Ratios, ratios, ratios: Royal Commission Sydney hearing begins

You could be forgiven for missing the Lionel Bowen Law Building on Sydney’s Goulburn street. Its slate grey facade blends in on a sunless street situated between an apartment building and a decrepit looking car park. There is little fanfare outside the court that might hint at the event occurring within.

Inside, courtroom 7C is small and squat. Green-grey walls and thick wooden columns flank those seated. The room buzzes with activity, those working for the commission steady themselves for the day and those watching on filter in with suitcases in tow.

There is an intimacy to the stuffy courtroom, which lends itself well to the very personal witness testimony we are about to hear.

Darryl Hilda Melchhart, who is 90 years old and has lived in residential aged care since 2014, takes the stand.

The mood starts off light. Melchhart is asked, delicately (“If you don’t mind, may I ask…” counsel assisting Gray will often say) how her mental faculties are?

“Pretty good I think,” she says without missing a beat. The small crowd chuckles.

And they are. She is sharp and speaks calmly and apart from a heart condition her health is “pretty good” too.

Counsel assisting Gray enquires about her health more generally, she requires GTN spray from time to time she replies and without it could suffer heart failure, therefore her doctor recommends she keeps it on her at all times. Gray leaves health there, but we know this information is important: we are being set up for a reveal.

Melchhart goes on. She covers many problems within residential care as she sees it. Having to ration incontinence pads is one, she has seen friends unable to come to group activities because they were left in soiled pads.

“I would like to have given her one but I thought no, she’ll have to fight for herself. She’s got three daughters, but they don’t come in very often,” she said.

Bland food was another, with the sticky butter-bereft mashed potato a particular bugbear.

Loneliness and under stimulation joined the list, and Melchhart groaned when prompted to talk about the problems she faces when asking nurses for simple things such as getting her medical paperwork ready for the cardiologist.

More shocking still were recollections of violence she faced at the hands of other residents on the ward where, in her estimates, only 10 of the 90 residents have their full faculties.

One woman came onto her room and tried to steal her walker, and when Melchhart resisted the woman “hammered” on her hands to get the walker.

Another incident saw a resident come into her room to steal her jewellery box, and when confronted by Melchhart, proceeded to attack her with a mug.

Melchhart has spoken to staff about all of these issues, but said she “feels as if I have no voice”.

Here we are brought back to the GTN spray. Melchhart alerted a nurse to her expiring GTN spray and asked for a new one.

The nurse refused and instead took the existing spray away, leaving her without this potential life-saver for nearly four days, until her doctor intervened.

Another aged care resident, Merle Mitchell AM, gave evidence via a pre-recorded video.

Mitchell told the court of the “terrible” time she had transitioning from an independent life to an “institution”. She spoke of the “sense of loss” she felt and feeling she had “no choice” but to conform to strict schedules imposed upon her.

When asked what the sector could do to improve, Mitchell had many well considered opinions.

Access to a counsellor for residents and staff is a must she insisted, as at times she has a “feeling that this isn’t a proper life… a feeling that the quicker this is all over the better”.

Like Melchhart before her, Mitchell recounts her own near-death experience.

“Three senior people” ignored Mitchell’s complaints of pain, telling her “it is all in your head”.

A fellow resident took action telling nurses that “if you don’t get Merle to a hospital you’ll be guilty of elder abuse”.

Only then was Mitchell rushed to hospital and was found to have a crushed disc and broken back.

At the end of her testimony, Mitchell was asked whether she felt that staff are adequately trained to provide care.

“No,” came the blunt reply.

And if she could nominate one thing to change in the sector?

“Ratios.

“Ratios, ratios, ratios. Everybody will tell you that.”

The royal commission is in Sydney until 17 May.

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