Behind the numbers of elderly people who have died of Covid-19, and the glib dismissal of them by politicians, are stories of rich lives ended in often terrible loneliness. By Rick Morton.
The story of a life behind the aged-care statistics
It is not just that aged-care residents have died in the hundreds during the Omicron wave of Covid-19. It is how these elderly people spent their final weeks or months alive. For many, there was great suffering.
This miserable state of affairs is not limited to those recorded in the official statistics as succumbing to the virus itself but to residents whose deaths were hastened by Covid-19 illness or were completely unrelated except for the fact they happened in a systemic aged-care crisis that has been made worse by the pandemic.
Consider Michael Stransky, an 88-year-old man who fled the Nazis in Europe as a child and whose adult life was a rich tapestry of family, love and music. As I write this, I am listening to one of his favourite compositions, Maurice Ravel’s Boléro. I am struck by the strange and lovely trust that exists in telling another person’s story, in holding a life.
“He really and truly was a wonderful man and he did not deserve the dreadful suffering over the last four months. It has just been horrendous,” his partner of 35 years, Marion Jacobson, tells me. “As a child he used to go to the concerts and sit behind the orchestra. He had been a very good tennis player, loved horseriding and he loved the countryside.”
Stransky was an active man. Before the pandemic he played lawn bowls three or four times a week and attended University of the Third Age lectures. He drove. He lunched with friends. Much of this ground to a halt when lockdowns and restrictions came in rolling waves from March 2020, keeping this socially energetic man at home for long periods. Still, he had Marion. In late September last year, however, Michael Stransky fell in his home while getting changed, breaking a femur and setting off a chain of events that would lead – eventually – to his death earlier this month. Uncharacteristically, he spent much of these final months alone.
Ambulance services were already under incredible strain when Michael Stransky fell. In the end, it was the Jewish emergency first responders Chevra Hatzolah who reached him on September 28. Following a complex surgery to repair his hip and broken thigh bone at Cabrini Malvern private hospital, Stransky recovered in the high-dependency unit for about three weeks. He developed post-operative delirium, which required a longer stay in rehab, and was moved to Caulfield Hospital, where services were under extreme pressure following the Delta wave of the pandemic.
“Poor Michael, he was left. If he needed to go to the toilet he would ring the buzzer and wait ages and ages,” Jacobson says.
“And the worst part, for all of this, he was alone. I couldn’t see him. He was all on his own with no emotional or physical support whatsoever. It was only in the last week at Cabrini that I was allowed to visit twice, but when he was moved to Caulfield I couldn’t visit at all for weeks and weeks and weeks.”
At no stage do Michael Stransky’s family members blame individual care staff for the conditions in which his life ended. At every turn, over a period of more than four months, they describe underresourced and overworked carers, nurses and doctors across multiple jurisdictions. One thing is certain: Stransky was getting better when he was moved to a transitional care program at a HammondCare nursing home in Caulfield. Although this program is jointly operated by Victoria’s Department of Health and the Commonwealth, the care takes place in an aged-care facility, as it does for any other resident.
It was here that Stransky caught Covid-19.
“He was okay. He had started to read the newspaper again. He reserved books from the library. He was going to the dining room with his walker, walking on his own and having his meals with a couple of other people there,” Marion Jacobson says. “And then we visited him on Boxing Day and as soon as I looked at him I could see that he was pale and he was coughing. I went straight to the nurses’ desk and said, ‘He’s not well’, and she said, ‘Well, look, wait until after lunch and we’ll give him a Covid test.’ ”
Four days later the result came back positive. Stransky was placed into seven days of isolation. Although he had fallen many times already during his various stints in hospitals and in the nursing home, the virus brought back the delirium that had waned almost entirely during his recovery.
On January 5 this year, some time in the dark of the very early morning, Michael Stransky fell from his bed again. It was serious; he’d cut his head on the floor. A carer discovered him during rounds, although his family says they have no idea how long he had been lying there.
“He might have been on the floor, poor darling, for quite a while with a smashed head,” Marion Jacobson says.
Found at 4.30am, aged-care staff said they could not move Stransky for fear of causing further injury, and so he remained there waiting for ambulance crews to arrive. It took Ambulance Victoria four hours to arrive and in the meantime Michael’s family again requested the Jewish ambulance service Chevra Hatzolah. These crews can comfort and treat patients but they do not transport. When Ambulance Victoria took Stransky to emergency at The Alfred about 9am they were stuck “ramping there until 1pm”.
“It wasn’t until 1am, the following morning, that I was told the CT scan of his brain was okay and he hadn’t broken any bones,” Jacobson says. “They had given him several stitches.”
