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COVID-19 aged care restrictions and tips for supporting older residents in isolation

Federal Government has put in place visitation restrictions into aged care facilities to protect older Australians with the clause that this could develop into facility lockdowns if the coronavirus, or COVID-19, escalates further.

Some of the restrictions appointed by the Government are a bit vague and aged care facilities are interpreting them the way they feel best suits and protects their residents. [Source: Shutterstock]
Some of the restrictions appointed by the Government are a bit vague and aged care facilities are interpreting them the way they feel best suits and protects their residents. [Source: Shutterstock]

It is leading to a lot of questions around what restrictions are and how they can affect your visitation rights to see your older loved ones, as well as how lockdowns will work if implemented in aged care facilities around Australia and the impact on the mental state of residents.

With potential lockdowns in the future, it is important that aged care homes staff and families are prepared to support their older loved ones through social isolation, loneliness and boredom.

How do aged care restrictions work and why are they important?

Some of the restrictions appointed by the Government are a bit vague and aged care facilities are interpreting them the way they feel best suits and protects their residents.

You need to check with the facility where your older relative lives to know exactly what rules or bans they have put in place. 

Some facilities are only allowing visitations between certain times, while others have gone into full lockdown.

The official Government rules are that any visitations from families or friends to facilities can only be for "short durations". This isn't incredibly specific on the duration of visits, however, some aged care facilities have implemented 15-30 minute visitation times.

These visitations need to be conducted in either the resident's room, outdoors, or in a designated area, and social distancing rules of 1.5 metres apart apply.

There is a maximum of two visitors per day for each resident. This includes the resident's practitioner, so make sure to coordinate the days you want to visit.

The above restrictions also apply to people cared for in palliative care in aged care facilities, however, Prime Minister Scott Morrison asked facilities to be compassionate in their visitation restrictions in these cases.

People who have just returned from overseas or have been in contact with a confirmed or suspected care of COVID-19 are not allowed into aged care facilities. 

Additionally, from May 1, if you have not received the 2020 influenza vaccine, you will not be able to enter an aged care facility. You will need to provide evidence of a batch code or a letter from your doctor proving you have received an influenza vaccine to enter.

Aged care facilities have been enforcing mandatory sanitisation for everyone coming through their doors and every person should be asked the basic COVID-19 questions to see if they have been at risk of exposure.

The staff have been going through the same sanitisation and questioning process. Some facilities are also checking the temperatures of staff on entering.

While the restrictions will be tough for residents and families, they are necessary to prevent or reduce the likelihood of coronavirus entering aged care facilities.

In a recent webinar from the Older Persons Advocacy Network (OPAN), Patricia Sparrow, Chief Executive Officer (CEO) of Aged and Community Services Australia (ACSA), appeared on a panel, saying, "The first priority we have is to protect the older people we have in care".

Ms Sparrow explained that aged care facilities have very good infection controls in place which are usually for flu or gastro, but these processes are quite similar for the prevention of COVID-19.

What are lockdowns and how will that affect my access to my loved ones?

If the coronavirus evolves to a point of needing lockdowns, this could impact outside relatives and friends from seeing their older loved ones in aged care face to face for a period of time.

Similar to an influenza outbreak in an aged care facility, any resident who contracts COVID-19 would either be transferred to a hospital or be placed in isolation in the facility.

Other residents would need to go in social isolation and be monitored for any further symptoms of the coronavirus

Any resident that has a respiratory illness or current comorbidity that makes them more vulnerable will be taken care of in a single room where possible.

Additionally, during an outbreak, it is unlikely for residents to be allowed to move around the facility, including to communal areas or meal areas.

Staff members will be utilising personal protective equipment (PPE) and practising high-level sanitisation procedures, like disinfecting all hard surfaces every two hours. During the current restrictions, many facilities are already utilising some of these procedures now.

Aged care facilities in lockdown may not take in any more new residents for a period of time.

Social activities have already been restricted in aged care facilities, this would be more heavily enforced during a lockdown.

For families, only essential visits would be allowed and that discretion would be up to the individual facility.

Supporting the mental health of residents during restrictions and lockdowns 

Isolation in aged care has always been an issue, but now more than ever aged care providers need to implement different projects and activities to engage their residents. Many aged care facilities are putting in extra effort to make their residents feel socialised, respected and engaged.

A widely circulated photo on social media showed an Irish aged care provider hosting a game of bingo with residents sitting in the doorway to their rooms. It highlighted the creative ways aged care providers are attempting to continue engaging their residents while imposing safe social distancing practices.

Tamar Krebs, founder and co-CEO of Group Homes, says that social distancing can be tricky to manage, but is imperative for residents safety,

"I think it is really important for families to support carers as much as possible during this time, and for carers to support families. We are all on the same team here and that is to try and keep residents healthy as possible during this really difficult time. I think that is something we can all align and commit ourselves to this, we will get through this together," says Ms Krebs.

"We have to think about it as social distancing, not self-isolation. So that puts a fair amount of responsibility on carers in the homes to make sure they are engaging residents with things that are meaningful and purposeful.

"It happens in aged care facilities or at Group Homes, just during the day doing those things that bring people purpose so they don't feel that social distancing and make sure they are following the COVID-19 rules.

"Watching a movie together or getting them moving so their moods are elevated and they are feeling positive, not feeling the pressure."

At Group Homes, they have encouraged families not to discuss the "pandemic" with their families too much because it can cause a level of anxiety and fear.

For their residents, many with dementia, they may be watching the issue on the television and forgetting later, but they still have that anxious feeling without being able to articulate what the provoking element is.

"Like we would do in any place when a person is anxious, we would validate them and help them work through the anxiety, whether that is engaging them with something calming, it could be a massage, listening to music, cooking, baking, anything that can help with the information overload," says Ms Krebs.

Tips for improving helping improve the mental health in aged care

Group Homes has been responding "responsibly" not reactively to the coronavirus epidemic. The organisation has brought in more activities in the house in preparation for a complete lockdown. 

This includes different games, activities, gardening tools, as well as preparing their medication supplies and consumables stock.

Ms Krebs says that during these restrictions, people need to be responsible and think ahead when seeing their loved ones, especially with potential lockdowns on the horizon

She recommends that families bring in photo albums or memories for their relatives to reminiscence over or look through, or bring in a much-loved book series or puzzles.

Aged care facilities will be ramping up their internal activities where possible to keep their residents engaged.

While social groups are no longer able to visit, a few aged care facilities have been receiving letters from school children addressed to residents.

Another option for relatives and friends to keep in contact with their older loved ones is to utilise technology.

Ms Krebs says most providers can help set up video links on phones or computers, additionally, sending videos with nice, heartfelt messages are great for residents because they can play the video over and over again.

Other available platforms include online social groups or clubs, similar to the Feros Care's Virtual Social Centre, which provides a much-needed connection to people who are remote, lonely or looking for entertainment. 

Ms Krebs adds that forming a connection between a resident and their loved ones is really important for boosting their moods and improving their mental health.

For more information about coronavirus, visit the Aged Care Guide's COVID-19 update page.

Do you have any questions about the coronavirus that you want answered? Tell us in the comments below or email journalist@dps.com.au.

What should aged care providers implement to help residents and families during these difficult times? Let us know in the comment box below.

Related content:

Potential lockdowns for aged care facilities at risk of coronavirus
How to self-isolate and tips to not get bored indoors
Providers to limit visitations to protect elderly from COVID-19

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