Inside our rest homes: Lifting the lid on aged care in NZ

By Martin Johnston, Simon Collins

Some facilities likened to chicken farms over shortfalls in aged care.

Photo / Getty Images
Photo / Getty Images

A Herald investigation of rest homes - where a greater proportion of elderly people die than in 12 other developed countries - has found that although most care is at least adequate, some reflects major failings.

The two-month investigation found a confused married woman was "mauled" by a male resident in his bed at one home, and a scabies outbreak wasn't properly managed for nine months at another.

There were concerns about poorly treated pressure sores, residents left in pain because caregivers were too busy to answer call bells, and cuts in physiotherapy and activities.

Aged-care health specialists were concerned about under-funding, low pay, and caregiver turnover of 25 per cent last year, all combining to weaken the quality of care.

"They are like chicken farms, some of these places; they plonk people down in front of TV and over-medicate," said Age Concern field worker Chris Frew.

Rest-home operators say they are simply not funded to provide more than "a minimum level of care".

Are you or someone in your family thinking about moving into a rest-home? The Herald has compiled this guide for you to consider before you make your choice.

The Government has instructed district health boards to provide more front-end nursing and medical support to aged care homes because of their high referral rates to hospitals.

Aged care nursing expert and rest home manager Dr Noeline Whitehead said this support was far better than "beating up the sector".

"If we as New Zealanders care about our older people, we will get up and tell our politicians to do better and support the sector."

A Consumer NZ survey of audit summaries of all 634 care homes found that 3 per cent had major shortfalls and a majority had more-than-minor shortfalls.

Families will get more information to help choose care for elderly relatives from tomorrow, when the Ministry of Health will start posting full rest-home audit reports online in a six-month trial. But the Government says it will take the reports down again if no one bothers to read them. An outraged husband told the Herald a Hamilton rest home left his confused wife to be "mauled" by a male resident in his bed for 15 minutes before intervening.

Adrian Waterhouse is unhappy with the care his wife, Josie, received at Maeroa Lodge. Photo / Christine Cornege
Adrian Waterhouse is unhappy with the care his wife, Josie, received at Maeroa Lodge. Photo / Christine Cornege

Retired meat consultant Adrian Waterhouse, 77, received a report from Radius Care's Maeroa Lodge saying his wife Josie, 70, thought the man she got into bed with was her husband.

But Radius chief Brien Cree said the pair were "consenting adults" and caregivers were right to leave them alone until the clinical manager arrived 15 minutes later.

The incident is one of three complaints the Herald has received about the 92-bed rest home. At least seven complaints about it have been substantiated by the Ministry of Health or Waikato District Health Board since 2010.

Mr Cree said the facility had improved and an August audit put it in the top 20 per cent in the country.

Mr Waterhouse has cared for his wife at home since she suffered brain damage in a stroke in 2004, and uses Maeroa Lodge as respite care to give himself a break.

He has been unhappy with several aspects of her care, including evidence that she was sometimes not given her medication, did not have her teeth cleaned, and had developed a "nappy rash" while there.

But the worst incident was on June 26 last year. "One night she ended up in bed with a guy in the guy's room," Mr Waterhouse said. "The report said she was just getting into bed and the man said to the nurse, 'Get out and shut the door.' She did.

"The three that were on duty reckoned they couldn't handle it; they had to call a senior. It was 15 minutes till she turned up, so here's my wife being mauled by this guy for 15 minutes. I got the report. Then I got a letter saying they didn't accept any responsibility."

The report said the home's clinical leader Maree Burley arrived 15 to 20 minutes after getting the call and found Mrs Waterhouse in bed with the man, who was 96.

"Maree spoke to Josie and told her that she was married and that her husband would be very unhappy with what was happening," the report said. "Josie replied that this was her husband, and Maree told her he was not. Josie then looked at [the man] and said to him, you told me you were my husband, at which [he] replied, you are not my wife. Josie seemed a bit confused by this."

Mr Waterhouse complained to the district health board (DHB). Its manager for older people's health, Fiona Murdoch, told him that Radius should have had a policy for such incidents and trained staff to follow it.

But Mr Cree said the company did have a policy on sexual issues and treated the two clients as "consenting adults".

"Whilst both clients suffer from mild dementia, neither were deemed by the DHB to require specialist dementia care and Maeroa Lodge does not provide this level of care. In a non-secure facility, clients have the right of free will."

He said staff had found no evidence to back up Mr Waterhouse's earlier concern about a "nappy rash" on his wife, and noted that Mr Waterhouse had continued to use Maeroa Lodge for respite care five times since the incident occurred.

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