Australian aged care providers have been nothing short of admirable throughout the COVID-19 pandemic.
Disastrous outcomes in nursing homes across the U.S, U.K, and Spain are a clear indication that Australia’s current guidelines for limiting visitor access are working, and many providers deserve praise for their proactive approach to protecting their residents.
The reality for many aged care providers is that limitations on visits are an ongoing point of conflict between themselves and their residents’ families.
Prime Minister Scott Morrison’s recent claims that he was ‘very concerned’ that aged care providers may be “overstepping recommended visitation guidelines” have added fuel to an already volatile situation, however well-meaning it may have been.
The fact that the PM utilised the public spotlight to place even more pressure on providers who are under resourced yet still minimising the spread across Australia, has left many industry figures shaking their heads.
After more than 35 years of clinical and executive management experience in the aged care industry, Envigor Home Care, CEO, Nick Loudon, has unique knowledge of both the Australian aged care sector and government processes.
And he took the time to share his thoughts and the collective thoughts of many aged care providers with HelloCare.
Although many would assume that the success regarding COVID-19 would stem from a close relationship and ongoing consultation between government and aged care industry professionals, unfortunately, this is not the case.
According to Mr. Loudon, most people would be more astounded by the things that don’t actually happen rather than what does.
“There is no mechanism at a state level for there to be any sort of interaction whatsoever between the aged care industry and the acute health sector. There is no consultation at that level.”
“The advisory group that is advising the Chief Health Officer and the Government are all of the other Chief Health Officers from all of the states. There is no person there who represents aged care.”
“This is essentially a group of bureaucratic doctors, and although some of them have sound experience, none of them have any experience in aged care whatsoever and there is not even a geriatrician on there.”
“A number of us have approached state health ministers with the view of setting up regular round tables with the acute care, primary care, and aged care sector, but that has not been forthcoming. They are not interested.”
“There is an absolute arrogance in the acute care setting and health departments, at state levels in particular, that think that they know every damn thing that there is to know.”
“Then they try and tell aged care providers how to run their homes when they themselves have no idea and no experience in it.”
No-one is perfect and leaders don’t always get things right.
Scott Morrison’s performance over the last two months has exemplified many of the leadership qualities that were heavily scrutinised throughout the Australian bushfire crisis.
Although his recent comments may have merely been an attempt to reassure the masses that older people were not being completely disconnected from their families, suggestions of an industry over-reaction to current guidelines appear to be divided.
According to Mr. Loudon, most providers have been working closely with residents and their families to implement arrangements that work for all parties involved while keeping residents safe.
“There might be instances where providers are concerned about local incidents of coronavirus in their particular area that may require more stringent visitation access for a period of time, but that just makes sense,” said Mr. Loudon.
“Providers still have to adhere to the guidelines, but the guidelines haven’t changed, the only thing that has really happened is that the government has run to the media acting as though something has changed.”
“They throw out statements like ‘older people shouldn’t be kept from their families,’ but these same people put out guidelines that say we need to ensure the welfare of older people – well, to be able to do that, we need restrictions.”
“Coming out with inflammatory statements that totally contradict the guidelines on their own website only adds to putting providers at odds with the relatives of residents.”
“These people will now be saying ‘well, the prime minister said that I can come in,’ and that has some very real ramifications.”
Although current guidelines are clearly working, closer inspection of visitation restrictions seems confusing at best.
While there is a total ban on children, visits have only been limited to two people per resident, at one-time per-day.
To put that into perspective, that actually means that a facility with 120 beds could potentially have 240 people coming into that facility which would appear to be a complete contradiction to mass-gathering guidelines.
“How could anyone think that doing this safely would not require additional resources?” said Mr. Loudon.
“Managing the comings-and-goings of these people and then checking their influenza status, checking temperatures, and having them complete questionnaires – that’s a two or three-person job by itself.”
When you consider the high regard that hospitals and their staff are held in, it’s hard not to understand why so many in the aged care industry are growing tired of the negativity and continual lack of consideration.
After 18 solid months of being dragged across the coals throughout the ongoing Royal Commission, Tuesday’s press conference would have been the perfect opportunity for the aged care industry to take a bow and receive some well deserved praise.
Instead, Scott Morrison utilised the opportunity to question the work being done by aged care providers, in a move that he may look back upon as a misstep.
“We get under-resourced because we don’t have a voice and then we get called whinges because we are always calling out for more money,” said Mr. Loudon.
“You can’t have quality unless you pay for it, you can only pay for what you can pay for.”
“There is no doubt that the Royal Commission will uncover some unsavoury things and we are disgusted by it. As an industry, it is not reflective of the overwhelming majority of providers and the people who work in them.”
