First: it is not paranoia
A bruise on the arm nobody can explain. Your mum suddenly "settled" and absent. A pad wet for hours. A call bell ringing while you stand there. The feeling that something is wrong almost always arrives before the evidence — and the first instinct (raising your voice at the nurses' station, taking her out that afternoon) is understandable but usually weakens your position.
What counts as abuse — not just hitting
- Neglect: hygiene left undone, dehydration, meals not given to someone who cannot eat unaided, pressure injuries that developed in the home, repeated falls with no action taken.
- Improper restraint: bed rails, belts, chairs that immobilise. Under the restrictive practices rules a provider must have assessed alternatives, obtained informed consent, documented it in the care plan and reviewed it regularly — a restraint nobody told you about is a breach, not a detail.
- Chemical restraint: medication used to influence behaviour rather than to treat a diagnosed condition. This is a restrictive practice with the same consent and review requirements — ask which it is.
- Physical or psychological abuse: rough handling, yelling, humiliation, threats, isolation as punishment.
- Financial abuse: money or belongings going missing, signatures on documents, pressure on the resident.
The first 72 hours
- Photograph, with the date showing — bruises, redness on the sacrum and heels, the state of the room.
- Keep a log: date, time, what you saw, who was present, what you were told. Record the "I don't knows" too.
- Get your relative seen by a doctor from outside the home if there are physical signs. An independent record is the strongest evidence there is.
- Do not confront the carer on shift alone. Ask in writing for a meeting with the facility manager and the clinical manager, setting out the facts and your questions.
- Request the records: progress notes, the medication chart, incident reports, falls and skin assessments, and the current care plan.
- If there is immediate danger, call 000.
Who to report to, in order of effect
- The provider, in writing — they must have a complaints process and respond.
- The Aged Care Quality and Safety Commission. Complaints can be made by anyone, including anonymously, and the Commission can require the provider to act. Just as important: under the Serious Incident Response Scheme (SIRS) the provider itself is legally required to report serious incidents — unreasonable use of force, neglect, unexplained absence, unexpected death — to the Commission within set timeframes. Ask directly: "Has this been reported under SIRS, and when?" The answer tells you whether the home is handling it or hiding it.
- OPAN — the Older Persons Advocacy Network: free, independent advocacy, including help writing the complaint and sitting in on the meeting. Use it before you need it.
- Police: assault, theft and fraud are crimes wherever they occur.
- The state or territory public advocate / guardian and the tribunal, if financial abuse is suspected or decision-making arrangements need reviewing.
If your relative cannot describe what happened, your observations and the records stand. "She says that, but she's confused" is not an acceptable answer — ask for it to be documented.
Move her, or stay?
Moving immediately is not always right: an abrupt move disorients, and a formal complaint often changes a provider's behaviour within days, because nobody wants the Commission looking closely. But if there is violence, if the signs repeat, or if nothing changes after your written concern — do not wait. Run both tracks at once: the complaint on one side, alternatives on the other.
Curalune Care Help (A$109) puts together, usually within 24 business hours, a shortlist of 3 to 5 homes matched to your area and care needs — with the questions to ask about restrictive practices, medication and night staffing.
*General information, not legal or medical advice. If someone is in immediate danger, call 000.*