My grandmother died. She died this year, January 11, aged almost 101. Her death was no tragedy, really. What is tragic is the horrible, agonising, lingering way in which she died. And it could so easily have been so different.
Maria Stella Costa was a remarkably independent woman. Demanding, insistent, stubborn, interfering. This was one feisty, fiery woman. Funny and brutal, suspicious, razor-sharp and whip-fast. Just plain ballsy, she always knew what was going on.
For 96 years she did things her way, then a fall in the shower meant she could stay at home no longer. So Nanna, born in the midst of one world war and bearing her own children through the next; battling through one hard life on an Italian farm to come halfway around the world, four kids in tow, to battle through another, was now utterly dependent on the care of others.
From some, that care came. From others, it did not. As a consequence, her demise at St Bernadette’s Aged Care Facility in Sunshine North, run by Villa Maria Catholic Homes, was terribly and unnecessarily painful for her and for those around her.
It all began with something that could easily have been fixed.
Nanna had a long history of urinary tract infections and on Christmas Day, when she had left the nursing home to join the family lunch, it was clear she was unwell. The home had been alerted days earlier, on December 22, to the possibility that she’d contracted a UTI. They took her temperature after that initial approach and brushed our worries aside – as they did on many, many other occasions.
We contacted the home on Christmas Day and told them we believed she needed antibiotics. Nothing was done. On Boxing Day, suffering the delirium that comes with UTIs, she fell out of bed, hitting her head badly.
No one told the family. Villa Maria later acknowledged Nanna’s bed was set too high, which made the impact of the fall worse.
Four days later she was taken to hospital, after becoming increasingly ill and by then unable to communicate well. We cannot understand why it took so long. She had huge bruises, particularly on her back. We could not see them at the time, as she was always dressed when we visited. We relied on the staff to ensure she was OK.
By the time Nanna got to hospital the infection was terrible and her condition worsening. There was little they could do, so they sent her back to the nursing home. She died a week later, moaning in pain at first, barely able to speak coherently, before she became almost vegetative. Breathing, but not much more.
If she had not had the infection, she would not have fallen from the bed.
Had she not fallen out of bed from such a height, she would not have been so badly bruised and in so much pain.
Had those facts not been ignored, she may have been sent to hospital before it was too late.
There were other problems. Her toenails (out of sight – the fingernails were usually painted beautifully) had clearly not been cut for months. She barely ate the food, which was generally terrible. Apart from one or two staff, workers did not seem to care whether she ate or not. When we took her food she would try to stockpile it.
She needed help from staff to use the toilet and was often left to wait for half an hour or more when she needed to go. I never made a fuss – I figured that might be taken out on her later. I just watched the clock. And watched … and watched.
Usually I would visit during the day, on my way home from work, about lunchtime. At that hour there are people coming and going and mostly, everything is very orderly.
A few times when I couldn’t go during the day, I’d turn up in the evening. Once I arrived to find the door closed and yelling coming from her room. When I knocked, the yelling stopped. Nothing to worry about, I was assured, she just didn’t want to go to bed. My grandmother, however, told me the staff were being rough bastards.
Another time I pressed her call button. The woman who came to tend to her had no idea I was in the room. She charged in about 20 minutes later, yelling at my grandmother as though she were speaking to a dog.
She stopped immediately when she saw me there.
So what happened during the day, when there was an audience, was quite different to what happened at night, when so few people were around.
Some of what you have read above comes from a formal complaint I helped one of my aunts compose. It was sent to Villa Maria. No one ever responded. No one in authority cared.
I know individual staff members who cared, but for the most part these people are running a business. The fact that it involves a life, and dignity, and suffering, seems to not enter into the equation.
I’ve had my share of loss. And I have learnt that death need not be made harder.
My grandmother did not need to die like this, back and forward to hospital, unable to speak or move or hold anyone’s hand or even know that they were there. My aunt is still so troubled by the way her mum was treated. She has told me that she thinks about it every day, and tells me of her anger and frustration at having been ignored.
I say to her: “Aunty Nance, you can’t think that way. Who knows how Nanna would have died if it had been different?”
The truth is that I think about it every day too. It might well have been worse. But it could certainly have been a good deal better.
All it would have taken is a course of simple antibiotics and someone who bothered to listen.
Gabrielle Costa is morning homepage editor of theage.com.au.