He was cleared to come back the following day at 2pm, although the transport ambulance did not arrive until “about midnight”. Two days after the fall, Michael Stransky returned to HammondCare Caulfield, where he was then diagnosed with pneumonia.
“He just went more and more downhill. He was still in isolation, no one was able to visit. He just lay there. He was so lonely,” Jacobson says. “It was shocking.”
The aged-care facility came out of lockdown on January 19. On January 23 it was declared that Stransky had clinically recovered from both the pneumonia and Covid-19. By this stage, however, it was too late to save a man so thoroughly weakened by a series of accumulating medical emergencies.
He was made palliative on January 26 and died a week later. Marion was by his side, “stroking his face, wetting his lips and loving him until the end”.
A Covid-19 vaccination booster clinic run by one of the Commonwealth’s outsourced providers arrived at the HammondCare home in December, when Michael Stransky was already in their care.
“He was eligible to get his booster and I had emailed the caseworker and got a copy of his Covid vaccination,” Jacobson says. “I’d emailed it to her and I brought a copy to Hammond House because I wanted him to have it.”
Instead, the vaccination provider administered booster shots to every permanent resident at the facility but not to Stransky.
Stories such as his are full of maybes, of what might have happened had the vaccine come sooner, or had the virus not made it into the home. As more and more people die, families are stuck with these questions for which there are no answers, only grief.
“Because he was under Alfred Health, and transitional, they didn’t give it to him,” Jacobson says. “So he wasn’t due to get his booster until the first Wednesday after Christmas. Of course, he couldn’t have it because by that time he had Covid. It was just a financial decision. I think if he had the booster, he would have had a much better chance of not being so affected by the disease.”
On January 31, just days before Stransky died as a palliative patient in the nursing home, Health Minister Greg Hunt used a grim statistic to deflect criticism about another set of grim statistics: the aged-care Covid-19 death toll.
“And I think an important piece of information as well, the latest advice that I have is that approximately 60 per cent of those that have agonisingly passed have been in palliative care,” Hunt said during a press conference in Canberra. “They are absolutely rightly counted as a national loss. But approximately 60 per cent of those that have passed were in palliative care.”
The line, repeated by Hunt several times that day, has since been used by Prime Minister Scott Morrison and other senior members of the Coalition government to distort criticism of longstanding aged-care problems. Another way of saying the same thing is this: It was going to happen anyway.
Michael Stransky’s son Raoul, a barrister, is a reasonable man. He accepts that the elderly and people with “underlying” health conditions are at more risk of dying from Covid-19. But such a realisation changes nothing about the kind of deaths the nation allows.
“They’re covering their arses I suppose,” he says. “I don’t think my dad died from Covid. But I think it complicated things at the end because it brought in a state of delirium and possibly, possibly, we may have got some extra time.”
Marion Jacobson is more forthright about the framing chosen by political leaders.
“It’s callous. It’s terrible,” she says. “And it shows a complete disregard of our older population. It’s about how people are dying and it is horrendous, horrendous, absolutely horrendous.”
Almost a decade after coming to power, following 20 major reports and inquiries into the aged-care system, and many years of slashed funding, culminating in a two-year royal commission with explosive findings, the sector remains in crisis and the federal government appears unable or unwilling to fix it.
The coronavirus pandemic did not create the fissures, but it opened them wider.
It was former New South Wales premier and HammondCare chief executive Mike Baird who first made the public call for the federal government to consider bringing in Australian Defence Force personnel to support a thoroughly depleted workforce, struck by infections and furloughing of staff.
“They could help cleaning, bed-making and cooking. The exhaustion of the sector and lack of resources means this is an option,” he told Nine News on January 12.
Later, other leaders and unions joined in a statement urging the government to do exactly this. Still, nothing happened. On February 1, the day before Michael Stransky died, Greg Hunt announced a policy that would “reward” aged-care workers with up to two bonus payments of $400 each “in recognition of their dedication in continuing to care for our vulnerable older Australians during these difficult times”.
The day Stransky died, it was put to the minister for Aged Care Services, Richard Colbeck, that he earned more in a single day at the cricket than was being offered to these workers in total. He responded: “That’s the case every day of the year, senator.”
Of all its responses to various recommendations from the royal commission, workforce pay rates have not featured explicitly in the government’s blueprint for reform.
On Monday, after the prime minister overruled Colbeck and called the situation in aged care a “crisis”, Defence Minister Peter Dutton announced a contingent of 50 ADF personnel would be sent to various nursing homes across the country to provide support during acute crises. It was almost a month after the request was first made.
