Hospital pneumonia kills Wollongong man waiting for aged care bed

Shuffling up and down a hospital geriatric ward corridor, kicking his feet on whatever medical equipment is in his way, his incontinence pad on display.

They are the painful last memories Renee Santos has of her father, James Brown, who contracted hospital-acquired pneumonia and died last year at Wollongong Hospital while waiting three months for a bed in a residential aged care facility.

"That's no existence for a human being. That's not living," Ms Santos said.


Hospital-acquired pneumonia is a lung infection caused by antibiotic-resistant microorganisms which exist throughout hospital settings.


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James Brown contracted hospital-acquired pneumonia and died in August 2024. (Supplied: Jan Brown)


Mr Brown was diagnosed with dementia in 2018 and was cared for at home by his wife, Jan, until June 2024, when he was hospitalised after a fall.

Ms Santos said it was decided her father required full-time care in an aged care home.

"We hoped that he would find a placement quite quickly," she said.

"That he would live out his remaining days with comfort and care and dignity in a facility that had an outdoor space, and he could get some fresh air and look at the sky.

"That's what I had envisaged and wanted for dad, but it never came about."

Mr Brown's story is becoming increasingly common due to a growing ageing population, and with that, increased rates of dementia, on top of a gross shortage of residential aged care beds and National Disability Insurance Scheme (NDIS) placements.

"Bed block" or "delayed discharge" are the terms used to describe the more than 1,000 people who are stuck in New South Wales public hospitals, waiting for appropriate residential care.


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Renee Santos says dementia patients seem to be "left on the shelf" and the last to find aged care homes. (ABC Illawarra: Romy Gilbert)


NSW Health said about 830 people in state hospitals were seeking placement in aged care facilities, and about 300 required National Disability Insurance Scheme-supported homes.

It said the issue was "particularly challenging" in the Hunter New England and Illawarra Shoalhaven Local Health Districts, where higher numbers of patients awaited an aged care placement due to larger ageing populations.


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Renee Santos with her late father James Brown and mother Jan Brown. (Supplied: Renee Santos)


Ms Santos said her father was let down by a broken system that "fails to look after the most vulnerable people in their greatest moment of need".

"Dad was a humble, working-class, family man who worked hard all his life, and he deserved to have some dignity, peace and comfort in his remaining years," she said.


How did we get here?​

Former Illawarra residential aged care chief executive Mark Sewell said the issue had exploded in the past three years.


image4.jpg
Mark Sewell says a large wave of older people will require care in aged care facilities in the next 10 years. (ABC Illawarra: Romy Gilbert)


He said the Illawarra had seen around 500 new beds over the last decade, but equally lost the same amount due to inappropriately designed facilities closing.

"[They were] too old, had crowded shared rooms, maybe in flood-prone areas," he said.

"It's static. We've had no growth, no extra beds."
Mr Sewell said the region had 4,000 beds in use, but was 1,000 beds short, or 25 per cent.

"Aged care beds have people stay for short times, two to three years maximum, and their turnover is a third of all their beds," he said.

He said one-third of people who needed a bed came from hospital, and two-thirds came directly from the community.


image2.jpg
James Brown's family says they feel devastated by how he spent his final months. (ABC Illawarra: Romy Gilbert)


Mr Sewell warned the situation would worsen, with the baby boomers born in 1945 about to turn 80, 85 and 90.

"There's a large wave of people coming," he said.

"Our service systems aren't prepared, our hospitals aren't prepared, our aged care services aren't prepared.

"We should have known this for a long time. We should have seen this coming."


Federal and state government at odds​

The NSW government has blamed inadequate federal funding, a weak National Health Reform Agreement (NHRA) and delays in accessing Commonwealth aged care and NDIS services.

But the federal Aged Care and Seniors Minister Sam Rae said in a statement to the ABC that the Commonwealth had supported the state with almost $200 million and was rolling out 80,000 packages in the next 12 months as part of its new Support at Home program.

