My wife lives in a nursing home and overall seems happy with the care that she receives. However, recently the staff seem to be very busy and do not attend to her toileting as regularly as she needs. When I speak to staff they are too busy to attend for some time.

My wife finds this very distressing. I am her representative and she has indicated that she wants me to intervene on her behalf.

What can I do?

Your wife has the right to be taken to the toilet as needed and within a reasonable amount of time. She should not have to wait unnecessarily, causing distress or discomfort, and compromising her right to be treated with dignity.

You can:

• Talk to a senior staff member about how your wife's continence needs are being managed. Was there an assessment of her needs? Has there been a review? Is there enough staff available to meet the needs of residents?
• Discuss the frequency and pattern of this problem as it occurs for your wife and identify if there is a particular time that is more problematic.
• Seek a second opinion from a medical practitioner if there is any indication that there might be some change to this pattern that needs further investigation.

As your wife's representative it is your right to be consulted and informed about all aspects of her health and care. You can contribute to improving your wife's experience of life in the home and provide useful information to care providers about preferences and likes when formulating and updating the Care Plan.

My mother lives in a nursing home. I am very happy with the care she receives but recently she has been unwell and her medication has increased and changed.

I would like to know what each tablet is for and how long she is expected to take them. As my mother's representative am I entitled to a full explanation? I am very concerned and would like to know why my mother takes so much medication.

Yes, you must be informed and consulted about your mother's care which includes the prescription and administration of her medication.

You Can:

• Talk to your mother's doctor and ask why each medication is prescribed, how long it will be administered, and any side effects it may have.
• Talk to a senior staff member who should be able to inform you about your mother's medication regime and how she is responding to it.
• Seek a second medical opinion

As your mother's representative it is your right to be fully informed about all aspects of her health and care.

Yes, but only if the move is necessary on genuine medical grounds as assessed by an Aged Care Assessment Team or at least two medical practitioners who are competent to assess your needs. One of those assessors should be a practitioner of your choice.

Other than for medical reasons, you cannot be moved unless you want to move.

A home can ask you to leave if your care needs change significantlyand they can no longerprovidethecare you need. In cases of increasing need, an Aged Care Assessment Team or two medical practitioners, competent to assess your needs, must first assess you. One of the practitioners should be of your choosing.

During this process, the home must not take action to make you leave or imply that you must leave until suitable and affordable accommodation is available, and give you at least 14 days written notice.

Ageing in Place is encouraged by the Department of Health and Aged Care, which subsidises residential care. It aims to prevent residents having to change facilities as care needs change. However, if your care needs change significantly it is not always possible to provide Ageing in Place. The final decision to offer Ageing in Place rests with the home concerned.

It is alright to discuss with your care worker what you would like them to do and how you would like them to do it. Sometimes you may find that workers have different ways of performing a task such as lifting, showering or transferring you.

No one should take offence at being requested, politely, to do something for you in your home. If they do, or there is a problem of any sort with a care worker, you can always contact the co-ordinator of the service and discuss the matter with him or her.

Legislation governing home-based services has been developed to ensure that "Each consumer's complaint about a service…is dealt with fairly, promptly, confidently, confidentially and without retribution."

What you are experiencing may be physical abuse or mistreatment from your daughter. An advocacy service can:

• Provide you with information in relation to the management of your finances, property and assets and to consider safeguards to protect your finances* in case of illness, accidents, or mental incapacity.
• Help you plan to be safe and feel safe by providing you with information and strategies of who can help so you can address the physical abuse you are experiencing

In situations like this if a person has dementia and there are concerns that others may not uphold their rights or wish to stay at home, then an application can be made by the concerned person, to the Guardianship Board for a Guardianship Order to be guardian of the older person with dementia. This then gives the delegated guardian the legal right to make decisions on choices of accommodation, health and lifestyle matters and relationship with others for the benefit of that person.

Guardians do have responsibilities. The guardian is a substitute decision maker for that person and must ensure that they make decisions about certain aspects of the person's life in the way that they would have wished it to be carried out.

To ensure your finances are managed in a way you would want you can write conditions that act as safeguards into your Enduring Power of Attorney document. Safeguards need to be considered in case of illness, accidents, mental incapacity, or because someone you trust may try to take advantage of you.

Conditions would include giving clear and written direction to those you choose to assist eg., nominees on your bank account, donees of your Power of Attorney or your financial manager and deciding what you would like them to assist you with ie., paying bills, selling property, managing investments. Carefully choose the person/s who will manage these, by asking yourself do you trust them implicitly? Remember, most financial abuse, is committed by people you know and trust. Choose when they are to help you. Is it immediately, or only when you lose the ability to make decisions?

The building in of conditions to act as safeguards assist those, taking on the role of managing your finances, to be clear about what you want and act in your best interest. Go to the safeguards fact sheet