Family’s fury over death
In the home video, Shirley Vermeren dances happily with one of her daughters at Hamilton Gardens during a family outing. She had Alzheimer’s disease but appears in good physical health.
A photo of 80-year-old Shirley two weeks later shows a shocking decline – she lies in a hospital bed, face and body covered in dark bruises. Less than three months later, in January 2018, Shirley is dead.
Now her five daughters and widower are demanding answers from the rest home where she spent her last months, Radius Kensington in Hamilton, part of the Radius Care group.
They say the home has not given a satisfactory explanation for what happened and, despite repeated requests, not supplied Shirley’s clinical notes. They plan to lay a complaint with the Health and Disability Commissioner.
Radius Care’s owner and managing director, Brien Cree, did not respond to requests for comment.
Radius Care management would not answer a long list of questions from Stuff, citing patient privacy, but through a public relations firm issued a statement saying internal investigations had found all processes and services at the home complied with district health board requirements and the Health and Disability Services Act.
‘‘We take every precaution to keep our dementia patients safe and comfortable,’’ the statement said. ‘‘The comfort and wellbeing of our residents is at the heart of everything we do at Radius Kensington, and our hearts go out to the affected family.’’
Shirley’s 86-year-old husband, David, a double amputee, was also a resident at Kensington but has been moved to another Radius home. The family are also concerned about his care at Kensington. On one occasion, they say he was left on a toilet for about 20 minutes while his carer took a cigarette break.
The family say they have been given conflicting accounts by the home of what happened to Shirley and are speaking out due to concerns about the level of care in dementia units nationwide.
Initially they were told Shirley had fallen out of bed in the home’s secure dementia unit and possibly fractured her wrist. Later, a carer told them the incident happened in the dining room. ‘‘She said [the two on-duty carers] were getting some of the other residents out of bed, so there was actually nobody supervising in the main area . . . where mum was,’’ daughter Wendy Davison says. ‘‘She heard mum scream and ran out and found all the residents gathered around her, some trying to help her up.’’
Her mother was unable to explain what had happened and the only witnesses were fellow dementia-sufferers. A heartbreaking video taken later by the family shows a tearful Shirley unable to verbalise what had happened.
‘‘I said ‘were there cameras?’ and [management] said ‘oh no, that would be a breach of privacy,’ ’’ Davison says. ‘‘I work in a public hospital – we have cameras in every public place.’’
The New Zealand Aged Care Association says many rest homes have cameras in communal areas.
Shirley’s family say she had no history of falls and was not unsteady on her feet. She suffered a broken wrist, dislocated shoulder, black eye, and bruising to much of her body.
‘‘There is no way she could have sustained those sort of injuries with a simple fall,’’ Davison says. ‘‘We absolutely [believe] there was some force behind it.’’
The sisters are furious that their mother was sent to Waikato Hospital in an ambulance by herself. Daughter Rhonda Vink questions why staff at Waikato Hospital did not raise the alarm when they saw the extent of Shirley’s injuries.
Ron Dunham, Waikato DHB’s interim chief operating officer, says they cannot disclose patient information to the media, but the DHB provides staff with a health and risk assessment sheet advising how to spot elderly abuse.
They believe there were not enough staff in the dementia unit – two carers for about 19 patients – staff were young and inexperienced and the U-shaped layout of the unit meant it was impossible to keep an eye on patients at all times.
The sisters had not officially complained about their mother’s care because they were focusing on their father, but approached Stuff after reading about a string of homicides committed by dementia patients, some in rest homes.
Shirley Vermeren’s health deteriorated rapidly after the incident on October 15, 2017. She stopped eating and her weight dropped to about 32kg.
She died, surrounded by family, on January 16.
The family say they were told of a couple of other incidents over the New Year period, including one where staff saw Shirley being pushed by another resident. They were unable to visit at the time because the home was in lockdown during a norovirus outbreak.
Davison says she ‘‘had to pull two women apart myself one day
. . .’’ in the dementia unit. ‘‘I saw verbal aggression from one gentleman and I saw physical aggression quite a lot.
‘‘I went back and told the staff, it was almost like ‘oh well, that’s par for the course’.’’
David Vermeren would visit his wife in the unit every day. ‘‘It’s like a time bomb in these places. One minute they’re happy, the next minute . . .’’
He says after his wife was injured he pleaded with staff to help with her pain. Unable to express how she felt, she was mainly given paracetamol, the family say.
Dr Eilon Caspi, a dementia behaviour specialist at the University of Minnesota, conducted one of the world’s first studies on assaults by dementia patients on other residents in longterm care homes, looking into 105 deaths in the US. Most were not witnessed by staff, he says. ‘‘All you need is one push really, when you talk about a frail population, to cause serious injury and sometimes death.
‘‘If those incidents occurred in childcare settings or in a playground I believe . . . the reaction and response and preventive measures would be much more serious.’’
Caspi says homes need to ensure they have adequate staffing on evenings, weekends and holidays, and that staff have updated training and develop individualised care plans.
Jessica Wilson, head of research at Consumer NZ, says the organisation continually receives complaints about rest homes. ‘‘Pretty much in all cases it comes down to the fact that there’s just not enough staff on the ground, or the staff that are there aren’t qualified enough to provide the care needed.’’
Consumer NZ has been calling for greater staff-to-patient ratios, as minimum requirements set down in DHB contracts are ‘‘very low’’ – only two staff required for 50 residents. Wilson says when resthome carers received a Government-mandated pay rise in 2017, some employers restructured staffing ratios to compensate.
She says when choosing a rest home, people should ask about staffing ratios and qualifications. ‘‘How many hours a day is someone going to be there to look after them?’’
Simon Wallace, CEO of the NZ Aged Care Association, says it’s true some homes have been forced to look at cost-cutting following the wage increases. ‘‘But they will do so in areas that don’t compromise quality of care,’’ he says. ‘‘They would rather close down than compromise care, and indeed that is what has been happening.’’
According to Wallace, dementia care is complex and rather than staff-to-resident ratios, ‘‘it’s more important to have staff with the right skills and qualifications to deliver the type of care that fits each resident’s needs’’.
Over the next four years, the Ombudsman will carry out additional monitoring of rest homes, including dementia facilities, he says, including ‘‘both announced and unannounced indepth inspections and shorter adhoc visits to these facilities.’’
Davison says some of the staff at Kensington were fabulous and as a midwife, it is hard for her to criticise other health workers.
‘‘But how would you feel if this was your family member? That’s how I apply practice to my midwifery – it’s just not happening in aged care.’’