May 05, 2020

Who is listening to residents in the aged care visitation debate?

As the government and aged providers grapple over the way forward on visitor access in aged care homes, we’ve heard from families but have we really heard from the voice of residents?

Over the past three weeks, we have conducted public polls and private surveys with over 5,000 aged care residents, relatives, frontline workers and aged care providers.

Results from these surveys initiated by CarePage have shown that the majority of family members and residents are supportive of the measures put in place by homes to minimise the risk of infection.

We recognise this is a small snapshot of residents and of a moment in time. But what is important here is that homes are taking the initiative to actually ask residents their opinion rather than be led by anecdotal evidence, which historically is how decisions have been made.

It’s a complex issue and families have good reason to feel anxiety and stress to not see their loved ones, especially for those residents living with cognitive impairment.

So, it is not surprising that while the majority of family members support the home’s response, they do have some concerns about their relatives.

Feedback across our surveys also highlighted a number of theses concerns and areas for improvement, ranging from concerns about ‘loneliness’ and ‘residents not having enough activities’, to concerns for their loved one living with dementia, concerns of families who normally visit daily to help with care needs, through to the opposite end with some families concerned about the homes opening the doors to the aged care home too soon.

Visitor restrictions in aged care homes across the country have proven to be a divided debate, with providers and the government initially clashing over the best way to protect the elderly.

Like anything though, it’s often those with the loudest voice that often trigger a response. And too often we see decisions to adopt changes impacting the elderly without adequate consultation. 

While aged care providers have vast experience dealing with outbreaks of infectious disease, this has never been on a community-wide scale like COVID-19; strategy and stakeholder management for infection prevention and control is extremely challenging in these circumstances.

As the situation continues to evolve, and as time passes and residents and relatives continue to have limited interaction the mood and wellbeing of both residents and relatives will change.

By gathering regular feedback from residents, relatives and employees aged care providers can be responsive to the changing sentiment and wellness in the home, and ensure the measures they have in place are best suited to the needs of their community at that time.

As the debate continues regarding the next stage of aged care’s response to COVID-19, what is evident from our insights is that there needs to be broader consultation with residents,  relatives and frontline workers.

During these times, giving the elderly a voice and using feedback data to make informed decisions has never been more important.

Image source –  istock licence – the image does not depict real people.

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  1. We surveyed our residents, well, the ones who are cognizant anyway, & they ALL said they would rather stay in lock down until it is completely safe & they trust the care manager to make the right decision. The response from families has been the same; only two families wanted to lift visiting restrictions immediately but were understanding of our decision not to. I do not understand why the government is so hell bent on exposing some of the most vulnerable people in society by opening up prematurely.

    1. I’m with you Skye. Further, who will be “blamed” [because that’s what it becomes rapidly by media; politicians and social network commentators alike as we’ve seen with Newmarch]? The PM will duck for his usual teflon cover and spin the infections as the provider not doing anything / enough. The responsibility for creating a safe workplace is a legal one and not just under the aged care act. I have heard nothing from Government around removing such responsibility from providers.

  2. While I agree residents should have a voice they are not experts. We did not listen to teachers when they were told schools would remain open and we know children are super-carriers of the virus. We did not listen to workers or employees when businesses were shut down. We did not listen to the general population when we went into lock-down phase three.
    No instead in every instance we listened to the infectious disease experts and as much as residents in aged care face loneliness and other issues, we have to listen to the experts.
    Both my parents are in aged care but I say to those baying for visitation rights, if you bring the virus into the home and infect just one resident, one aged care worker or, God forbid, your own family member then what? Where do you stand on visitation rights then and what do you say to your loved one or the families of those who lose a loved one to the virus?

