Warehousing the elderly during COVID-19 must be challenged

Anne Cahill Lambert 8 June 2020 45
Nursing home residents

Nursing home residents have been without visitors and in some cases access to fresh air for months. Photo: File.

This pandemic has seen individuals and organisations reorganise day-to-day activities in a different way. Some have risen to the challenge – think cafes that have turned into takeaway venues overnight – while others have taken the opportunity to resort to the bad old days.

While the pandemic has thrown a curveball at aged care providers, some have not risen to the challenge, introducing shocking arrangements for our most vulnerable – the elderly.

Residents of many aged care facilities are essentially in solitary confinement because of the decisions being made by providers on behalf of residents. I have no doubt that the providers think they have the best interests of their residents at heart, but I believe the arrangements that have been made are for the benefit of the providers rather than the residents.

The Prime Minister instructed aged care facilities to cease the curtailment of visitors to residents of nursing homes during a press conference on 24 April 2020. Up until then, national guidelines announced by the PM in March 2020 advised that it was acceptable for residents to have two visitors a day in their rooms. Facilities could apply for exemptions.

That same day, an aged care facility in the ACT issued a note to all residents and families advising that it would not be opening up for visitors at that time. No visitors had been allowed into the nursing home for more than five weeks.

The aged care industry released guidelines on 12 May 2020. Unfortunately, some homes continue to make visiting arrangements a nightmare.

The facility mentioned above now allows residents to have just one visitor per day for half an hour – after more than seven weeks of no visitors. The visit must be booked.

My friend who lives in that facility was able to have just one half-hour visit with one person this week because all the available booking times were taken by other residents. No visits for my friend over the weekend and just one during the week. For half an hour.

That same facility has not taken its residents outside since mid-March because, according to one staff member, they do not have enough staff to supervise the residents. No sun on their faces, no sun on their backs, no vitamin D.

Certainly, there are ways to redress the removal of human rights, such as complaining to the Aged Care Quality and Safety Commission. However, my friend’s family does not want to jeopardise their loved one’s care through repercussions. While the Commission takes a dim view of repercussions, nevertheless they happen.

I have had plenty of people tell me that these restrictions are in place for the good of residents. I wonder at this – the aged care facility has no COVID-19 (indeed, the ACT has been COVID-19-free for over three weeks), and it has no other outbreaks of infectious conditions. It’s been shown that with good hygiene practices, there is no reason not to follow the Commonwealth’s directions.

Hospitals are able to manage visitors: temperature checks and hand hygiene at the front doors, limiting the number of visits to each patient and length of visits. Those arrangements do not exclude access to visits. They merely manage them.

I despair of the fact that some aged care providers are basically getting away with reverting to the dim black days of history in the way elderly residents are managed – their human rights are significantly diminished. Yet, they continue to act with impunity, sometimes across nationwide chains of facilities.

This particular aged care facility is part of a national chain and these arrangements apply to other facilities across the chain. This is happening while the Royal Commission into Aged Care Quality and Safety is underway.

It is happening despite the Commonwealth’s instructions. It is happening despite the existence of an aged care charter of human rights. It is happening despite the code of conduct agreed by aged care providers.

Mental health experts will no doubt have a significant contribution to make in this space, but it will be too late for the current residents who may just give up over this appalling ‘care’.

I am sure we should not be waiting for individual complaints: aged care is clearly a Commonwealth responsibility and actions should be taken immediately to address this abuse of human rights.

Anne Cahill Lambert AM has worked in the health system for more than 40 years. She was the former chair of the ACT Remuneration Tribunal and a member of the National Health and Medical Research Council. She has a particular focus on ensuring that the voice of consumers is heard.

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45 Responses to Warehousing the elderly during COVID-19 must be challenged
David Perkins David Perkins 6:12 pm 31 May 20

I went to visit my sick mother in a Canberra aged care "facility" on 18 March. The woman at the front desk refused me entry because I was not the sole "nominated" family member. I asked to speak to the CEO. She also refused me entry . This was at the time when Government policy allowed for 2 visitors per day. I explained that I would go straight to her room and touch nothing on the way in or out. No go I was told there was no discretion to vary the national policy of Calvary aged care facilities. I saw my mother two days later on 21 March 2020. She was dead, having passed away overnight. We were given 24 to 48 hours to vacate my mother's room. Access was unlimited for this task. I just don't have the words to express how much I loathe the management of Calvary for their heartless inflexibility.

