An aged care provider peak body is calling for the Federal Government to develop clear COVID-19 outbreak protocols that include the hospitalisation of infected residents.
It is important for residents who test positive with COVID-19 be transferred to hospital to prevent a major outbreak in the facility and to give people the best possible chance of survival, said ACSA CEO Patricia Sparrow.
“We want to see protocols in place that clearly outline what should happen in the case of a COVID-19 outbreak, and we believe hospitalisation should be a key part of that process,” Ms Sparrow told Australian Ageing Agenda.
“Aged care homes are not intensive care units. It’s not what we are equipped to do,” Ms Sparrow said.
If COVID-19 gets into aged care facilities, the outcome can be disastrous, she said.
Expecting aged care facilities to handle outbreaks without hospital transfers is age discrimination, Ms Sparrow said.
“Anyone else in the community is rightly automatically given the best possible care in an environment that prevents further transmission,” she said.
“We must not discriminate against older people or ration access to hospital care.”
Ms Sparrow said ACSA welcomed and valued the input of state and federal health officers and their expertise in the development of the protocols.
Monash University’s head of Health Law and Ageing research Unit Professor Joseph Ibrahim said he supports ACSA’s call for the development of outbreak protocols in aged care.
“Older people deserve the same level of care as anyone else in the community,” Professor Ibrahim told AAA.
He said he has been calling for the development of outbreak protocols in aged care for two months.
He has also discussed this in his podcast series Proj Joe Covid 19 Aged Care Podcast, which he launched in April.
Four Corners focuses on Newmarch case
ACSA made the call ahead of Monday night’s ABC’s Four Corners episode on the COVID-19 outbreak at Anglicare Sydney’s Newmarch house in western Sydney.
The outbreak resulted in 37 residents testing positive to coronavirus, 19 of whom died (read our story here).
The program highlighted that 16 per cent of residents from Newmarch House who tested positive to COVID-19 went to nearby Nepean hospital compared to the hospitalisation of 80 per cent of COVID-positive residents at BaptistCare’s Dorothy Henderson Lodge, also in Sydney.
At Newmarch, the other residents who tested positive remained in the facility to receive care through the state’s hospital in the home approach.
The program also highlighted the case of a resident whose health improved after being transferred to a hospital.
Representatives from Anglicare Sydney, the Aged Care Quality and Safety Commission and the state and federal health departments declined requests to be interviewed for the program, Four Corners said.
Professor Ibrahim said he was disappointed at the lack of explanation from government and regulators in the program.
“It was extremely disappointing that not a single authority in aged and health care were willing to explain what happened and the basis for their decisions,” said Professor Ibrahim, a practising senior specialist in geriatric medicine.
Hospital transfers are lifesaving and a human right, peaks say
Aged care peak body Leading Age Services Australia CEO Sean Rooney also called for nationally coordinated health system protocols to protect aged care residents.
“People in aged care facilities who test positive must be permitted to transfer to hospitals, where lifesaving care and infection quarantine facilities are available,” Mr Rooney said.
“In the event that a resident tests positive to COVID-19, consideration must be given to the risk of infection to other residents and staff and the option of transfer to hospital for treatment and quarantine control,” he said.
The design of aged care facilities can make quarantining difficult, Mr Rooney said.
Consumer peak body Council on the Ageing COTA Australia echoed LASA’s call to allow the residents who test positive with COVID to be transferred to hospital.
COTA chief executive Ian Yates said the fact that residents had improved clinical outcomes after being transferred to hospital from Newmarch as shown by Four Corners is troubling.
“As a matter of basic human and legal rights COTA believes that every resident of every aged care home has the right to transfer to hospital if they need it and that is their preference,” Mr Yates said.
“Older Australians have identical rights to access the same quality of healthcare as every other Australian. Unfortunately, it seems that in some cases, the highest quality healthcare through hospital in the home hasn’t occurred,” he said.
The NSW Coroner, the Commonwealth and the Royal Commission into Aged Care Quality and Safety are each undertaking independent inquiries to investigate the COVID-19 outbreak at Newmarch.
“These inquiries should include detailed investigation of the clinical care provided to residents who tested positive to the disease, whether infection control measures and other clinical treatment provided at the facility were effective, and whether more residents should have been transferred to hospital,” he said.
Mr Yates also supports additional powers for the Aged Care Quality and Safety Commission to take preventative action.
“We would welcome the ACQSC having a wider range of powers to step in sooner, rather than later, and with a much broader range of tools in its regulatory tool kit,” he said.
The Aged Care Guild also said it supports the right for seniors to access hospital care.
“Aged care is an important part of the broader health system, and senior Australians in residential aged care must be supported by state health departments and public health units to access these services when necessary,” the Aged Care Guild said in a statement.
Aged care minister says hospitalisations are case by case
Minister for Aged Care Richard Colbeck said the Commonwealth Department of Health has reached an agreement on a joint protocol with the NSW Ministry of Health to formalise coordination of government support to NSW aged care providers with their COVID-19 outbreak management.
“The primary objective [is] to make clear the roles and responsibilities of each party to optimise care for all residents in impacted residential aged care facilities, irrespective of their COVID-19 status, and to contain and control the outbreak to bring it to an end as quickly and safely as possible, Mr Colbeck told AAA.
“The government is of the view it is not appropriate to design a protocol that requires transfer of all COVID-19 positive residents to hospital,” he said.
Mr Colbeck said the appropriate response to a COVID-19 outbreak in aged care needs to be informed by the unique circumstances of the outbreak at that facility.
“A decision on whether to transfer a resident to hospital should be made on a case-by-case basis, based on the best available medical advice, balancing the needs of the facility as a whole, with consideration given to the individual resident’s wishes and in consultation with their family,” he said.
“Residents who wish to access hospital care are supported to do so in instances where there is a clinical need for hospital care.”
AAA has sought comment from the Aged Care Quality and Safety Commission.
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You would think that the various Commonwealth & State Health Departments would have learnt from Newmarch House’s disastrous experience and arranged for those aged persons in care that had been COVID-19 infected to be isolated and transferred to a hospital as soon as adverse health signs became evident. Clearly, most RACFs are not resourced to manage this type of outbreak whereas hospitals are.
I agree wholeheartedly with the call for hospitalisation of Covid 19 infected residents to the nearest hospital with the necessary resources for quality care of the resident, Once an infection is diagnosed nobody knows what the outcome will be -will it be minor or will it be a tragedy, Nobody knows how long the infection will take hold-could be days /weeks /-in the waiting around period others will be infected as it is difficult for facilities to provide hospital-type care. How many groups need to decide if the time has come to place resident in hospital? I understand that there were covid19 beds available in the Nepean hospital during the recent crisis situation-.
The main people to consider during outbreaks in residential facilities are the RESIDENTS in plural -do you consider the situation of one or the many. I am sure that residents and their families would not want to endanger the lives of others by not explaining to their person with dementia the risk of allowing the virus to spread-regardless of the resident having made an advance care directive under completely different circumstances. Not moving a person with the virus into hospital means the AGED CARE RIGHTS To QUALITY CARE of other people are being discarded