An online petition has reignited the debate surrounding current COVID-19 isolation protocols for aged care residents and its ongoing impact on the elderly, especially those with dementia.
The petition was started by Clinical Psychologist, Irene Fihrer, after her own mother, Cynthia, endured several week-long isolation periods in her New South Wales aged care home due to being a close contact and later catching Rhinovirus.
With more than 8,000 signatures on change.org, Dr Fihrer said the petition has attracted a passionate group of followers.
“The feedback’s very positive. People feel strongly and there is quite a bit of anger because it’s so cruel [isolating residents],” she said.
“For people who don’t have parents or grandparents in aged care, maybe it doesn’t really affect them but now that I’m firsthand living it and none of the aged can really complain, that’s actually made me so much more of an advocate.
“Someone has to speak up because my mother wouldn’t know what to say or what’s going on.”
Cynthia’s aged care home has maintained isolation protocols for positive COVID-19 cases, close contacts and residents who are sick with cold and flu symptoms.
The NSW Health website says a resident that tests positive should stay in their rooms for at least 7 days and wear a mask for up to 10 days. If they do not test positive for COVID-19 but are symptomatic, residents should remain isolated until symptoms disappear.
Aged care homes across the country have seen a downturn in COVID-19 cases throughout February and March, and many providers have been able to relax some of their restrictions.
Due to the deadly nature of COVID-19 and seasonal influenzas, safety precautions like mandatory vaccinations and social distancing have been influential in reducing the number of COVID-19 cases and deaths within aged care.
But while there is a sense that Australia is moving away from life with COVID-19, the virus remains a threat and as winter approaches, experts also predict another strong influenza season as we saw in 2022.
Dr Fihrer does not want to see all COVID-19 protections lifted as she still supports isolation for positive cases and precautionary measures, but she said isolation and loneliness have affected Cynthia’s cognitive and physical abilities.
“Normally she’s out at activities with everyone and generally is a very positive person,” Dr Fihrer explained.
“But during and after isolation she was more depressed, so vacant and it’s well documented that depression is a common comorbidity with dementia but imagine how depressed you would feel sitting in a space for two weeks.
“She is in this little room and even when she had Rhinovirus, it was just a cold, they kept her there.
“I asked if I could take her to the balcony to get some fresh air but the nurses said no as she was on strict orders and is not allowed to leave the room.”
Cynthia now requires a wheelchair to move around after previously being able to walk assisted by a frame.
Dr Fihrer also said her mother struggles to use technology unassisted, and due to her cognitive decline, the activity packs and Zoom calls offered by her home are not beneficial.
The ability to have one visitor at a time even while isolated has been beneficial, but Cynthia still withdrew from the world without regular interactions outside of her room.
“What keeps a person with dementia tethered to life are all the regular routines, a rhythm to the day. Once that’s gone they don’t know whether it’s morning, noon or night. She relies very heavily on interaction and that keeps her tethered to the world outside.
“When she’s in the dining room and she sees other people eating, it’s a cue for her to pick up her spoon and eat. But when she’s in a room by herself, unless one of us is there to feed her, she just stares at the food.
“I can’t tease out what’s dementia and what’s confinement, but before these periods of confinement she was able to feed herself and she was much more engaged.”
When balancing an individual’s well-being against the risk of infecting a greater number of residents, a precautionary approach to COVID-19 remains important, but Dr Fihrer recommended a more flexible approach to supporting residents who have to isolate.
“It’s a balance between keeping them safe, but also keeping them psychologically safe as well, so what kind of creative solutions can we be offering?” she said.
“When the other residents are in the dining room, you could take the isolated residents one at a time to sit on the balcony to just let them sit in the sunshine or have an activity on the balcony for a few residents.
“Of course it requires manpower but just to let them see other people and do an activity or listen to music outside of their room is beneficial.”
Aged and Community Care Providers Association (ACCPA) Chief Executive Officer (CEO), Tom Symondson, told The SMH that the current approach to managing COVID-19 cases is better than the previous “one size fits all” approach of total lockdowns.
“Every State is different, and then there is the national advice, and then the provider has to make the decision based on their residents and circumstances,” he said.
“We have to balance keeping COVID-19 out of a facility with allowing people to live how they want to because it is their home.”
Dr Fihrer also acknowledged her mother’s ability to live her life to the fullest and said she does not want to see her quality of life reduced.
“I don’t want my mother to live to 100 locked in a room once a week, every month to keep her alive, that’s not quality of life,” she said.
