System under fire after aged-care death

The death of a rest-home resident after an altercation with another dementia patient has prompted fresh calls for an overhaul of the aged-care system.

This is the third time in a year that a coroner has called for a review of rest-home funding and it follows a damning report by Auditor-General Lyn Provost that criticised the Health Ministry for the way it monitored rest homes.

Health Minister Tony Ryall says increasing rates of dementia are one of the biggest challenges for families and the health system in the next 20 years and has promised more money for aged care this year.

Hastings coroner Chris Devonport has recommended putting CCTV cameras in rest homes to monitor dementia patients and more funding for dementia care after Nola Revell, 82, a resident of the severe dementia unit at Gisborne's Dunblane rest home, died last July.

A staff member, alerted by Mrs Revell's screams, found her on the floor with a walking frame on top of her and a patient kneeling over her and pulling her arm upward. A third patient was also in the room.

Mrs Revell was taken to hospital where her condition deteriorated, and she died four days later.

Mr Devonport and Wellington coroner Garry Evans have expressed concerns rest homes are having to cope with higher dependency in patients but are not getting more money to care for them.

In December, Mr Evans called for an overhaul of the aged-care sector after Upper Hutt rest-home resident Florence Coombes, 98, who was being bullied by other dementia patients, died after suspicious falls in May 2008.

And in March last year, he found Newtown rest-home resident William Culley, 88, who died after a fall in August 2006, did not get the level of care he should have.

Mr Devonport said in the case of Mrs Revell, no-one saw her fall and neither Mrs Revell nor the other patients could communicate or answer questions on the incident.

As well as CCTV cameras and more funding, he also recommended that the ministry review rest-home staffing levels.

Rest homes such as Dunblane were meeting required staffing levels but those levels needed review, he said.

Geoff Hipkins, chief executive of Oceania Group's 63 rest homes and hospitals including Dunblane, said his organisation was considering using CCTV cameras. These would identify aggressive behaviour in residents, but may not prevent incidents like those in which Mrs Revell was involved.

Increasing staff would make no difference, Mr Hipkins said.

Dunblane's dementia wing had 14 residents and "a worst-case scenario ratio of one staff member to seven residents". It was usually a 1:3 ratio, he said. "It's more about the quality of staff than the quantity".

Mr Ryall said not enough had been done to prepare for the growing frailty and dementia rates of many aged-care residents. He said a major DHB project was under way to start shaping services to meet this challenge.

"The Government has put extra money into aged care this year – 5 per cent extra – including $18 million into nursing quality and supervision and there will be more in this year's budget."

There are 34,000 people in New Zealand's 715 registered rest homes.

A spokeswoman for DHBNZ said the organisation was unable to comment yesterday.

- © Fairfax NZ News