A coalition of sector groups, including peak provider bodies and five unions, published an open letter to the prime minister on Thursday calling for an immediate “uplift” in wages as discussed by the royal commission, and a commitment to fully fund whatever outcome arises from a separate Fair Work Australia value case under way.
“We have kept government informed of the impacts of the pandemic on aged care services and proactively put forward solutions to address them,” the letter says.
“Although there is much that has been done to respond to the presenting issues, regrettably, much of the government’s response has fallen short of what Australia’s older people in care have needed. Older people, their families and our aged care workers are all suffering as a consequence.
“Sadly, the tragic human cost of this crisis continues to grow.”
Michael Stransky’s story is of an entire life, bookended by a dreadful death. There are many such stories, some of which have been provided to The Saturday Paper. It is impossible to do justice to all of them, but the issues are almost always the same.
Betty died from Covid-19 during an outbreak at her nursing home in Sunshine, in Melbourne’s west. At 94, she was razor sharp and in good health. Her only “underlying” condition was asthma.
“My grandmother had her first dose of Pfizer in May 2021 and the second dose in June. That meant that she was eligible for her booster in mid-December, a week or so after she passed away,” a family member says.
“If the rollout had been completed like the original plan, then she’d likely have had her booster before contracting Covid and she might have been able to fight it off. The lack of infection prevention control and PPE … meant it was merely a matter of time, which is a disturbing thought.”
In another account, a woman’s father died without family present on December 19 due to an Omicron outbreak at his aged-care home in Sydney. He did not die from the virus but his daughter has queried staff management around his death.
“All staff were furloughed and they were managing with agency staff and workers provided by Health,” she says. “I do want to say the aged-care facility overall has been outstanding. However, the management of the situation around his death and just prior to it is woeful. This was, I believe, partially attributed to the staffing issues during the outbreak.”
None of this, of course, was unprecedented or unpredictable or unforeseen. The stories all refer to the life of a person who had family, who was cherished by someone and who loved others in return.
While the government may focus on clinical indicators – and death is the most shocking available – the royal commission it established was much bigger than that. It examined safety in aged care, but it also examined quality – the stuff that makes a life, no matter how ordinary, worth living in the first place. That is what is hidden when politicians talk about underlying conditions or the fact a death happened when a person was already palliated. It is one final indignity.
At his father’s funeral, Raoul Stransky remembered a man who loved music – especially jazz and symphonic music. His car, even as he was being laid to rest, was still full of CDs.
“When he and his sister Judith were teenagers in Melbourne, he bought their first record player and classical music records. Marche slave, Danse macabre, and then Boléro,” Raoul said. “He used to stand in the middle of the sunny living room conducting this dramatic music furiously for hours.”
There was no Boléro in the nursing home. Michael Stransky’s hearing aids kept faltering. His family were prevented from visiting him. He never quite learnt how to use modern technology, so there was no music streaming service and the staff were too busy.
When they did speak with him, usually to tell him what they were going to do with his medication or toileting, he could not understand them properly through the protective equipment and masks.
“He died a miserable, distressing death,” Marion Jacobson says.
Although his adult life was filled with joy and love, there was not a lot that came easy for Michael Stransky the child. He survived the Holocaust, dislocation, the loneliness of new places away from friends and family.
When he was six and about to leave his home town of Žilina, in Czechoslovakia, a young friend wrote him a note.
“We will be sad in the yard, you being away,” his friend, Bubo Adler, wrote on May 31, 1939.
“Who will then play with Zdenek and Roni? Certainly no more you. You will be somewhere far in a strange country, but remember that Bubo will never forget you.”
Years later, he talked to his adult son and daughter-in-law about this note. Tears welled in his eyes. Bubo Adler was murdered in a Nazi concentration camp.
“The thing about what happened is that you lose family, you lose connections, you lose your sense of place,” Raoul Stransky says. “And that stays with you.”
It is a deeply human instinct, to be tethered to others. For Raoul and the rest of Michael’s family, they wonder what this alienation must have felt like in its new form, at the end of a life. No statistic or talking point will capture these essential truths.
For Marion Jacobson, her grief is personal and systemic. “Before he got Covid, Michael would have his meals with another man and a lady at his table,” she says.
“Now Raymond, his friend – cognitively he was fine. But I used to feel sorry for him because he had no family, no advocate to look after or watch over him.
“And after the lockdown of four weeks, being locked up and isolated in his room, I was shocked to see Raymond. He had lost so much weight and cognitively he had lost it because he had no one to talk to for four weeks.
“He was a changed person. And he is just one of thousands and thousands.”
This article was first published in the print edition of The Saturday Paper on February 12, 2022 as "The story of a life".
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