NSW Health Minister Ryan Park welcomed the new in-home care program, but said what was really needed was adequate funding in the next NHRA, due to be renewed by mid-next year.

"One reason the state hasn't signed up to the new national health reform agreement is because it does not recognise the amount of money the state needs to support aged care in hospital," he said.

NHRA is the primary agreement between the federal government and state and territory governments that outlines how public hospital services are funded, managed and delivered.

Written by Romy Gilbert, ABC News.
 

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A huge part of the problem is that, like here in Bundaberg, so many new retirement villages are being built but who in the name of heaven can afford to live there.
I have tried talking to people about assisted dying and I was told I wasn't sick enough to help even though I've lived with kidney problems since age 8, 4 different cancers, my legs don't work very well and the arms and hands aren't much better. When I've had enough I've got 4 packets of sleeping pills in a drawer which everyone knows about so I can help myself to a peaceful end.
 
My daughter and I were only having a discussion on aged care the other day.

She was working at our local hospital over the past month. She was working in the surgical ward but noted there were quite a few of elderly patients who never had surgery but were in with other illnesses and were there for weeks while waiting for a bed in an aged care home.

They do have an aged care ward but that is full and patients need to be placed in other words including surgical.
Unfortunately its not only these patients its affecting but other people waiting for a bed for surgery.

My daughter as a nurse experienced her first (VAD) Voluntary Assisted Dying which was very sad and was a 80 year old male and should have been in the aged care ward not surgical
 
My daughter and I were only having a discussion on aged care the other day.

She was working at our local hospital over the past month. She was working in the surgical ward but noted there were quite a few of elderly patients who never had surgery but were in with other illnesses and were there for weeks while waiting for a bed in an aged care home.

They do have an aged care ward but that is full and patients need to be placed in other words including surgical.
Unfortunately its not only these patients its affecting but other people waiting for a bed for surgery.

My daughter as a nurse experienced her first (VAD) Voluntary Assisted Dying which was very sad and was a 80 year old male and should have been in the aged care ward not surgical
Yes Suzanne, what your daughter has experienced has sadly, been going on for many years, long before I retired from nursing. Even my doctor won't talk about VAD probably as I've heard before, "we trained to save lives not take them" Heaven help them when they get old or disabled.'
 
A huge part of the problem is that, like here in Bundaberg, so many new retirement villages are being built but who in the name of heaven can afford to live there.
I have tried talking to people about assisted dying and I was told I wasn't sick enough to help even though I've lived with kidney problems since age 8, 4 different cancers, my legs don't work very well and the arms and hands aren't much better. When I've had enough I've got 4 packets of sleeping pills in a drawer which everyone knows about so I can help myself to a peaceful end.
My daughter who is a nurse experienced her first Vad (Voluntary Assisted Dying)
She said it was so sad,she is normally involved with making patients comfortable and doing everything she can to keep them alive.
This patient had bad lungs and struggled to breath. He needed two doctors to sign off and he needed to have a life expectancy of less than 12 months.
My daughter was looking after him for two weeks and bonded.
She was doing afternoon shift and would give him his medication. The day before his procedure she handed him ventolin and he said ,look it has exactly 4 puffs left, 2 for now, 2 for the morning. His procedure was being done at 2pm.

I asked her was he saying it with doubt in his voice and she said no, he was saying it with peace and positivity.

His family spent the morning with him and as by his request he didn't want them their while the procedure happened , they went to the cafeteria while it was done which took 45 minutes all up.

My daughter started work at 1.30 pm so sadly was there.
It was good that the nurses didn't need to be involved in the administration of the injections as the hospital brought in two palliative care nurses who administered the medication through a drip.