    Margaret Freemantle Margaret Freemantle 10:06 pm 31 May 20

    David Perkins so very sorry for you.

    David Perkins David Perkins 10:30 pm 31 May 20

    Margaret Freemantle thank you

    Anne Cahill Lambert Anne Cahill Lambert 11:38 pm 31 May 20

    David Perkins ohh, I’m so sorry, David.

    Aldith Graves Aldith Graves 3:22 am 01 Jun 20

    David Perkins so very very sorry for your Mum & your family. It isn’t good enough

Christopher Mawbey Christopher Mawbey 5:50 pm 31 May 20

Australia is not the USA where individual freedoms are held sacrosanct to the detriment of the community at large.

We in Australia have a long history of giving up our personal freedoms in time of community need.

The good of the whole is as equally important as the individual.

Jeanette Atkins Jeanette Atkins 5:41 pm 31 May 20

I visited my dad a few weeks ago, and was pleased they had so many processes in place! He was happy and healthy and ‘that’ is appreciated ❤️

Jackie Fuller Jackie Fuller 2:31 pm 31 May 20

Thank God they are all still alive to tell the tale 🤷‍♀️

    Helen Goddard Helen Goddard 5:59 pm 31 May 20

    But depressed.

    Jackie Fuller Jackie Fuller 6:02 pm 31 May 20

    Helen Goddard depression can be treated...death can't

    Helen Goddard Helen Goddard 6:18 pm 31 May 20

    Jackie Fuller I don’t know how many times I have to explain it. There are no cases in the ACT. Yet many nursing homes are making it nigh on impossible to have loved ones visit their family. And when you’re in your 90s depression is nigh on impossible to fix. Read the article.

    Jackie Fuller Jackie Fuller 7:50 pm 31 May 20

    Helen Goddard it's not forever

    Helen Goddard Helen Goddard 7:53 pm 31 May 20

    Jackie Fuller For elderly people it is. It’s already been 12 weeks for some.

Robyn Holder Robyn Holder 1:28 pm 31 May 20

Re people in aged care being isolated, would you prefer the Swedish model where half the country's deaths were in aged care homes, no medical assistance? Not just older people in general but the ones in aged care homes, locked in with the virus and infected workers. Like what happened with Newmarch only worse and it was all aged care facilities.

    Helen Goddard Helen Goddard 5:59 pm 31 May 20

    That's not what the article says at all. Perhaps if you read it you'll see precisely what it says. And my comment elsewhere apply to your comments. It is about an example in Canberra, where there are no CoVid-19 cases at all.

Helen Goddard Helen Goddard 1:14 pm 31 May 20

Didn't aged care get a big injection of funds for nursing homes to enable extra staff to manage visitors? I think there are many in aged care who are dying of loneliness rather than anything else. It's OK to have temperature checks; it's OK to inspect proof of 'flu vacc; it's OK to have visitors only in the resident's room; but to mandate that this all happens at the convenience of someone who is not the resident is not OK. The writer is has cited the ACT as an example ... there have been no cases in the ACT for more than three weeks, yet aged care facilities still refuse to allow visitors in a more humane manner. The point of the article is that facilities are *not* implementing the guidelines ... they are operating in an environment which has removed the human rights of residents. Indeed, the author makes the point that, with good hygiene practices, there is no reason not to follow the Commonwealth’s directions. I hope this changes soon ...

Kriso Hadskini Kriso Hadskini 12:17 pm 31 May 20

I guess the question is more philosophical, What is living? Some, like commenters above would say, living/existing is all that matters, even if it makes life miserable. Others would rather take a gamble and live well for the time they have left. I guess it would come down to your beliefs around sickness and death. Before you go hard core keyboard warrior about it...remember I am talking philosophically here.

