Don’t lock residents away from their families.
That was the message Prime Minister Scott Morrison and chief medical officer Brendan Murphy sent to aged care providers in an address last week.
Now, aged care providers are calling on government to issue a revised statement on the sector’s approach to visitor restrictions.
In March, the government limited visitors to aged care facilities to two a day but some providers have imposed further restrictions.
In his address, Morrison said the government had reviewed recent events in a number of aged care facilities and was “very concerned” about the impact of restrictions that were above what was recommended by the national cabinet.
“There is great concern that the isolation of elderly people in residential care facilities where they have been prevented from having any visits, from loved ones and support people, is not good for their wellbeing, is not good for their health.”
He said there needed to be a strong reminder that the National Cabinet's decision was not to lock residents away in their rooms and that further restrictions should not be imposed “out of the convenience of isolation”.
“Where further restrictions should be put in place in aged care facilities is where you may have an outbreak in that facility or indeed an outbreak in the area in which the facility is located," he said.
Taking to the podium next, Murphy said the government understands the need to protect residents from outbreaks but added that is best achieved by ensuring that nobody enters an aged care facility if they are in any way unwell or have slight respiratory symptoms like a sore throat or tickle.
“It is not reasonable… to lock poor residents away from their family.”
He reiterated that providers should welcome no more than two visitors a day, and never for long stretches time, and should only do so with appropriate health screening and by ensuring visits occur in a safe part of the facility.
But he said residents should not be denied access to their families.
Following the Prime Minister’s comments, Minister for Aged Care Richard Colbeck warned that should providers decide not to follow the Australian Health Protection Principal Committee (AHPPC) guidelines the government would consider mandating the requirements. Any exemptions would need to be authorised.
During a webinar with Colbeck and Murphy this week, the provider peak bodies said it was incorrect to characterise the sector as having kept residents isolated, under lock and key, in their rooms.
“It does a disservice to the hundreds of thousands of dedicated aged care staff – working on the frontline and putting their own health at risk – as they work tirelessly to keep residents safe and happy,” the peaks said in a statement afterwards.
They are now calling for a revised statement from the government regarding enhanced resident protections that confirms that in some cases additional restrictions beyond AHCCP guidance are necessary for public health and resident safety.
One such peak body, Leading Age Services Australia (LASA), earlier said implied criticism of providers who have taken more precautionary measures to protect residents and save lives have caused alarm and anger among the care sector.
“The reality is that if providers in COVID-19 hotspots like Sydney and elsewhere had not gone beyond the official guidance when it was first issued there would likely have been many more outbreaks with dire consequences for the safety of residents and staff,” Rooney said.
Noting the loss of life across aged care facilities, Rooney said the sector is still to be commended for the low rates of infection experienced by residents and staff to date.
He added that providers were acutely aware of the stress and pressure visitor restrictions place on residents, families and staff. “Decisions to implement these measures are not taken lightly and are in place with the specific intent to save lives."
The Prime Minister's comments came just hours before Anglicare confirmed that a 92-year-old woman had become the third resident of Newmarch House aged care facility in western Sydney to die after being diagnosed with COVID-19. This week, the provider confirmed the death of a sixth resident.
LASA said residents or their family members or advocates who feel a provider is being unreasonable with visitor restriction measures should address them directly with the care provider and, in cases where the issue hasn't been resolved, can contact the Older Persons Advocacy Network (OPAN) or the Aged Care Quality & Safety Commission.
OPAN was one of four consumer organisations, along with COTA Australia, National Seniors Australia and Dementia Australia, which wrote to National Cabinet on 8 April seeking a nationally consistent approach by all aged care providers.
The group's chief executive Craig Gear said providers must strike a balance between keeping older people safe from the virus and keeping their health and wellbeing strong with social and mental support.
“Social isolation, loneliness and lack of access to services will cause a second wave of consequences and hit the public health system hard," Gear said.
COTA, the peak body representing older Australians, backed the Prime Minister’s comments.
Ian Yates, chief executive of COTA, said compassionate access, especially where there is a long-held pattern of people providing care and support to their loved one in aged care, must be permitted.
“This is particularly so where it is crucial to the person’s health and wellbeing, or in end of life situations," Yates said. "We have heard too many stories of family barred from seeing their loved ones at the end of their lives. There is no reason why such visits should not continue with the same stringent health and screening measures as providers currently have in place for their staff.”
Responding to Morrison and Murphy, the peak body for non-profit aged care providers, Aged and Community Services Australia (ACSA), said the sector is taking strong action to control the spread of the virus and protect the vulnerable people in its care, which has, in the case of some providers, included further restrictions due to the their individual circumstances, including location and needs of residents.
“We have taken a very strong position in aged care because we are looking after vulnerable people,” ACSA chief executive Patricia Sparrow said.
“Given the terrible circumstances we face, results to date indicate the situation has been managed as well as can be expected, but we need to remain vigilant.
“This is an unprecedented situation. Not all decisions will be perfect because we are balancing a serious pandemic with keeping people socially connected.”
Prior to Morrison’s Tuesday address, Alison Rahn, a senior research officer at Western Sydney University’s Translational Health Research Institute, said aged care visitor bans raise a number of ethical questions – with no simple answers.
Writing for The Conversation, Rahn said reports from European and American care homes, where large clusters of residents have been infected, provide sobering reminders of the need to take precautions.
She added: “The most ethical approach is for providers to involve residents and their families in decision-making.
“The aged care quality standards – which enshrine consumer dignity and choice – don’t become redundant just because we’re in a pandemic.
“It’s important for providers to ascertain what matters to residents. For many, their priority is likely to be quality of life, not length of life.”Do you have an idea for a story?
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