Death sparks inquiry into dementia care

The death of a "loving, gentle" dementia patient after several falls in a rest home could lead to better care for fellow dementia sufferers.

Coroner Garry Evans yesterday released his report into the death of Florence May Coombes, who died in Hutt Hospital on May 21 last year following three falls at the Norman Kirk Rest Home.

The proximity of two other patients to Mrs Coombes after two of the falls led to a police investigation and, while it failed to find clear evidence she was assaulted by the other patients, it did call into question the supervision of residents.

"I believe that two staff for up to 17 residents is not sufficient," Detective Sergeant Tony Heathcote said in his report.

"These residents are very demanding and ... frequently both staff members can find themselves fully occupied in dealing with one or two residents, essentially leaving others unsupervised for periods of time."

As well, residents with violent or aggressive tendencies should be placed in appropriate facilities; to do otherwise put other residents at risk, Mr Heathcote said.

Mr Evans found Mrs Coombes died of a head injury suffered in one of the falls but the case prompted him to commission a report into the care of dementia patients assessed as needing stage three care in a secure unit.

The report was conducted by retired nurse and aged care manager Barbara Martin, who found the Government needed to provide better facilities for aggressive dementia patients.

"Such patients need the care of people who are used to working with residents with aggressive behaviour," Mrs Martin said.

"Those patients need to be kept away from patients whose dementia is more genteel in character."

Mrs Martin made several recommendations, endorsed by Mr Evans, including that:

* The Ministry of Health work with aged care providers to attract registered nurses.

* District health boards (DHBs) work with aged care providers to recognise the skills of those working with dementia, such as a caregiver of the year award for each facility.

* Managers be able to authorise extra hours in emergencies, and

* DHBs work with aged care providers to ensure enough high dependency beds are available.

The recommendations were sent to Health Minister Tony Ryall, who last week said the Government was drafting legislation which would require rest home audit agencies to be audited themselves, and accredited by an international organisation. The legislation would require mandatory reporting of significant healthcare incidents in rest homes.

- NZPA