Annunziata Santoro lived to feed the chooks and tend to her garden, but died with maggot-infested bed sores from a negligent nursing home.

Harrowing tales of neglect in the Royal Commission's eight-volume report into aged care, made public this week, include that of Italian migrant Annunziata Santoro, a retired dressmaker who enjoyed drinking espresso coffee, watching old movies and gardening.

Mrs Santoro's life ended soon after maggots infested a weeping bedsore that had festered for weeks on her foot at the Assisi Aged Care centre at Rosanna in Victoria.

A nurse told her horrified daughter that "maggots are often used in modern medicine'', then suggested a fly must have laid eggs in the open wound when visitors took Mrs Santoro outside.

Annunziata Santoro suffered broken bones in aged care. Picture: Supplied
Annunziata Santoro suffered broken bones in aged care. Picture: Supplied

A doctor declared that "unless she was prepared to have her foot amputated, palliative care was the only realistic option''.

Mrs Santoro was moved to a better nursing home for palliative care, where she died in 2018 at the age of 94 after a spending a painful year at the Assisi nursing home.

She had lost 10 per cent of her body weight in two months - weighing just 49kg - and broke three bones in an unwitnessed fall.

The Royal Commission spells out the extent of Australia's aged care crisis, in a 2733-page report revealing heartbreaking abuse and neglect, corporate greed and regulatory incompetence.

One in three elderly Australians living in aged care homes have suffered "substandard care in the most basic of human needs'', the report warns, with as many as one in five assaulted by a staff member or fellow resident.

 

Patient Annunziata Santoro had eight maggots found in a wound on her heel. Picture: Supplied
Patient Annunziata Santoro had eight maggots found in a wound on her heel. Picture: Supplied

A Medicare-style levy to fund aged care reform is now on the table, after Prime Minister Scott Morrison pledged an extra $452 million for aged care this year and flagged more taxpayer funding in the May budget, on top of the $20 billion to be spent this year.

He announced an extra 1500 snap inspections of aged homes every year, after Royal Commissioners Tony Pagone QC and Lynelle Briggs concluded that "substandard care and abuse pervades the Australian aged care system''.

The two-year inquiry has exposed physical and sexual abuse of residents by staff members, with two out of three residents malnourished, medication errors common and abuse of restraints rampant, and vulnerable residents left in pain from untreated fractures and bed sores.

The Royal Commission's 148 radical recommendations for reform include mandatory quotas of properly trained staff, with at least one nurse on duty at any time to provide guaranteed hours of care for each resident.

It warns that Australia's aged care system is "understaffed and the workforce underpaid and undertrained''.

Japara Healthcare CEO Andrew Sudholz.
Japara Healthcare CEO Andrew Sudholz.

Short-staffing and shoddy care have caused residents to live in pain, sit in their own faeces and literally starve to death through malnourishment.

At the Anglicare-owned Brian King Gardens nursing home in Sydney's northwest, the Royal Commission found that an 82-year-old woman had to have rotten teeth pulled out in 2016 because her "dentures had not been removed or cleaned for a number of weeks or more'', despite an internal care directive that they be cleaned daily.

The woman's daughters took her to a dentist and held her hand, watching their mother "quietly sob as her teeth were extracted''.

In Sydney, 72-year-old Terry Reeves - who spent most of his working life as a Telstra technician - was admitted to the Garden View nursing home in Merrylands with Alzheimer's disease.

He was heavily sedated and tied to a chair with a lap belt for up to 14 hours a day, until his cancer-stricken wife managed to move him to a different home that stopped the medication and let him walk with supervision.

Terry Reeves, centre, was strapped into his wheelchair and allegedly chemically restrained with antipsychotic drugs whilst at Garden View aged care home in Merrylands.
Terry Reeves, centre, was strapped into his wheelchair and allegedly chemically restrained with antipsychotic drugs whilst at Garden View aged care home in Merrylands.

At the Oberon Village nursing home in NSW, 82 assaults upon and between residents and staff were recorded in the space of four years.