I'm not for VAD but its everyone's own decision.
I hope you can get enough pain relief and help to keep enjoying your life and if you come to the point of needing to use VAD then you get the proper help.
My prayers 🙏 are with you to live many more years without suffering
 
I am not in agreement with VAD for myself but feel that if someone else wants to go down that route, it should be made easier for them. I have chronic lung diseases and my greatest fear is ending up in hospital drowing in my own fluids. @gamiry I hope you don't have to use the sleeping pills because there is always the chance that they won't work even when you think they will. I hope the medical profession or whomever supervises VAD will step in and aid you to die with dignity. I hope you also get more years on this mortal coil without suffering too badly.🙏
 
My daughter who is a nurse experienced her first Vad (Voluntary Assisted Dying)
She said it was so sad,she is normally involved with making patients comfortable and doing everything she can to keep them alive.
This patient had bad lungs and struggled to breath. He needed two doctors to sign off and he needed to have a life expectancy of less than 12 months.
My daughter was looking after him for two weeks and bonded.
She was doing afternoon shift and would give him his medication. The day before his procedure she handed him ventolin and he said ,look it has exactly 4 puffs left, 2 for now, 2 for the morning. His procedure was being done at 2pm.

I asked her was he saying it with doubt in his voice and she said no, he was saying it with peace and positivity.

His family spent the morning with him and as by his request he didn't want them their while the procedure happened , they went to the cafeteria while it was done which took 45 minutes all up.

My daughter started work at 1.30 pm so sadly was there.
It was good that the nurses didn't need to be involved in the administration of the injections as the hospital brought in two palliative care nurses who administered the medication through a drip.

I'm not for VAD but its everyone's own decision.
I hope you can get enough pain relief and help to keep enjoying your life and if you come to the point of needing to use VAD then you get the proper help.
My prayers 🙏 are with you to live many more years without suffering
I've lived 83 years, worked up until the last few years. When do you think I'll be old enough to make my own decision re living or dying? I've had the kidney disease since age 8 and cancers from 16. I haven't given in yet although have come close a few times. I live alone, do my own cleaning.... house and me...but now get my meals from LtenEasy who are great people. Why do I need others to tell me how to live or die?
 
I've lived 83 years, worked up until the last few years. When do you think I'll be old enough to make my own decision re living or dying? I've had the kidney disease since age 8 and cancers from 16. I haven't given in yet although have come close a few times. I live alone, do my own cleaning.... house and me...but now get my meals from LtenEasy who are great people. Why do I need others to tell me how to live or die?
You don't need to tell others to make your own decision. It is an individual choice. i was just thinking it would be easier to do VAD if you had the help of medical professionals who might make it more comfortable for you.
 
I was a person who was against VAD until I watched and experienced the last weeks of my mother's and brother's long drawn out deaths. The loss of dignity, pain and suffering in those last weeks were horrendous. VAD, now I believe, provides a dignified and peaceful way to end the approaching inevitable in situations such as this. This is when I think it has the advantages.
 
A friend of ours volunteered with Palliative Care for many years, visiting Cancer Patients and administering medication. When their pain got too bad they had to go into a hospital or aged care facility that can give much stronger pain relief. Some patients even the strongest pain relief available gives very little or no relief and some of them asked for help to die to have no more pain. That was when she changed her mind watching sufferers crying in pain and the heartbreak of family members being unable to help their loved ones
 
You don't need to tell others to make your own decision. It is an individual choice. i was just thinking it would be easier to do VAD if you had the help of medical professionals who might make it more comfortable for you.
it certainly would be easier to do VAD. The only ones who know about my pills are my psychologist and my carer who both agree that we should have a choice without others telling us how to live and behave. I asked my doctor what he thought of VAD and he didn't even reply. He's from Burma so maybe they have other ideas.
 
it certainly would be easier to do VAD. The only ones who know about my pills are my psychologist and my carer who both agree that we should have a choice without others telling us how to live and behave. I asked my doctor what he thought of VAD and he didn't even reply. He's from Burma so maybe they have other ideas.
I suppose it is early days with VAD and some foreign doctors, it would be against their beliefs? But Australian doctors probably are waiting to see how it goes before they commit to offering their services. I remember when my mother was dying with cancer in a nursing home, the doctor just kept upping the morphine till she passed, I don't know whether they still do that.
 
