The families of aged care residents have become demanding and aggressive, with some unwilling to accept their loved one is dying, an inquiry has been told.
The aged care royal commission has heard evidence about the importance of family involvement, but some nursing practitioners say dealing with relatives can be one of the most challenging parts of their work.
Sandy Green said family behaviour has dramatically changed since the 1997 introduction of accommodation bonds, which are paid when people go into residential aged care.
"I have experienced and observed family members becoming verbally aggressive, demanding, threatening and unrealistic towards nursing staff and medical teams in their expectations of their family member's current health conditions," she said in a statement to the commission.
Ms Green said residential aged care facilities were more like subacute hospitals than a home-like environment, given families' demands for services from a range of specialists such as geriatricians, dietitians and speech pathologists.
"I'm just finding families are getting angry," she told a hearing in Cairns.
"They're demanding services. They're demanding care. They're demanding treatment a lot quicker."
Ms Green, who provides nurse practitioner services to residents in aged care facilities, said family members may not accept their mother or father has multiple medical conditions and are medically unstable.
"They want us to fix it. And if we say 'I'm sorry, your mother or your father, they're dying', they don't want to accept that."
Consultant nursing gerontologist Drew Dwyer said families are often the biggest barrier to providing the best outcomes in care for many stakeholders in residential care services.
"It's a simple case in any home you go to, that the families are extremely demanding and have a higher expectation for the fees and services they are paying," he said.
Dr Dwyer said families require more education in the impacts of ageing in order to understand and accept what is occurring in front of them, when a relative reaches the end stage of their life.
"There's a huge gap in what we are not telling or informing society about what they are about experience, and that is the transition of a large number of our society who are going to move towards end stage of life very soon as a cohort of older Australians."
The royal commission's next public hearing, in Mildura in regional Victoria from July 29, will focus on the needs of family, informal and unpaid carers for older Australians.
Australian Associated Press
