There will be agonising over what the best options might be, often coupled with sadness or even guilt among family members because the care for that loved one has become beyond their capability.
The move might come after a crisis. There may not be many choices available.
Whatever the preamble, placing a fragile elderly person, who may have both physical and mental incapacity, in a rest-home or hospital-level care means placing a huge amount of trust in the organisation running it and their staff.
Families know they cannot be there every moment of the day to ensure the care is up to par. And, if the treatment meted out by staff is awry, it might not always be easy to discern.
Is there a risk some families suppress concerns because they fear they have no other care options?
What that revealed resulted in a complaint to the Health and Disability Commissioner with aged care commissioner Carolyn Cooper finding two carers acted abusively towards him and one failed to report abusive behaviour. Further, the widespread failure in the man’s care reflected a culture of disrespect by caregivers at Presbyterian Support Otago (PSO) towards those under their care.
Ms Cooper said while the individual caregivers involved were responsible for their inappropriate conduct, she also examined the PSO’s role as the organisation responsible for ensuring the man’s wellbeing.
She raised questions about the adequacy and understanding of incident reporting and whether staff had enough training in managing people with dementia and challenging behaviours.
Tellingly, the issue of adequacy of staffing within the home was raised by all three caregivers, with one reporting a situation where she had been on her own for two hours with 14 residents, some with high needs, and she did not get any allocated breaks.
Another of the caregivers said she had worked seven days without a break, including a double shift she felt obliged to complete because nobody else could be found.
Ms Cooper acknowledged there was a significant shortage of registered nurses and caregivers across aged care, but it was the organisation’s responsibility to ensure it operated safely.
"I am concerned that the safety and wellbeing of the staff at Iona was not being protected, and therefore the subsequent impact this had on the residents’ wellbeing."
PSO has moved to make changes to improve its culture and education and its monitoring.
All the same, there will be families with loved ones in aged-care establishments across the country who will find this case unsettling, wondering if this is an isolated scenario.
They may remember across the Ditch a daughter’s hidden camera footage of her dementia patient father’s treatment in an Adelaide nursing home in 2015 put the spotlight on elder abuse which eventually led to a royal commission into aged care.
Here, we await the outcome of the government’s health select committee inquiry into the aged-care sector’s current and future capacity to provide support services for people experiencing neurological cognitive disorders.
It includes examining the funding model.
In her submission to the committee, Ms Cooper referred to the urgent need for sustainable funding for home and community support and aged residential care to reduce pressure on hospitals, and the need to plan and fund geographically equitable access to acute and long-term care that was culturally safe and community-based where possible.
She also referred to the need for action on workforce shortages, which would include pay parity with Health New Zealand workers.
With our rapidly ageing population, the time for procrastination and piecemeal treatment of all these issues is over.
However, in the current cost-cutting climate in health it is hard not to be sceptical.
