Many staff in aged care are unprepared and unqualified to support people in the final stages of their lives, the aged care royal commission heard on Wednesday.
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Canberra woman Kate Davis told the commission about her "witty, warm, intelligent and most of all loving" mum Noeline Taylor, and the different experiences she had at residential facilities in the ACT.
In the final weeks of her mum's life, Ms Davis said staff seemed unprepared for what was ahead, and discussions about an end of life care plan were not detailed and didn't properly prepare her for what it would be like.
"I think we all assume that a core business for an aged care business is death," she told the aged care royal commission.
"It might be okay if you just passed away in your sleep but if you have any kind of extended death they are just woefully ill-prepared, in my experience."
There were small things, like shocked carers not realising Mrs Taylor was "beyond the point of eating".
Some staff were upset when they saw Mrs Taylor, which Ms Davis said only added to her own distress and concern over their ability to look after her mum.
There was also a distressing incident when Mrs Taylor was moaning in agony for three hours as there was no registered nurse to give her pain medication.
"The nurse was almost in tears and said to me 'I'm sorry, I wish I could do more but I'm stretched. There is no one else that has the ability to administer through the syringe driver'," Ms Davis said in her statement.
They lack the knowledge and skills and it's not because they don't care. It's just that they've never been taught.
- Nikki Johnston
Ms Davis praised the work of specialist palliative care nurse practitioner Nikki Johnston, who had supported the family for several months, organised for Ms Taylor's transfer to Clare Holland House hospice where the 83-year-old died in August 2015.
"The care provided was so professional, it was directed at an actively dying person and was instrumental in ensuring Mum died free of pain and suffering."
"You just felt enveloped in this support and care."
Ms Davis said the aged care system needed more registered nurses and palliative care needed a better role in the aged care system.
Ms Johnston also gave evidence and said palliative care training for aged care staff was important.
"They lack the knowledge and skills and it's not because they don't care. It's just that they've never been taught."
Ms Johnston said the funding model in place in the ACT was successful and had allowed her support of Ms Taylor in transferring her to Clare Holland House.
- with AAP