'Line them up, hose them down': Aged care in short-staffing crisis

Photo: Getty Images
Photo: Getty Images
A nurse has compared showering aged care residents to hosing them down in a milkshed, in a new report highlighting the impact of short staffing.

Residents were sometimes going two weeks without a shower and staff were forced to ration incontinence pads and wound dressings, it found.

The report from the Nurses Organisation said the sector was in crisis, largely because of staffing shortages that were having impact on the care and dignity of people.

One nurse who was quoted lamented how much less time she had with residents than 20 years ago.

"Some days it honestly feels like a milking shed, you know, line them up, hose them down. Some days you're running from one resident to the next," she said.

About 500 health workers were surveyed in the report, 80 were interviewed in details, and 150 formal documents were reviewed.

Lead author Nathalie Jaques said about a quarter of those surveyed told them people were often going without showers - sometimes for many days, and were missing out on other important care.

"People were receiving meals cold or late or they don't have someone who can sit with them and feed them - so maybe only getting fed a quarter of their meal before that worker has to run off to help the next person," she said.

There were confronting, visceral examples of the loss of dignity and support around toileting, Jaques said.

"Where people would otherwise be able to be supported to the toilet if someone could get to their room, help them out of bed, supervise them, instead they are put in incontinence products and then just told to wait because there is no guarantee that someone will be there when they call the bell to get that sort of support," she said.

Homes were also rationing the incontinence products, keeping them in locked cupboards and making staff justify requests for more, she said.

Particularly concerning was that some nurses said they struggled to dress wounds regularly enough, and were sometimes forced to use substandard dressings, she said.

That was "incredibly high risk," she said.

The Nurses Organisations Bridget Richards said no-one ever wanted to have to go into aged care but the report would likely make those who needed to think twice.

She had worked for many years in the sector and loved it but it was no longer being funded properly and that had big flow on effects to those in care.

"When you have got appropriate funding and staffing - when you can nurture them and allow them to flourish, it is such a rewarding place to work," she said.

The union wanted the government to fund the sector more and to make it compulsory to have enough health staff to take time to do all the jobs that had to be done.

Report 'distorted'

There has been strong push back on the report from the aged care sector and the government.

Seniors Minister Casey Costello said she had visited dozens of facilities and everyone involved was committed to providing great care.

"This report paints a very distorted picture of what is happening, and the quality care being delivered, including by nurses and other care workers. I think it does them a disservice," she said in a statement.

"The sector is not in crisis and the government has increased spending across the sector by $270 million in the last two years to ensure that."

The Aged Care Association, which represented care homes, said it also took "strong issue" with aspects of the report.

Its chief executive Tracey Martin acknowledged the staffing pressures were very real and said everyone in the sector wanted to fix them.

"However, we take strong issue with some of the stories presented in this report that suggest older people in residential care are routinely receiving unsafe or neglectful care," she said.

"If that is happening anywhere, it is deeply concerning - but it is also a matter of professional accountability."

There were many routes for people to complain about care, she said.

"It would be naïve to pretend that every experience is perfect - but equally wrong to portray the sector as defined by failure," she said.

"The overwhelming majority of facilities provide high-quality, compassionate care under extremely tight resource constraints. Where incidents occur, they are the exception, not the rule - and the sector continues to educate, train and advocate to prevent them."