Essential foundations of a successful new aged care visitor restrictions regime
Some aged care providers are using the new restrictions for visitors to residential aged care facilities as an excuse for unacceptable restraint on the rights of residents and families to be treated with compassion and respect says the Council on the Ageing (COTA) Australia, the peak body for older Australians.
The new guidelines, approved by the National Cabinet and announced yesterday by the Prime Minister, have been welcomed by COTA as clear and sensible guidelines for care providers and families. COTA Australia is now calling on all providers to ensure they apply the guidelines in a manner that both ensures safety and is also sensible, compassionate respectful and proportionate for each resident and family.
COTA Chief Executive, Ian Yates, said the guidelines provide appropriate measures to keep vulnerable residents safe and prevent the spread of the disease. "These new guidelines on screening visitors and restricting visitor access provide clarity and consistency across residential aged care, an industry that will play a crucial role in keeping older Australians safe and containing the spread of disease."
People who have been overseas or had contact with a confirmed case of COVID-19 in the last 14 days, those with cold or flu symptoms, and those who have not been vaccinated, will not be allowed to visit. No group or schoolchildren visits are allowed. All visitors need to be screened against these criteria, and all should be required to sanitise their hands before entry, go only to their resident's room and not access common areas, keep visits brief and have only two visitors with the resident at any time. Children under 16 are in general not permitted to visit.
The guidelines allow for exceptions and flexibility on a case by case basis - for example as the Prime Minister said, for residents who are dying and in palliative care. How exceptions and flexibility are implemented is up to each provider.
"Compassion and respect on an individual basis are key to the implementation of these measures," Mr Yates said "not the cookie cutter approaches, top down edicts and lack of sensitivity and common-sense some residents and families are experiencing".
"Contact with family and loved ones is a crucial part of care for many aged care residents, such as those with dementia," said Mr Yates. "An example is the elderly wife who comes each day to sit and talk for hours with her husband with advanced dementia. If she is prevented from doing this her husband will become anxious, disoriented and have behavioural problems and the facility will have to spend more staff time with him, or he will end up being drugged."
"Today I talked to a major provider with very strict visiting rules, who would nevertheless enable this wife, while following all hygiene precautions, to continue visiting as usual in the name of both compassionate care and sensible management. But I also listened to family members of another major provider who have been banned from visiting their family member, without any notice. That's not in accordance with our Aged Care Standards that demand providers treat residents with dignity and respect and constructively engage with residents and family".
"The same compassionate provider has a tougher than government recommended restriction of one visitor at a time, but if a daughter brings her frail mother to visit the dementing father - that's two people, and its OK, because that's compassionate care."
"Yet today my staff took a call from a resident who alleges she has been punished for leaving an arbitrarily "locked down" facility to attend a grandchild's baptism and has been told she cannot attend a medical appointment with her doctor outside the facility unless she goes into isolation afterwards.
"If an aged care facility can manage the health and safety of its staff, who come and go daily and could potentially pose a significant health risk to residents, then there is no reason it can't also safely manage family visitors with strict control measures.
"So called "lockdowns" are the opposite of a sensible and compassionate response and should only be a temporary emergency response to an internal or nearby community outbreak, while longer term measures are worked out. They should never be a long-term response. As a long term approach "lockdowns" are a lazy, alarmist and counter-productive reaction, the opposite of being compassionate and caring.
"Restrictions on aged care visits during this crisis must not be a result of panicked response, or driven by provider convenience, or by concerns about profits. They must emerge from ongoing consultation with, and listening to, residents and families within the framework of the Aged Care Standards, which emphasise on an equal footing consumer dignity and respect, the dignity of risk, best practice infection control, and consumer engagement and quality of life.
I will continue consulting with the Government and the Aged Care Quality and Safety Commission as the situation develops and will advocate for a compassionate approach to visiting policies and the rigorous application of the Aged Care Standards.
"Reducing the risk of COVID-19 to older Australians in residential aged care requires aged care providers, regulators, families and the wider community to work together in a joint effort to achieve safe outcomes consistent with the dignity and respect that the Standards seek to guarantee every resident."