“It is really easy for the media and people in the government to throw out the term ‘providers’ because it makes it sound as if there are no people involved in this. It makes it sound as if they are cold, unnuanced organisations that robotically make decisions about other people’s lives.”
“These organisations are run by people. Good people. People who give a shit about older people and care more about them than anyone else in society does.”
“They didn’t sit around waiting for the government to make a decision, they took things into their own hands to protect their residents so they didn’t end up like the poor people over in the U.S, U.K, and Spain.”
“Older people in these countries are dying like flies because their governments, like ours, are neglecting them as well.”
The views represented in this article are those of Nick Loudon. They do not necessarily reflect the views of HelloCare, yet we believe all opinions are important as they often represent the views of those with a softer yet important voice.
Photo Credit – iStock – sfmorris
Thankyou. Logic and common sense – explained so clearly and well.
As a provider of Aged Care, we adhere to that motto, “because we give a shit!”. Well said. A well argued story that I agree with 100%. Give us a thank you and a pat on the back not a slap across the face!
These comments make sense, and I understand why many good Aged Care Providers might feel offended that their great work seems to be undervalued
Unfortunately, the evidence before the Royal Commission clearly shows that some Aged Care Providers cannot be trusted to look after residents properly.
For example; there are some residents who only get to eat a meal properly when family members are there to feed them. I can remember the frustration of my wife when she would visit her mother [functionally blind] to find that her meal was left on a serving table over the bed where her mother could not see it to eat. That is not an isolated incident. As families and carers we could fill another Royal Commission with examples.
Total transparency of everything including ownership, taxation, subsidies, costs, profit, care standards and staffing will be needed before a lot of people can trust that Aged Care has much “care” in it.
My own experience of 5 family members in care across two States and numerous Aged Care Providers tells me that neglect and incompetence are almost as dangerous as COVID-19. The frightening thing is that neglect and incompetence will be around a lot longer than COVID-19.
The caring and competent Aged Care staff and Providers do deserve recognition for the great work they do.
I sincerely hope your Senior Management takes the time to reassure you that your residents, families and carers know who you are and are thankful for your untiring commitment under these very difficult circumstances..
The aged care sector deserves praise and applause for the work it has been doing int eh COVID crisis – total agree with the sentiment in the article ‘“These organisations are run by people. Good people. People who give a shit about older people and care more about them than anyone else in society does.”
Well written succinct article – could not agree with him more.
What a revealing article when we look at the industry’s record and Loudon’s concern about the disconnect between health and aged care. I seem to recall his assertive argument that “Age is not a Disease – Aged Care does NOT belong in the Healthcare Domain”. One wonders whose fault this really was.
I was fascinated that the industry performed so well in containing COVID-19. But weren’t the vast majority of Australian infections acquired from international cases so readily identified and contained. There was a much smaller community source than in other countries. Compare this with Sweden where there was little social isolation and as a consequence extensive transmission through the healthy community. This came at an enormous cost in their aged care facilities who paid for the economic benefits with their lives.
Isn’t it a bit much to neutralise industry’s failings by claiming Australia’s success for industry rather than just a lucky escape because citizens did the right thing.
We now know that in the USA where staffing recommendations are based on careful studies done over many years and not by an accounting firm advising industry, residents get double as much nursing care from trained nurses and a third more care overall than in Australia.
In an attempt to help US families choose wisely staffing was divided into 5 groups based on numbers and skills. The bottom group was described as dangerously low – not enough for basic care. Many failures would be expected. Over half of Australia’s nursing homes fall into this category. A report prepared for the Royal Commission by the Univ. of Wollongong confirms this very poor staffing. Do we really have the staffing levels and skills needed to perform so well or did the sector have a lucky escape? Do the aged need to thank citizens instead?
The Royal Commission has shown that the many who were ridiculed for claiming the system was failing in the past were correct. It has confirmed the findings of Four Corners and identified further problems.
The industry has not got the message that the informed community no longer trust either the industry or the government whose free market policies and regulatory inertia allowed this to happen. They have been deceiving us for over 20 years. Those years are over.
As communities and as responsible citizens we are each of us responsible for our fellows. Aged Care is a social service provided to frail community members on behalf of each community. Any market entity providing care is doing it on our behalf and is our agent. It is our taxes that are paying for it. The free market has kept us in the dark and then taken our right to work with and hold our agent to account away from us.
As communities we need to be directly involved so that we know how our money is spent and how facilities are staffed. We need to have our more skilled members working with staff and management so that we know what sort of care is provided. We need to engage with and cooperate with local managers in addressing issues and planning. We will be grateful and reward those we find we can trust and reject those who are untrustworthy. That is how markets in vulnerable sectors are made to work – the real hidden hand.