Opinion piece from a nurse in residential aged care

Why are there more deaths in residential aged care ? Below is a great article from a nurse working in aged care that highlights the need for mandatory staff:resident ratios and adequate government funding. Well worth a read.


Earlier this year, a study showed there’d been an increase in preventable deaths in aged care. Kylie’s an aged care nurse and had a sceptical reaction to this study. Aged care is a complex area and there are so any factors at play. Here’s what she thinks.

Kylie: I’m 14 years in aged care … started as a pca and am now an enrolled nurse.

We can continue to point fingers at aged care facilities but until the government puts ratios in place and funds facilities properly, improvements are never going to happen. Recent changes to ACFI mean that getting full funding for a resident that needs it is near impossible.

The study points out three causes for premature deaths – falls, choking and suicide.

Falls: Due to increased services and support for the elderly to remain at home, we are now getting more and more residents that are far more frail and suffering from dementia – we are not allowed to restrain residents (chemically or physically) without very strict protocols and procedures being in place. So how do we stop them from wandering and consequently falling? Increase staffing levels? Nope, the government doesn’t fund enough for that. Restrain them? Illegal and unethical. Remove walking aids so they don’t walk … you’re joking right? They will just walk without them, increasing their risk of falls. So now we demand minimal staff to watch residents with compromised mental state 24/7 like eagles and catch them when they fall … oh, but we are taught not to catch them because it can put both the person trying to catch them and the person falling at risk of injury.

Choking: Again we are now getting residents at the worst of their disease proccess – dementia, CVA, Parkinson’s, etc. Factor in that you then have families who want them to continue to eat and drink a full ward diet because thickened drinks and vitamised meals are bland and unappetising, and the resident agrees… Do we let them starve or do we give them a normal diet? As professionals we explain the risks till we’re blue in the face, we give them the right diet and then you walk in the room and the family has left them a big box of chocolate and the resident is munching away like a kid in a chocolate factory.

Suicide: I must say in 14 years of aged care nursing I have never had to deal with this (I’m certainly not saying it doesn’t happen), but let’s take a look at the government again. The government actually stops funding for professional psychiatric help to any resident not deemed low care, all costs are then on the resident. However, if this resident was at home they would have access to funding through an EPC. So their mental health has to be managed by us nurses who have minimal training in mental health because we are aged care nurses.

All this and we want to blame the aged care facility? Get a grip … nothing is ever as black and white as some would have you believe.