    Jenny Bolin Jenny Bolin 12:37 pm 31 May 20

    Kriso Hadskini I appreciate what you are saying, but when people live in a communal setting one person’s decisions can affect a lot of others. I would hate to be responsible for taking this virus (or any other) into the facility and potentially causing the illness and even death of the people I care for!

Acton Acton 10:35 am 31 May 20

Unfortunately everything written here is correct and accurate. Aged care facilities are engaging in convenient neglect using the excuse of a virus. Meanwhile the ACT Government builds a monument to its own mismanagement and waste on the grounds of Garran oval, an unnecessary and unused facility pandering to the fears and paranoia of a blinkered community that does not want to know about the neglect of their abandoned elderly.

Juliane Samara Juliane Samara 10:15 am 31 May 20

The ONLY reason we have not had an outbreak of COVID19 in RACFs in the ACT is because the facilities have done so well with implementing the guidelines. One or two facilities have chosen to ignore the recommendations to allow compassionate visits for palliative care, causing extreme distress to families, but on the whole I think the staff deserve praise and thanks for keeping our elderly safe. They have worked so hard, been abused, and yet still turn up and care for their residents. Many went above and beyond to keep families connected with technology, to work with GPs and Specialists to use Telehealth and to provide extra training and education for their staff. Those criticising should go and work in RACF for a week and see just how challenging this work is, with limited staffing and poor funding models.

    Carole Ford Carole Ford 10:34 am 31 May 20

    Juliane Samara Well said Juliane. 👍 Just as the Royal Commission into aged care has highlighted, we do need to make sure that we plan for crises.

    Fiona Guy Fiona Guy 1:08 pm 31 May 20

    Agree staff have been amazing 👏

    Bec O'Brien Bec O'Brien 2:05 pm 31 May 20

    Juliane Samara whole heartedly agree. Being an OT at an aged care facility in Canberra we have let our residents with medical appointments out. Residents that are not a falls risk have been allowed to walk around the grounds with my clinical reasoning. All our residents can attend indoor activities. We have a special palliative care room for families to stay with tea,/coffee, microwave, fridge. They can go to the library if they want a book. I'm dealing with residents mental health issues. What I would like to see is having more technology for residents. I got frustrated when they said to use Skype, but couldn't use wifi. I've been working there for 6 months, & it's not all doom & gloom. It's tough but my residents understand & when you explain it's the same for us at home they look surprised. Please give us a break & stop branding all aged care facilities as being in the dark ages. I have been at work every day through this pandemic.

    Helen Goddard Helen Goddard 5:53 pm 31 May 20

    Why can't family visit their loved ones? If they've had a 'flu vaccination (and provide evidence of same) and have their temperature taken at the door, there should be no reason to keep them away. And I don't think all aged car facilities are being "branded" ... just some, who deserve it.

    Michelle Preston Michelle Preston 10:18 pm 31 May 20

    Juliane Samara I agree the nursing home my MIL is in has done a great job of keeping families informed.

Jenny Bolin Jenny Bolin 10:06 am 31 May 20

Thank goodness I work in a Canberra facility that has closely followed the government directives. We started by (and continue to) discourage nonessential visitors; palliative or dying residents have always been able to have unrestricted visits, particularly family members; children were excluded, now only those under 16 are excluded; the podiatrist and speech pathologist continue to visit as do doctors; bus outings are on hold - partly due to the unreliability of one service, another going into receivership; use of taxis is not allowed, if a resident has an outside appointment and there are no family members available to take them the appointment is cancelled/postponed; residents are allowed outside in nice weather as normal, group activities continue with social distancing in place, communal dining areas still operate, residents are free to walk around the facility without restrictions. The only residents who are confined to their rooms are those showing symptoms, they are tested and isolated until results return. The mandatory flu vaccination is a government initiative and is to protect residents, staff and visitors, it has always been voluntary but strongly advised! Does this sound like draconian, excessive restrictions?

    Helen Goddard Helen Goddard 5:51 pm 31 May 20

    "Discourage non-essential visitors"? Why? Why can't family visit their loved ones? This is exactly what the article addresses. And yes, you're lucky that your residents are getting outside in nice weather. Some aren't. And most residents in a couple of facilities I know are confined to their rooms. Canberra has no cases and there is no need for this in Canberra.

