COMMENT Since writing this series of articles, a number of people have asked me to put together another piece on what is considered a good nursing home.

In my opinion, we do not need to look further than Australia, where the nursing homes have to meet the Accreditation Standards before they are allowed to operate.

The Accreditation Standards were provided to me, courtesy of Christopher Kee, a trained psychotherapist / counselor with the Extended Hours Medical Clinics in Melbourne, and also a pastoral care counselor at Victoria by the Park Lane Residential Aged Care.

According to Kee, the Human Services Department in Australia is strict about this.

“Failing to comply with these standards will lead to a fine and a closure of the home,” he said.

In some cases, the period of accreditation can be reduced, which means that another inspection is scheduled much earlier.

The nursing homes in Australia are accredited and monitored by the Australian Aged Care Quality Agency. The assessors take interest in meeting up with the residents and their family members to assess the homes on whether they meet the required standards.

Once an assessment is completed, its latest accreditation report on every nursing care home will be published for public viewing on the aged care homes finder. This is how serious advanced countries like Australia are with their nursing care standards.

To add another feather to their hat, if these homes want to nominate any of their projects for the Better Practice in Aged Care Awards, they have to meet the Accreditation Standards for a minimum of two consecutive years.

This is how a developed nation ensures that their aged population is being taken care of. Whereas Malaysia is now just another five years to becoming a developed nation, but our nursing care industry is still in shambles.

Apparently, the concerns that I raised about nursing homes in Malaysia are also shared by other readers, judging from the one comment posted by a reader about her 90-year-old grandmother who suffers from Alzheimer’s disease. Despite being managed by qualified nurses, the services provided at the nursing home is considered just average.

Things can, and should be improved further, for the sake of the senior citizens. After all, they deserve to be treated with a little more dignity.

The four standards

There are basically four standards, known as the residential aged care Accreditation Standards, which are used throughout Australia.

These standards are formulated for the industry and need to be complied with by the nursing care homes, in order to ensure that the residents are given the best care possible.

They cover areas such as management, staffing, health and personal care, resident lifestyle, living environment, catering, cleaning, continuous improvement, and safety and security.

Within these standards, there are 44 outcomes, or examples of what people should expect when homes meet the standards.

Standard One covers mainly about the management systems that respond to the needs of the residents. In short, the staff have to be appropriately skilled and qualified, while the nursing home has to have reasonably good facilities and access to a good complaints system.

On all counts, a number of local nursing homes have failed to meet this most basic standard of good nursing care. Those who meet one or two criteria in Standard One may not necessarily meet the other three standards.

Standard Two deals with the residents’ health and personal care needs. The residents’ medication is being managed safely and correctly by qualified staff; residents are given a varied, healthy and well-balanced diet; access to medical specialists; and finally, their general and physical well-being.

Apparently, in the particular nursing home where my relative had consumed over a hundred pills, the home has flung in this basic standard - medicines were not locked away.

Standard Three deals with the lifestyle of the residents - their privacy, dignity and confidentiality are respected; they are encouraged and supported to participate in leisure and lifestyle activities; they are encouraged to get involved in cultural and spiritual life; and residents understand their rights and responsibilities.

How would you describe a caretaker who uses his leg to kick the buttock of a resident to get him to sit down? Or, one who wants you to undress before some 20 other pairs of eyes?

Finally, we come to Standard Four, which is about having a safe and comfortable living environment, where residents are able to escape in the event that there is a fire, security or emergency risks; there is also an effective infection control programme in place; and catering, cleaning and laundry services are provided.

Go and check out some of the nursing homes, and see what emergency response procedures are being put in place. With 33 residents in one home, should a fire break out, how many of these residents would be able to escape in time with the number of caregivers in the home?

A lot of things are being taken for granted, especially since there is no enforcement or frequent monitoring by the authorities. Lives are therefore at risk, despite being placed under the care of nursing homes.

Take ownership now

The big question is: will we ever see any change in our local nursing homes?
 
What we do today will determine our future. It takes more than one person to raise the standards of the industry. With the help of social media, all of us can do something to effect change.

Fellow members of the press who have read this series of articles - which I hope to continue writing - will you also take up the campaign?

It will take the Women, Family and Community Development Ministry to look into the plight of senior citizens, who have contributed to the development of our nation in their own little ways.

Here’s my question to its minister, Rohani Abdul Karim (right): Does her ministry take personal interest in the welfare of the senior citizens in this country? Does the ministry ever make any efforts to train caregivers? It is a shame that efforts were undertaken by volunteers to provide such training.

At this juncture, I must commend Dr Chong Lu Ann of the Prince Court Medical Centre (formerly from Universiti Hospital) for taking the initiative to raise funds from a local bank and bring in a very experienced dementia nurse from the United Kingdom for two months to train caregivers, but I must say - with a tinge of sadness - that despite putting my time and efforts to organise seminars on a pro bono basis, the response from nursing homes was very poor.

We even had a nursing home operator arguing with the nurse during the seminar, saying that she does not understand the local conditions. I do not have to elaborate, but it was in this nursing home that my relative was bashed up by one of her caregivers.

It will also mean that the Social Welfare Department, under the same ministry, will have to now carry out continuous checks on nursing homes to ensure that basic standards are being complied. The objective has to be clear: to help these nursing homes raise their standards of care.

Likewise, the Health Ministry has to send teams out to check the medical and dental health of these senior citizens, and ensure that caregivers have a proper system to manage the medications.

It is not my intention - or that of my fellow campaigners - to tarnish the reputation of any organisation, but enforcement has to be carried out so that improvements can be seen; otherwise, the operators of these homes will continue to run their business as usual.

What happened to my relative after swallowing over 100 pills belonging to other residents - can we afford to allow the same thing to happen to your relatives?  

What if that were to happen to you and I, when we suffer from dementia or Alzheimer’s disease and are unable to comprehend what it is that we are doing?

Part I: Malaysia not ready for ageing population

Part II: Miserable state of some nursing care homes

Part III: Growing old is expensive!


STEPHEN NG is an ordinary citizen with an avid interest in following political developments in the country since 2008.