A dementia patient tied to a bed for five days at John Hunter Hospital allegedly suffered "mistreatment, abuse and torture", the man's wife said.
Mayfield man David Stevens, 61, was taken to the hospital for treatment for abdominal pain and a bleeding problem in May last year.
His wife Linda Stevens said hospital staff believed he was "aggressive and a threat", so they used physical restraints around his ankles and wrists.
Medical records show he was restrained at the John Hunter from May 23 to May 27.
Mrs Stevens said she did not give permission for restraints to be used and said their ongoing use caused her husband "physical and emotional injuries", including a fractured hand. She said he suffered "torturous, inhumane treatment under the pretence of extreme aggression and violence".
"His body was bruised and battered from head to toe," she said.
"He had open wounds, scratches and severe excoriation due to being forced to urinate on himself while laying on a plastic mattress."
Mrs Stevens said she voiced her concerns to hospital staff on several occasions.
"I understand restraints are sometimes necessary to contain a violent incident that's occurring for a brief time, but would never ever be needed for five days," she said.
She also alleged hospital staff "falsified documents" by stating she had approved the restraints.
"They kept asking me would I agree and I said no, as Dave was showing no signs of aggression and was only agitated because he wanted to be able to get up," she said.
A document titled "Mechanical Restraint - Authorisation and Monitoring", dated May 27, said the "consent for use" of restraints came from "Linda Stevens, wife".
Another document obtained from his medical records showed the same date, but the consent area for the use of restraints was blank. On other days, the consent area on documents for the use of restraints was also blank.
"They did not have my consent, but they wrote my name on the restraint forms," Mrs Stevens said. "They tried to cover up what they'd done."
Hunter New England Health acting CEO Susan Heyman denied "any attempt at a cover up" in a letter written to Newcastle MP Tim Crakanthorp, and said she was "confident our staff have acted respectfully and genuinely in their interactions with Mrs Stevens".
She said staff aimed to "always provide appropriate and safe care for Mr Stevens, under very challenging circumstances".
"Unfortunately, throughout his admission at John Hunter Hospital, Mr Stevens required mechanical restraint due to extensive agitation and aggression, to maintain the safety of himself, other patients and staff while he was being medically assessed.
"Mr Stevens' medical record includes extensive entries about multidisciplinary team meetings with senior management, medical and nursing staff and security to ensure staff and Mr Stevens were kept safe, and that the care provided remained compliant with the relevant policy for using restraint.
"I assure you our staff will never opt to restrain any patient unless it is a last resort and absolutely necessary."
Concerns over restraints
Mrs Stevens said medical records show nurses raised concerns with hospital management on multiple occasions about the ongoing use of restraints on Mr Stevens and the injuries they were causing.
Medical notes dated May 24 also stated that the "head of security" at the hospital sought for Mr Stevens to be released from the restraints.
"We are obliged by protocol to carry through with this," the notes stated.
Mrs Stevens said the initial reason given for her husband being put in restraints was that "he'd become extremely aggressive".
"It wasn't until obtaining his medical records it was revealed there was no display of aggression. All he'd done is merely grab a nurse by the wrist."
"For a non-verbal person with dementia, like my husband, it is a way of communicating," she said.
Hospital documents for "24-hour behaviour monitoring" of Mr Stevens from May 24 to 27 show one incident of physical aggression at 5am on May 25.
Mrs Stevens is considering legal action.
"If I tied up my husband at home like they did, I'd be charged," she said.
"He was humiliated and degraded."
Mrs Stevens said she repeatedly urged staff to give her husband a sedative so the restraints could be removed.
"They're supposed to trial other options to legally keep his restraints on. I asked to be left in the room with him to have his restraints removed and that was denied."
She asked the clinician to investigate his bleeding problem and abdominal pain.
"This was refused. The clinician stated, 'your husband had dementia and is dying anyway so any investigation would be of no benefit'," Mrs Stevens said.
She said the clinician's goals were to "make him comfortable and maintain his dignity".
"I argued that tying someone up that's already in pain and forcing them to urinate on themselves certainly doesn't meet those goals."
She said her husband was finally sedated after an orthopaedic surgeon recommended an x-ray of Mr Stevens' wrist.
That night, Mrs Stevens said a nurse told her he was "disgusted at the treatment of my husband".
"He proceeded to untie three restraints, leaving only his right ankle tied up.
"My husband took his hand and placed it on his chest and said thank you."
A NSW Health policy directive, titled Seclusion and Restraint in NSW Health Settings, states "seclusion or restraint may be used as an act of self-defence".
"In these circumstances, restraint or seclusion must only be carried out as a last resort and occur only until the risk has passed," the policy states.
A Dementia Australia report, published in 2014, said "restrictive practices can be considered assault and false imprisonment" if "appropriate consent has not been obtained and there is not an urgent need for the use of restraint".
After five days in John Hunter, Mrs Stevens said her husband was transferred to the Mater Mental Health Unit.
Independent review
Mrs Stevens said she later received an apology from John Hunter Hospital during a meeting with senior nursing management.
However, she said a hospital investigation into the incident was "inaccurate and inconsistent with his medical records".
A Hunter New England Health spokesperson said: "We acknowledge the distress this matter has caused Mrs Stevens, and we're sorry we have been unable to resolve her concerns".
"While we cannot discuss details regarding an individual patient's care due to privacy, Mrs Stevens' concerns have been taken extremely seriously by John Hunter Hospital and our district.
"John Hunter Hospital undertook a formal investigation into Mr Stevens' care. The Health Care Complaints Commission (HCCC) has also reviewed these concerns independently.
"The district has offered to meet to discuss the investigation and to better understand and address Mrs Stevens' concerns, including participating in a meeting independently arranged and facilitated by the HCCC.
"We remain committed to addressing Mrs Stevens' concerns, and believe that a meeting, facilitated by an independent third party if required, remains the most appropriate opportunity to do so."
The statement thanked staff for "their professionalism and the excellent care they provided under very challenging circumstances".
A Dementia Australia statement said it had "long called for everyone working across healthcare industries, including hospitals, to receive compulsory education about dementia".
"Inappropriate use of chemical and physical restraint is a significant concern for people living with dementia and their families."
Mrs Stevens said she does not want another family to "go through what she and her husband have gone through".
"People with dementia should be treated with respect, compassion and care. They hurt, cry and bleed just like everybody else," she said.
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