Taunted, left filthy in bed: My dad’s aged care horror
It was a cause far from her sphere of interest, a topic to skim over in the news, to brush aside.
Renowned, internationally published poet, author, critic and academic, Associate Professor Sarah Holland-Batt never envisioned becoming a champion of aged care reform.
But after her late father's horrific treatment in a Gold Coast aged care facility - that involved broken bones, neglect and sadistic abuse - Holland-Batt has become a formidable advocate for change.
Brisbane-based Holland-Batt, 37, an associate professor in creative writing and literary studies at Queensland University of Technology, became embroiled in the "abysmal'' state of Australia's aged care after her father moved into a residential aged care facility in 2015.
He was diagnosed with Parkinson's disease in 2000 and died in March, aged 83
Holland-Batt, who appeared as a witness and testified at the Royal Commission into Aged Care Quality and Safety in August 2019, says the aged care system in Australia is "genuinely shocking'', describing it as one of the worst in the developed world.
"I didn't pay a jot of attention to aged care until it happened to our family," Holland-Batt admits.
"It was not something I would read about, I probably would skim over it in the paper.
"We all believed what happened to my Dad could never happen … but then it did.
"Dad's experience was not an aberration; it is emblematic of the way the system works. It's very common for people in aged care to have failure after failure of care and abuse.
"The state of aged care is genuinely shocking, it's a disgrace.
"We are talking about really frail, vulnerable people who are completely voiceless in our society and more than half of people in aged care have dementia.
"They are out of sight and out of mind."
Dr Tony Holland-Batt prized his intellect. Born in Leeds, in the north of England, he had a successful career as an academic and metallurgical engineer and held a PhD in his area of research in sand mining.
While lecturing at Imperial College London, he took a group of his engineering students on an international field trip to Mount Isa to test some of the technology he had developed as part of his own PhD.
It was there he met his wife-to-be, Jenny, a Gatton schoolteacher, who was also in Mount Isa visiting a friend. They married in 1970 and lived in London before moving back to Australia in the mid 1970s.
Sarah, their only child, was born at Southport on the Gold Coast, attending Benowa State School and then St Hilda's School at Southport.
The family relocated to Denver, Colorado, in the United States, when she was 11 for her father's work as vice president of a mining company.
"When I was a kid, dad was an incredible intellectual mentor to me," Holland-Batt says. "He always talked about literature and philosophy and he read voraciously.
"Even though his career was about science and physics, he was fascinated by music and literature. He was a good pianist and he composed classical music including a piano concerto.
"He was always encouraging me in any kind of intellectual interest that I had.
"My parents suggested I might do a law degree or go into diplomacy because I was good at arguing and analysing.
"I think they were slightly crestfallen when, at age 20, I wanted to be a poet. But they were very supportive and Dad was really delighted with where I ended up.''
Before poetry, Holland-Batt seriously entertained a career as a concert pianist.
She began piano lessons at age five and in the US had ambitions to audition for the prestigious performing arts conservatory The Juilliard School in New York.
But moving back to Australia with her family in 2000 made her reassess her career plans.
She had started writing poetry in high school and felt it was a natural fit for someone interested in music and the "music of language".
She now holds a first-class honours degree in Literature, a Master of Philosophy in English and PhD from the University of Queensland, and a Master of Fine Arts in Poetry from New York University where she was the W.G. Walker Fulbright Scholar from 2010-2011. She also spent six months in Rome, Italy, with an Australia Council Literature Residency.
Her first book, Aria, was widely lauded and her second, The Hazards, won the 2016 Prime Minister's Literary Award for Poetry.
Her poems have appeared in numerous international journals and magazines - including The New Yorker - and have been translated into several languages.
At age 64, Tony Holland-Batt received the
devastating diagnosis of Parkinson's disease, a progressive, degenerative neurological condition.
Determined to keep his mental acuity as long as possible, he still published research papers five years into his diagnosis.
He taught himself harmonica, he continued to read and compose music.
But when it became apparent he could no longer be looked after safely at home, Holland-Batt and her mother Jenny, 73, who lives on the Gold Coast, spent considerable time researching aged care facilities. They settled on what they determined was the very best option - a home with "an attractive design" that impressed them with beautiful gardens and residents' private rooms with patios.
They were comforted by facility staff assurances about the level of personal care and promises set out in the facility's charter.
Overall, Holland-Batt says, it "seemed the most humane, pleasant and best environment". Her father moved into the facility in June 2015 with acute care needs.
Holland-Batt says, initially, her Dad was given a lot of attention by staff but after about a month, the level of care and attention "fell away swiftly".
