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BUPA under the spotlight: Royal commission

This week the Sydney hearing of the Aged Care Royal Commission started with testimony detailing the death of an aged care resident at a Bupa facility in late 2017.

“We walked into the building and we walked into the corridor, which was about 50 minutes from Mum’s room. And it sounded like there was an engine of a truck or a lawnmower engine running,” the daughter of patient DE told the commission.

“It was this loud rumbling that was so disconcerting and scary I think as soon as my sister heard this we ran.”

This sound was their mother, struggling and gasping for breath in her final hours. DE died four weeks after she was admitted to the BUPA facility in Willoughby, Sydney, aged 70.

DE’s daughters outlined the poor care their mother received which included bed sores, malnutrition and poor upkeep of her hearing aids and glasses, leaving her, at times, essentially deaf and blind.

DE had no communication abilities and was unable to feed herself, and the daughters were soon worried that she was not being fed properly by staff.

“Every time we would go mum’s face was more sunken and she was becoming a lot more unwell. So, it was really evident.”

The daughters tried bringing this up with staff, but their concerns fell on deaf ears.

“I spoke to them on a couple of occasions. One occasion when mum’s sister was there, there was a full tray of food in front of her. And the assistant came and removed it and threw it in the bin,” one daughter said.

“And we said, ‘Why are you taking that away?’ And she said, ‘She’s not hungry.’ And we said, ‘Well, how do you know, because she can’t speak?’ And she said, ‘She doesn’t eat. She doesn’t eat’ and quickly threw it away.”

The daughters told the commission that they and other family members could successfully feed their mother when they visited. Other health professionals who visited BUPA knew it was an issue as well.

They recalled an incident with a speech pathologist who tired to teach them how to successfully feed their mother to avoid dysphagia.

“And she said to me, ‘Now I’m going to show you a three and a-half minute video on how to feed your mother so that there is no risk.’ And, meanwhile, I’m holding my newborn child who is screaming,” she said.

“And I said to her, ‘I’m sorry. Why are you showing me this video? … Shouldn’t you be showing this to the nurses here, because I’m not here every day.'”

“She said to me, under her breath, ‘There’s not a lot of point in that, and that’s why I show the family members who are here, because they’re usually the ones that end up feeding them.’”

The commission also heard how DE, who was originally moved to aged care after a series of falls, was admitted to hospital after only 36 hours spent in the BUPA home, diagnosed with aspirant pneumonia.

When talking to witness Mary Berry – formerly the interim chief operating officer of Bupa at the time DE lived at the Willoughby facility – counsel assisting Gray discovered that although the pneumonia was said by BUPA staff to be as a result of a pre-existing condition, poor practice in that short 36-hour period could have been to blame.

He asked Berry about the definition of aspirant pneumonia.

“That’s a form of pneumonia from inhaling particles, typically of food, into the lungs; is that right?”

“Yes,” came the reply.

He then went on to detail reports form the ambulance crew who found DE to be “with decreased GCS … and un-chewed food and medications in mouth.”

“And, in relation to clearing her mouth, that’s a very important matter, because of aspiration risk, isn’t it?” Gray asked.

“It is, yes,” Berry conceded.

Gray read hospital notes from DE’s discharge that explicitly state that DE should be monitored for “for signs of aspiration/penetration, coughing, wet gurgly voice with oral intake reduced chest health and refer to medical/speech pathologist”.

Berry admitted that BUPA had failed to follow this advice.

On the day of her death, DE’s daughters rushed to the facility after receiving a confusing phone call from staff.

“When I arrived, I could hear Mum’s breathing from about 20 metres down the corridor, it was so loud. When I got into the room I could see that her breathing was very laboured, and she looked uncomfortable,” her daughter said.

“This went on for at least 30 minutes before we could find someone to help us. Even when we were able to find people, we felt they did not know how to handle the situation.”

Eventually a GP appeared but still, the daughters were left to watch on as their mother lay struggling to breathe.

“And this man came in and was in the room for I think less than one minute and then muttered something to Emily, the nurse, and walked out.

“My sister jumped up and said, ‘What is going on? What’s happening with Mum?’

“And he said to us, which we just will never forget – he said, ‘This isn’t really my area of expertise.'”

Before coming to the commission, DE’s daughters brought their complaints to the Australian Aged Care Complaints Commissioner, but still felt helpless in the aftermath of their mother’s death.

“What do we do with this now? Yes, they put processes in place and hopefully, touch wood, that doesn’t happen to families in the future or patients, but what do I do with this now; we felt completely let down by them, not only in mum’s level of care but in the way that they managed us.”

BUPA has been dogged by negative headlines post the four corners investigations. As of March, nine BUPA facilities were under sanction for failing to meet compliance benchmarks set out by the Australian Aged Care Quality Agency.

The Sydney hearing continues.

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