for the elderly," she said. "I think it has to change."
Her father was 77 when he went to Sheaffs from Whakatane Hospital on March 10, 2011. He was on fluid-reducing medication for heart problems, which caused repeated dehydration. The hospital recorded his weight as 70.8kg.
Mrs Lepper said Sheaffs, a small 29-bed home, employs Mrs Armitstead for "at least 10 hours a week, it varies". On March 10 Mrs Armitstead went there after finishing a shift at Whakatane Hospital, where she also works. According to Ms Baker's report, she "asked Mr (Barraclough) some general questions about how he was feeling and how he got around" and then wrote a nine-page care plan for him based on this conversation and his medical records.
She wrote that the plan was completed with input from Mr Barraclough's wife Cherie, but Cherie Barraclough said Mrs Armitstead never spoke to her. Mrs Lepper said: "Unfortunately, yes, the registered nurse shouldn't have put that, but she intended catching up with her."
The plan said Mr Barraclough was to be weighed weekly, drink at least six glasses (250ml) of fluid a day, and have his food intake charted if his appetite decreased.
On March 17, a caregiver noted that he "refused tea". On March 21 a doctor saw him for the first time. She told Ms Baker that Mr Barraclough "complained of difficulty swallowing" and his throat looked dry, but she could not see any sign of thrush.
His weight was recorded for the first time in the rest home at 66.8kg. He refused lunch that day.
Caregivers noted several more times in the next three days that he refused food or fluids. On March 22 a note said his son visited and was "shocked at his deterioration".
The next day, Cherie Barraclough cried when she saw him. On March 26, Mrs Barraclough found him in a wheelchair for the first time.
The rest home started to chart his fluid intake that day. Mrs Barraclough called her daughter Donna over from Hamilton and it was agreed to send him straight to hospital. His weight was recorded there as 57.8kg, and Donna Barraclough said a doctor said her father's fluid level was 5 litres in deficit.
"He was so dehydrated that he ended up in kidney and cardiac failure," she said. He died on April 1.
Mrs Lepper said the rest home had changed its procedures. "We have learnt a lot from it, mainly in communication with families and the families' expectations," she said.
Where to get advice
• Age Concern - visit local office, contact details on website
• Needs Assessment and Service Coordination team at each district health board - decides if someone needs home help or residential care, contact details online
• Eldernet - directory of aged residential care facilities
• Health Ministry - directory, full audits, summary audit reports, how the system works
• Consumer NZ - checklist of what to ask and look for, list of rest homes that have been investigated
• nzherald.co.nz - comprehensive guide on how to choose a rest home
• findaresthome.co.nz - directory, how the system works
• Decision Time - book available at some public libraries and for sale at bookshops