Coronial inquest to investigate aged care facility's treatment of man's bed sores

A coronial inquest will investigate whether an aged care facility in Adelaide's inner north appropriately treated the bed sores a 79-year-old man with dementia developed in the weeks before his death.

John Michael Henry Allen died on September 9, 2022, at the Royal Adelaide Hospital, with his cause of death determined to be advanced Alzheimer's dementia with a background of pressure sores.

Opening the inquest in South Australia's Coroners Court on Tuesday, counsel assisting the coroner Rebecca Schell said Mr Allen had been diagnosed with advanced Alzheimer's in 2016 and resided at the Bupa Enfield aged care facility from 2019 until his death.

Ms Schell said the inquest would explore whether the treatment of Mr Allen's bed sores was "appropriate and reasonable over the period of July to August 2022".

She said it would also consider whether his death could have been prevented if the aged care facility had managed his sores differently.

Ms Schell told the court Mr Allen was transferred to the Royal Adelaide Hospital on August 21, 2022, after his daughter "had difficulty interacting with him and … was concerned with his mobility".

Upon his admission to hospital, Mr Allen was found to have a "5cm necrotic lesion" on his buttocks and a "stage three" ulcer on his foot.

Ms Schell said Mr Allen was "treated with intravenous antibiotics" and underwent "regular wound dressings" and "two hourly pressure area care".

"Mr Allen's admission was complicated by his rapid atrial fibrillation, poor oral intake and resistance to care," Ms Schell said.

"Following discussions with a family member, the decision was taken to cease oral antibiotics."

Ms Schell said Mr Allen's other medication, as well as his wound care, was continued in the hope his condition would stabilise.

However, she said his "oral intake continued to decline" and he became "clinically dehydrated", resulting in him being transferred to palliative care on September 1, 2022.

Ms Schell said, before Mr Allen's death, staff at Bupa Enfield aged care facility had noticed and treated his sores by dressing them — and at one stage had given him antibiotics.

She added that staff also took photographs of the sores on "various occasions … as part of their practice".

She said that after the identification of the first sore, a medical officer "noted" that Mr Allen should be "mobilised more".

Registered nurse Dipender Shahi worked at the Bupa Enfield Aged Care facility and had treated Mr Allen's pressure sores.

He told the court Mr Allen was non-verbal because of his Alzheimer's Disease.

Mr Shah said that, as part of protocol, he had created "wound management plans" for Mr Allen and would assess his pain by watching his "expressions" and "body language".

"He was a bit resistant with his care," Mr Shahi added.

Registered nurse Amritdeep Kaur, who also used to work at Bupa Enfield aged care facility, noticed a pressure sore on Mr Allen's foot on August 20, 2022, and believed it was causing him pain due to his body language.

Ms Kaur said she noted that Mr Allen's pressure sore should be assessed by a general practitioner — who would attend at the aged care facility three times a week.

She also told the inquest she had advised staff to reposition Mr Allen every two hours.

The inquest is expected to run for four days.