    1. Thanks Craig. I agree with your points almost 100%. My only difference is that the “experts” do not include a single Geriatrician or aged care clinician. Aged care and hospitals operate in entirely different environs and frameworks. I would have more faith in the “experts” if they included aged care experience but fundamentally I am in complete support fo your views. Cheers! Glenn

  3. exactly right who is listening to the residents whether they be for or against visitors. it is there choice. what happened to residents rights and person centered care.

    facilities should have in place systems to check ALL staff and visitors, no one should be allowed enter if they have any flu like symptoms.

    where are all the groups advocating for elders rights.

    there should NEVER ever be lockdowns in aged care Facilities, the elders who live in these facilities are treated like prisoners. shame on you Australia.

    1. I’m sorry Elizabeth but lockdowns are what keeps the safety and wellbeing of residents front and centre. It is the ultimate in person-centred care. The elders have freedom of movement and activities continue – they are not locked in their rooms as has been claimed by ill-informed media and politicians. As we have seen already in the case of Newmarch, people who are entirely asymptomatic can carry the virus. Many facilities have been taking temperatures and surveys on entry and abused by family members in the process. The fundamental truth is who carries the “blame” when an elder gets sick and passes? It’s not the politician; family member; media or social media commentator.

  4. Whilst I agree we certainly need to keep our loved ones safe, I am finding it quite distressing that we are unable to have personal contact with them. It has been particularly difficult for us because we had to drop my husbands Mum virtually at the door of her new residential village on 6th April, and although we have not been able to go in to see her, we have actually managed to see and talk to her from a distance on the times we have taken belongings out to her. Mother is also finding it extremely confusing just having been diagnosed with dementia.

  5. Thanks for a good article Lauren – but!

    If we had a system where community had not been pushed aside and medical support/clinical skills downgraded by claiming that ‘age is not a disease’ then we might have had community groups and support teams from the nearest hospital visiting regularly to maintain and build capacity and skills. They would have been talking to providers and each other regularly. They would know what was happening and be part of the decision making process. Community needs to have a sense of ownership and control of the system that is providing care to their spouses and parents if they are to be confident in it. They would be participants in making decisions.

    A model of care that instead is managing the sale of commodified products to an anxious community in order to benefit shareholders is not well suited to the sector.

    What our own and international data shows is that it is the incidence of cases in the community that determines how many facilities get infected. None of these countries have had the sort of skills needed or the resources (testing kits etc.) needed to control it once it gets into nursing homes. We have fewer and less skills than most.

    We need to learn from the experience and do something about it. We do not see much sign of that.

  6. I have heard experts saying all covid +ve residents in aged care facilities should be shipped off to hospital because infection control is better in a hospital!!!

    This is absolutely false.

    We must do what the resident wants when they are sick. Many, if not all, want to stay in their ‘home’ and not go to hospital.

    Once in a busy emergency department they are likely to infect staff and other patients in the vicinity and they may pick up infections from other patients. They are at risk of contracting infections from dirty blood pressure cuffs and tourniquets that are re-used thousands of times without being washed.

    There’s a good chance they will get sicker and confused. If confused they may go tumbling over the bedrails looking for a toilet or wanting to ‘go home.’ They are likely to sustain shocking head injuries or fractures and die.

    I’m an aged care, wound care, Registered Nurse. I have been in about 200 facilities since 1997 to see residents with wounds and advise on clinical care and infection control.

    Please do not take them to hospital.

  7. Is there another way to care for covid +ve residents in aged care facilities rather than shipping them off to hospital because infection control is thought (inaccurately) to be better in a hospital!!!

    I think more registered nurses (RNs) could be employed in aged care facilities, helping with sick, frail aged, residents to keep them out of hospitals. Some of the things RNs can do easily e.g. inserting indwelling catheters and cannulae, giving intravenous fluids, applying pulse oximeters then oxygen masks or nasal prongs if necessary, helping aged care staff, liaising with GPs and relatives.

    All these things can be done in the residential aged care facility.

    Please don’t send them to hospital.

  8. I am a retired Registered Nurse, /Clinical manager /Facility Manager and whilst I understand people are wanting to visit families, it needs to be in a controlled way so that infection is not taken to those who are most at risk
    .People say there should be more Registered staff ,however care staff ratios should be monitored to ensure adequate skilled carers are available

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