Meanwhile across Australia, case numbers are rising. Outbreaks in RACFs are increasing, and exhausted healthcare workers are preparing for the next wave to peak and overwhelm an already decimated health system.

https://twitter.com/QldGovernor/status/1592833448028217347

When you visit as many aged care facilities as often as I do, you would think that nothing would be a surprise and that after so many years I would always know what to expect. Not so. This week’s 🧵… Constantly surprised to walk in to a facility in the middle of a weekday where there are more than 100 residents over three levels, to find that there is only one single RN and a single EN on each shift for the entire facility.

As a specialist nurse who previously coordinated care for adults with malignant brain tumours, I’ve seen some of the best and worst outcomes from an infamous surgeon. From the 15 year survivor of GBM (multiple surgeries for recurrence) to the devastating outcome from a young mother’s failed surgery (death within days) there is one thing they all had in common.

I’m a nurse practitioner working in specialist palliative aged care. Let me share with you just a little bit about what happens in a residential aged care facility/‘nursing home’ that doesn’t have registered nurses 24/7 365 days of the year. A 99 year old who has clearly stated his wishes in an advance care plan NOT to be transferred to hospital has a fall in the bathroom at midnight. The ambulance is called by the carers and he is taken to hospital. He develops delirium & dies four days later in hospital.

Happy nurses after listening to @AlboMP promising to fix the #AgedCareCrisis in his right of reply to the Budget tonight. Ratios in aged care, registered nurses on site 24/7, nutrition standards, 215 minutes of direct care for residents by carers, backing the increased wages for aged care workers with the Fair Work Commission and accountability for every dillar received in Gov funding by providers.

Yesterday in met a lady with dementia, the referral was for ‘escalating behaviours and aggression’. Staff have been pushed and shoved and yelled at and are having trouble managing ADLs. According to her, she is 92 and 1/4 (we counted the months together on her fingers p).

1917.

A mother prematurely gives birth to triplets.
Two babies are strong and healthy.

The third is weak, barely breathing. No cry.

The midwife wraps her in cotton wool and places her in a shoebox by the fire.

Her mother nicknames her Tiny.

No one expects her to live. She survives.

Several years later she falls ill with rheumatic fever.
She is in hospital for many many months.

No one expects her to live.

January 2003.

The car is packed and ready for a camping trip on the coast.
She hesitates, but they decide to go anyway.
There is no way the fire will get into the suburbs. The day is hot, and suddenly the sky is black.
Smoke fills the air, sirens wail.
Canberra is alight
people are evacuated
houses and lives are lost.

Today I sat and held the swollen, fluid filled hand of an amazingly stoic 94 year old man who is in his last days of life. I have been helping him with managing symptoms for about 4 months. He told me he is ready to go to sleep and never wake up, that he has said goodbye to his family and is ready to die. His wife is waiting for him to join her.