In 2018, an assistant nurse on night duty saw a male resident, previously accused of assaulting three residents, drag an 82-year-old woman out of his room, "bleeding heavily from her head''. The man claimed she fell over, the woman claimed he pushed her - yet no one saw what happened.

The Royal Commission repeatedly criticised one of Australia's biggest corporate aged care providers, Japara Aged Care - the owner of Japara Noosa, where the Queensland Coroner is investigating the death of a resident bashed to death, and police are probing the alleged theft of narcotic pain patches from residents.

Terry Reeves, 72, a resident of Garden View aged care home in Merrylands. Source: Aged Care Royal Commission
Terry Reeves, 72, a resident of Garden View aged care home in Merrylands. Source: Aged Care Royal Commission

The daughter of the late Clarence Hausler secretly filmed carers assaulting her bedridden father at the Japara Mitcham nursing home in Perth 2015.

"He was the subject of a series of degrading assaults when he should have been allowed to enjoy the last years of his life in peace,'' the Royal Commission report concluded.

"Beyond the indignity and criminality of the assaults committed against her father, (his daughter) had to contend with an organisation determined to avoid accountability for its actions.''

Health giant Bupa Aged Care Australia was busted by the Royal Commission for savage cost-cutting, with managers ordered to slash staff across 72 nursing homes in a 2017 directive to "save shifts'' to improve its "commercial position''.

Bupa had a code name for its cost-cutting plan - Project James - which involved cutting the number of nurses, and their hours, and not replacing staff who called in sick.

In an email to Bupa managers, tendered to the Royal Commission, Bupa Aged Care's director of operations in 2017, Ian Burge, wrote that there were "no sacred cows and anything's possible'', with the goal of reducing operating costs to "roughly … double our current monthly profit''.

Noleen Hausler taped a nurse abusing her dad, Clarence, in a nursing home by secretly filming him. Picture: Tait Schmaal
Noleen Hausler taped a nurse abusing her dad, Clarence, in a nursing home by secretly filming him. Picture: Tait Schmaal

The Australian Aged Care Quality Agency slapped sanctions on 10 Bupa nursing homes, including Bupa South Hobart, between July 2018 and March 2019, after they failed quality audits.

At Bupa Willoughby, a 70-year-old woman too weak to eat unassisted was taken to hospital in 2017 with aspiration pneumonia - caused by food being inhaled into the lungs - with "unchewed food and medication" still in her mouth.

Her daughter told a hearing that she believed staff were putting food in front of her mother "then returning later to collect the untouched meal and throw it in the bin.''

The Royal Commission criticised Bupa Willoughby's "substandard care'', including pain management of a bedsore 4cm long by 3cm wide - so large that Bupa's then executive clinical adviser Maureen Berry told the Sydney hearing it "would have been helpful for a ruler to be used''.

Arthur Miller, the owner of Gold Coast-based Earle Haven. Picture: AAP
Arthur Miller, the owner of Gold Coast-based Earle Haven. Picture: AAP

Government aged care watchdogs were also slammed by the Royal Commission for "regulatory ritualism'', and failing to properly probe complaints or follow up on assaults.

At the now-closed SA Government-run Oakden Older Persons Mental Health Service in Adelaide, where resident Bob Spriggs suffering unexplained bruising and heavy sedation before his death in 2016, the Royal Commission identified "multitudinous failures that led to Oakden continuing to operate while it provided substandard care''.

"The system let Bob down,'' the report states.

"The mistreatment of Bob Spriggs extends to the failure of the system to detect that mistreatment.''

The Royal Commission found that the federal Department of Health failed to check the unusual business arrangements of the Earle Haven nursing home before it was shut down over a contract payment dispute - forcing the emergency evacuation of all 68 residents to a Gold Coast Hospital in 2019.

The Royal Commission was "struck by how unprepared the regulators appeared to be''.

Australia's aged care system, it concluded, is "a disgrace and should be a source of national shame.''

 

 

 

Originally published as Broken bones and maggots: Nan's horror death in aged care


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