    Jenny Bolin Jenny Bolin 6:54 pm 31 May 20

    Helen Goddard Non-essential visitors relates more to the distant relatives, the previous neighbours, the volunteers, the people who don’t usually come in regularly. There needs to be some controls, facilities need to know who is coming and going to facilitate the ability to track contacts if cases do occur. And yes, I agree, with no diagnosed cases in Canberra for several weeks now, restrictions can be reduced, but if any do occur, particularly in a facility we would cop the flak for not taking due care. Our residents are some of the most vulnerable in the community and even though they may be nearing the end of their lives, we still have a duty of care and protection. In so many ways aged care is stuck between a rock and a hard case and there are no easy answers.p and believe me we know it’s not easy! Not only do we not want to bring it in where it would spread like wild fire, but no one wants to take it home to their elderly parents or young children!

Carol Perron Carol Perron 9:47 am 31 May 20

I agree my friend can’t get her pacemaker check done or her eye tests.

    Wendy Kroon Wendy Kroon 10:20 am 31 May 20

    Carol Perron residents can leave for appointments and sit out side with families. Pace maker batteries are checked at a cardiologists rooms so I would image this is possible.

    Angela Thomas Angela Thomas 1:34 pm 31 May 20

    Carol Perron eye tests are possible, I had mine done a few weeks ago

    Carol Perron Carol Perron 1:57 pm 31 May 20

    Angela Thomas thank you I will follow it up as my friend was told she would have to be isolated for 2 weeks if she went out of the building. (This case is the North Queensland.)

    Karen Brown Karen Brown 1:57 pm 31 May 20

    Wendy Kroon a lot are done in the cardiology department and to my knowledge a lot of clinics have been canceled during Covid

    Wendy Kroon Wendy Kroon 2:04 pm 31 May 20

    Karen Brown exactly not the fault of the RACFs

    Angela Thomas Angela Thomas 5:28 pm 31 May 20

    Carol Perron Ah well, north Queensland, I dont know what they have on offer but Canberra optometrists are offering a service.

    Helen Goddard Helen Goddard 5:49 pm 31 May 20

    Wendy Kroon They can't sit outside with families. That's part of the point of this article.

    Wendy Kroon Wendy Kroon 7:22 pm 31 May 20

    Helen Goddard depends some do let them and allow them to go out

    Karen Brown Karen Brown 8:18 pm 31 May 20

    Wendy Kroon not saying that at all. But most (not all) public patients are seen in hospital clinics and a lot of those have been cancelled. Your comment was it could be done in cardiologists rooms. So Carol May have been correct

    Wendy Kroon Wendy Kroon 8:38 pm 31 May 20

    Karen Brown I wasn’t saying you were Karen previous comments by others were implying it.

Leah Smith Leah Smith 9:44 am 31 May 20

Suzanne, add to this mandatory flu vaccine for visitors.....

Fiona Guy Fiona Guy 9:35 am 31 May 20

The current restrictions also block access to essential health care services. My father has a cavity in his tooth that was booked in to be filled in March (!). It’s just awful 😥

    Juliane Samara Juliane Samara 10:17 am 31 May 20

    Fiona Guy no they don’t. But lots of essential health services closed and went to Telehealth only. Dental appointments were cancelled for everyone, unless extreme emergency.

    Fiona Guy Fiona Guy 11:37 am 31 May 20

    Juliane Samara Without going into the medical needs of my father, the services he was booked to attend were open, and are open at the moment.

    Juliane Samara Juliane Samara 11:40 am 31 May 20

    Fiona Guy moat of the facilities have allowed medical appts if transported by private car. If his RACF doesn’t, and he needs it, then take it up with the aged care quality and safety commission, particularly if affecting his ability to eat and he is losing weight

    Fiona Guy Fiona Guy 1:06 pm 31 May 20

    Juliane Samara Expecting every individual to fight for their human rights is unrealistic though, for reasons well articulated in the article.

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