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I am not in agreement with VAD for myself but feel that if someone else wants to go down that route, it should be made easier for them. I have chronic lung diseases and my greatest fear is ending up in hospital drowing in my own fluids. @gamiry I hope you don't have to use the sleeping pills because there is always the chance that they won't work even when you think they will. I hope the medical profession or whomever supervises VAD will step in and aid you to die with dignity. I hope you also get more years on this mortal coil without suffering too badly.🙏
thank you Liz. I too have a breathing problem called Pseudomonas which many doctors have never heard of. It's caused by living in a house with mould, mildew, asbestos and fibro. It was my eldest son's house and he kept trying to tell me mould and mildew wouldn't hurt me... strange seeing he was a LtCol in the Army Medical Corp. After renting this house and paying for repairs I finally forked out over $15000 to completely do the house up. My thanks was he had me evicted and sold it. I haven't seen him since.
The breathing problem I have has no cure and even asthma sprays don't help so it's a damned nuisance.
Anyway my Mum called me "pig headed and stubborn" and thankfully I still am.
Have a great day dear friend.
 
thank you Liz. I too have a breathing problem called Pseudomonas which many doctors have never heard of. It's caused by living in a house with mould, mildew, asbestos and fibro. It was my eldest son's house and he kept trying to tell me mould and mildew wouldn't hurt me... strange seeing he was a LtCol in the Army Medical Corp. After renting this house and paying for repairs I finally forked out over $15000 to completely do the house up. My thanks was he had me evicted and sold it. I haven't seen him since.
The breathing problem I have has no cure and even asthma sprays don't help so it's a damned nuisance.
Anyway my Mum called me "pig headed and stubborn" and thankfully I still am.
Have a great day dear friend.
I am so sorry to hear about this, breathing problems are the pit and going to hospital all the time is not fun. I am sorry that none of the treatments work for you. Good on you for being pig headed, that is sometimes the only way to get things done. You have a great day as well.
 
VAD is so much more humane than letting someone suffer so terribly when there’s no cure or relief. The worst part is for the loved ones left behind. But it’s our right to decide about how we need to be treated.

I agree with @Liz, I’m glad you’re pig headed and stubborn, @gamiry. 💝
 
thank you Liz. I too have a breathing problem called Pseudomonas which many doctors have never heard of. It's caused by living in a house with mould, mildew, asbestos and fibro. It was my eldest son's house and he kept trying to tell me mould and mildew wouldn't hurt me... strange seeing he was a LtCol in the Army Medical Corp. After renting this house and paying for repairs I finally forked out over $15000 to completely do the house up. My thanks was he had me evicted and sold it. I haven't seen him since.
The breathing problem I have has no cure and even asthma sprays don't help so it's a damned nuisance.
Anyway my Mum called me "pig headed and stubborn" and thankfully I still am.
Have a great day .
My sympathies go out to you. To have your son treat you with such disrespect would be so heartbreaking.
I send all my hugs and best wishes to you
Carry on being pig headed and stubborn. It's got you this far.💞
 
My Mum applied self administered VAD without ANY doctors, counsellors or nursing staff.

That was in September 2007.
 
VAD is so much more humane than letting someone suffer so terribly when there’s no cure or relief. The worst part is for the loved ones left behind. But it’s our right to decide about how we need to be treated.

I agree with @Liz, I’m glad you’re pig headed and stubborn, @gamiry. 💝
I think your beautiful husband knows what I'm like. Having been born with club feet and my Mum being told I'd never walk I soon discovered that the words "I CAN'T" are not in my dictionary. 💋 :p. Please give my love to N and tell him he is definitely missed
 
My Mum applied self administered VAD without ANY doctors, counsellors or nursing staff.

That was in September 2007.
How sad for you Vegie that your poor Mum had to make this decision. ❤️
 
I think your beautiful husband knows what I'm like. Having been born with club feet and my Mum being told I'd never walk I soon discovered that the words "I CAN'T" are not in my dictionary. 💋 :p. Please give my love to N and tell him he is definitely missed
We love you too! 💝💝
 

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