Aged care in the time of coronavirus - what should you consider?

Victoria’s embattled aged care sector is grappling with widespread infections resulting in over 100 deaths amid the coronavirus pandemic. There are lessons for desperate families when considering residential aged care for your loved ones during these trying times.

Nurse and elderly couple

Source: Getty Images/Morsa Images Source: Getty Images/Morsa Images

Highlights

  • At least 1.2 million older people live in aged care facilities across Australia.
  • In 2015,26 per cent of all home care recipients were from culturally and linguistically diverse backgrounds.
  • Families are feeling the strain of not being able to frequently visit their loved ones in nursing homes during COVID-19.  
 


 

Aged care facilities around Australia are on high alert with over a dozen Victorian nursing homes hit by coronavirus in recent weeks.

Professor Andrea Maier, an aged care specialist and director of medicine and community care at Royal Melbourne Hospital, says the closer proximity of residents in aged care facilities significantly increases the risks of SARS-CoV-2 outbreaks.

The last Census indicates that one-in-three seniors aged over 65 were born overseas.

At least 1.2 million older people accessed aged care services, 7 per cent accessed residential aged care, based on the 2017-2018 data from the Australian Institute of Health and Welfare.

Multicultural Aged Care’s CEO Rosa Colanero says residential aged care is often the last resort for families from culturally and linguistically diverse backgrounds.
Child visiting granddad
Source: Getty Images RyanJLane
The coronavirus pandemic has placed extra strain on families who feel extra guilty when they are unable to see their loved ones during lockdown.
The anxiety and stress is really quite significant.
The average waiting period for a place at an aged care facility is five months after approval by a health professional according to a recent Productivity Commission report.

Colanero recommends that families have their loved ones assessed by their GP early in case of a sudden crisis.

She says to be eligible for a government subsidy, the doctor needs to contact My Aged Care for an assessment which specifies whether the care needed is urgent. Whereas others are assessed for home care and may have access to respite.
Even before you start thinking of which residential facility, there’re all these other things that you have to be able to do when you are feeling really stressed.
Former aged care worker Michelle was in the dark as to how the system worked when her elderly parents required extra care.

She likens navigating the system of 3,000 Australian residential aged care facilities to speaking a foreign language. 

Michelle’s late father had no choice as due to his health he needed residential aged care over three years ago.

She is thankful that her mother managed to get herself into the system early by engaging a carer to help her with shopping and cleaning for some years prior to entering into residential aged care.
My mum’s Dutch and the carer that came to her house was also Dutch, so that transitioned into further care and needing more was much easier.
While Michelle is grateful that her mother’s not-for-profit residential aged care facility acted independently and swiftly ahead of government advice, it was an especially tough time as Michelle lost her father the day before the facility started restricting visitors.
It was a really difficult time, the uncertainty of what’s happening in the country but having just lost your dad and trying to stay connected with your mum was really difficult.
The grieving family found some comfort when the facility granted Michelle and her siblings compassionate visits albeit under strict restrictions.

Apart from daily phone calls, they were able to talk via video chats twice or three times a week.
That was really important to see her face and for her to see us. It wasn’t perfect but it made it so much better.
Nursing helping patient with tablet
Source: Getty Images Getty Images/Prasit
If you are considering respite or long-term care for your loved one, Professor Maier suggests considering the medical, social and cultural factors of the facility to see if they match your requirements.

With safety as the top priority, she suggests asking the following questions to different stakeholders:

  1. If there was a recent outbreak in the facility, how was that managed?
  2. Was the GP involved?
  3. How did the management react?
  4. Can you access a single room to self-isolate should an outbreak occur?
  5. Do other residents feel safe?
  6. What kinds of information has been provided to other family members in the last week regarding infection control?
Margaret’s* Sri Lankan-born mother had to move into a residential aged care facility when the family could no longer keep her safe at home due to her dementia.

From daily visits, Margaret was only allowed to visit her mother and speak to her via video chat once a week when aged care facilities started limiting visitors across the country.

It was stressful for Margaret as the only Queensland-based sibling when the others are unable to visit due to border closures.

In choosing a residential aged care facility, she warns against judging a facility by its appearance.

Margaret has noticed deteriorations in her mother’s mobility and communication since she moved into the well-presented residential aged care facility over a year ago.

She is frustrated that her mother only gets to have one shower a week due to staffing shortage.

Inadequate staffing in aged care is a serious problem felt by 89 per cent of participants in a released by the Australian Nursing and Midwifery Federation.

And Margaret is alarmed by the lack of personal protective equipment and the lacklustre infection control standards at her mother’s luxury aged care facility.
When you look at the directory of all the people that have signed in, every single person has the same temperature. Clearly, the temperature gage is not working.
حملة للتشجيع على زيارة الطبيب العام خلال جائحة كورونا
حملة للتشجيع على زيارة الطبيب العام خلال جائحة كورونا Source: Getty Images


Under normal circumstances, Professor Maier recommends visiting a facility several times to see if it seems and smells clean, if the staff are friendly amongst themselves and with visitors, to judge if it’s the right place for your loved one. 

These days, with tighter restrictions,many providers are offering virtual tours instead.

Professor Maier suggests doing your own check by looking out for certain signs.

  1. Are you able to see all the locations during the virtual tours?
  2. How do the management or the nursing staff react to your questions?
  3. Perhaps do a virtual tour on a Sunday or in the evening to ask further questions and test responses
  4. See how the staff work under stress to gage their resilience
According to Lisa Johnston, an education officer with the Seniors Rights Service, it can be a frightening time especially for seniors living with dementia in aged care homes.

The not-for-profit advocacy organisation for older people who receive Commonwealth-funded aged care services has received overwhelming calls from concerned seniors and families during COVID-19.

Johnston says the organisation is well-placed to provide three-way phone conversations with families and interpreters if needed.  

The main concerns are the language and communication barriers culturally and linguistically diverse seniors often experience in aged care facilities especially at a time with diminished visiting, less staff, and more transit staff with their faces covered.
Especially with people with dementia, having someone coming towards them with a mask on, that alone can be daunting.
Michelle says as hard as things have been for her family in the past few months, she is grateful that her mother’s small residential aged care provider employed extra staff to avoid the risks of transmission from temporary workers.

She believes good communication with a facility is a key criterion for families during a pandemic.
I felt able to call and contact the staff or the CEO or the staff members at any time and they were always quick to contact me for any opportunity that required it.
Research by the Department of Health found that in 2015, 26 per cent of all home care recipients were from culturally and linguistically diverse backgrounds.

Colanero says this indicates that multicultural families prefer keeping their elders at home with additional assistance and support.

She highlights the example of an 80-year-old woman giving a shower or a bath to an 82-year-old man, who may hurt her back helping him in and out of bed.
There can be other ways of accessing the system but also other ways of providing support.
*Not real name
Indian couple homecare - Getty
Indian couple homecare -Getty Source: Getty Images Mayur Kakade
For more information on different aged care options, ring on 1800 200 422 or visit their website.

For free and confidential legal advice, contact on 1800 424 079.

If you need language help, contact the national Translating and Interpreting Service on 131 450.

 


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7 min read
Published 5 August 2020 6:40pm
Updated 7 August 2020 11:31am
By Amy Chien-Yu Wang


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