She began to notice his dishevelled appearance. It was often unclear if he had been showered as he had stained clothing and his face was unwiped.
She also noticed "frequent relatively minor medical issues" such as an infected ankle, untreated cold sores on his face, grazes, a scratch or scrape and rashes.
He was also "bored witless" because no internet access was provided, despite being repeatedly promised. Holland-Batt says she came to understand these incidents were not isolated, but rather "indicative of a pattern of neglectful care".
Unfortunately, things only became worse. She learnt her father's critical Parkinson's medication, that needed to be administered at exact intervals, was not given on time and was in fact negated by another drug prescribed by a facility-arranged GP.
Then, in December 2016, her father suffered a broken hip as he was trying to get to the toilet alone.
A sensor mat to notify staff when he needed help to get up had been removed and it is unknown how long he lay on the floor in pain before being discovered.
He underwent hip replacement surgery and was wheelchair bound from that point.
Distressingly, Holland-Batt was to learn the neglect of her father was far worse than she could imagine.
In March 2017, a whistleblower alerted her to disturbing, deliberate and repeated abuse and victimisation of her father by a staff member on night shifts.
The whistleblower revealed the staff member verbally taunted her father telling him his "clean nappies" were in the hallway despite him having no way to access them.
She regularly refused to shower him, closed the door to his room for hours when he was awake and lying in soiled incontinence pads and deliberately moved his wheelchair away from his bed so he could not get up, leaving him immobile and distressed.
A serious infection in his elbow was also deliberately neglected for days.
Holland-Batt says she is "haunted" by what else the carer may have done to her father when no witnesses were present.
"I just hit the roof. I have never been angrier in my whole life. I was absolutely furious," Holland-Batt says.
"The whistleblower said she was telling us because if she told management nothing would happen.
"We were sick to our stomachs."
After complaining to the facility management, reporting the abuse to police, ringing "all the hotlines and bodies I could find" and lodging a complaint to the regulator (now the Aged Care Quality and Safety Commission), Holland-Batt says nothing was done.
Only after the whistleblower came forward and put a statement on record, was the staff member removed.
However, Holland-Batt says she later discovered through Freedom of Information that the worker was not fired but simply moved to another facility.
"When something like this happens in aged care there are so few protections for your family member it was genuinely shocking," she says.
"The thing that shocked me the most was not that there was failure of care, but that when there was an allegation of serious, deliberate abuse and neglect that there was no safety net at all for Dad when he needed it the most.
"The current protections and processes available in cases of abuse are manifestly inadequate."
In April 2017, Holland-Batt was further shocked to discover an unaccompanied corpse covered by a blanket on a gurney in the hallway outside her father's room.
She later wrote a poem, published in the New Yorker magazine, titled The Gurney, about this.
And, sadly, the general neglect of her father continued. In May 2018, he fell in his room going to the toilet and broke four ribs.
When he was X-rayed at hospital, doctors found an additional two partially healed broken ribs from a previous injury that had gone completely untreated.
"He had a really poor quality of life and it was devastating; it was just horrendous," Holland-Batt says.
"In the end he was too frail and distressed to move.
"We looked at other facilities but there is no way of telling you aren't going to be moving him somewhere worse."
Holland-Batt's dad died in hospital of non-COVID-19 related pneumonia in March, blessedly, she says, only a couple of weeks before health restrictions rendered family visits to dying loved ones impossible.
"I am forever grateful for the timing," she says. "We were able to sit with him in the hospital for a week, hold his hand, play his favourite classical music, I read to him, told old family stories, took him a family photo album.
"All things considered, he was able to have such a beautiful death. He was with his family the whole time.
"But with COVID, people are on their own - there is no one to hold their hand, family can't see them.
"It's not a humane death and lots of people have died not being able to see family."
With the passing of her dad, Holland-Batt's resolve to see reform in the aged care sector has only strengthened.
And her focus on change is not just about quality essential care but also about society's older citizens "feeling valued and having a good day".
She is keen to see the final report of the Royal Commission that is due in February.
"It's not just having someone take them to the toilet, it's that they are entitled to a pleasant day, to a day of engagement with other people," she says.
"As it is, carers - and there are a lot of good workers - can barely get the medication, the toileting and showers done.
"There's no hope of making sure someone is having a good day. It's not just about physical care, it's also about mental health and wellbeing.
"I realise it is an issue that people don't want to think about. It's not pleasant to think of our future in this way.
"But now that I've seen how badly it played out for my Dad, I feel an obligation to try and do my part.
"My involvement will continue until I'm satisfied there has been meaningful change that will preclude other people from going through the hell that Dad went through."
Originally published as Taunted, left filthy and kept in bed: My dad's aged care horror