Residents became “dangerously deconditioned, malnourished or dehydrated because of isolation, loneliness and neglect” during outbreaks, a report on the review reveals.
“Many were depressed and withdrawn, [and] cognitive impairment increased.”
Dementia care posed particular challenges during outbreaks.
“In some RACFs, during lockdown, residents with dementia died alone and neglected in their rooms.
“We heard repeatedly … that staff shortages and inexperience were aggravated by lack of experienced nursing leadership,” the report noted.
The “chaotic” responses were the result of staff shortages, poor leadership, inadequate pandemic planning, and poor infection control, the review found.
The review, commissioned by the federal government, gave rise to 38 recommendations, which the government has accepted in full.
The aim was to use past experiences to build better defences against COVID-19 and to be better able to manage outbreaks if and when they do occur.
Infectious diseases expert Professor Lyn Gilbert AO and aged care consultant Adjunct Professor Alan Lilly, who together have already conducted two examinations of Australia’s most serious outbreaks, conducted this latest review.
But the authors described nine lines of defence against COVID-19, likening each layer of defence to a slice of Swiss cheese. If the ‘holes’ in the cheese don’t overlap, the virus can not seep through, but when the holes line up, the virus can spread.
The nine lines of defence against COVID-19 in aged care are:
While all lines of defence are important, the authors said leadership is the “most critical” factor and “an essential component of all other lines of defence”.
The report makes 38 recommendations, with the government accepting them in their entirety. The recommendations include:
The Minister for Health and Aged Care, Greg Hunt, said the review will help the sector, which is still navigating its way through a difficult period.
Since the start of the pandemic, the government has spent more than $2.1 billion on COVID-19 support in aged care.
Australia’s pandemic performance was relatively positive compared to other similar countries. Of the 37 Organisation of Economic Co-operation and Development (OECD) countries, Australia ranks second lowest in terms of cases per 100,000 people and third lowest in case fatality rates.
“No time for complacency”
Yet, the report warns there is more to do; the subtitle of the report is ‘no time for complacency’.
The authors noted Australia’s early “widespread complacency” about the pandemic, with the sense the nation had initially “dodged a bullet”. Many providers were content with online infection control training and happy to continue employing contract staff from agencies. Many had little PPE in stock.
Their complacency was quickly shown to be misguided.
Even today, there are still problems within the aged care sector that have not been addressed, and for which “there is no time for complacency,” the authors wrote.
And the pandemic is not over yet. Today the world passed another grim milestone: more than 5 million people have died from COVID-19.
The report says, “With many countries currently experiencing an increase in confirmed COVID-19 cases and increasing numbers of deaths, it is clear that there is no time for complacency.”
You can read the full report here: ‘Independent Review of COVID-19 Outbreaks in Australian Residential Aged Care Facilities’.