Blanket visitor bans should not be used as a method to prevent the spread of COVID-19 in aged care facilities, new research recommends.

The research published this week in the International Long-Term Care Policy Network explores the impacts of visitor restrictions during COVID-19 lockdowns internationally including in Australia, Germany, Canada, the Netherlands, the United States and the United Kingdom.

The multinational study led by University of Sydney Associate Professor in ageing and health Lee-Fay Low makes five key recommendations to ensure residents are not negatively impacted by measures  to limit the spread of COVID-19.

Visitor and caregiver bans should not be used to prevent COVID infections in aged care homes while safe on-site visiting practices based on local levels of community transmission such as outdoor visits, screens or glass, and well-ventilated areas should be used, according to the recommendations.

Lee-Fay Low

Associate Professor Low said the research found visitor restrictions and bans during COVID-19 lockdowns had negative impacts on residents.

“It’s pretty clear from the evidence that that visitor restrictions and complete visit bans have resulted in negative impacts on the mood and behaviour of residents. And we see in a few countries an increase in psychotropic medications,” Professor Low tells Australian Ageing Agenda.

“We also know from studies that families from quite a few different countries feel worse, guilty, afraid, worried and isolated from their loved ones,” Professor Low said.

She said visitor bans and restrictions have increased staff workload, stress and burnout as many family members were no longer able to provide essential support to residents, such as feeding.

The research also recommends designating family caregivers as essential partners in a resident’s care during the pandemic to allow more frequent visits if it is safe to do so.

“Instead of saying no one can come, it might allow two people who would come regularly for that person, who might be trained in PPE, they don’t live in a hotspot and they understand the safety procedures. They can still come and visit that person on a schedule,” Professor Low said.

Professor Low said Australia has been “conservative” when banning visitors in aged care facilities where there are cases in the local community.

“Australia’s definitions of outbreak could be three or five cases and they’ll close all the nursing homes in that region to visitors, which compared to any country in the world – except maybe New Zealand – is very conservative,” she said.

When there was an outbreak inside a facility, how well it is being contained needs to be considered, Dr Low said.

“If you can cohort the area where there is the outbreak, then potentially you could still have safe visiting in the other wards or wing of the facility. But it depends on how on top of managing the outbreak [the facility is] and whether the facility has the additional resources to support it,” she said.  

The recommendations also call for additional government funding to help support safe visiting practices and for regulators to ensure facilities meet residents’ rights to have visitors and provide safe visiting practices.

Balance is important

Leading Age Services Australia CEO Sean Rooney said it was important to get the balance right between a resident’s emotional and social needs and keeping people safe from COVID-19.

Sean Rooney

“The priority is managing risk in order to protect our most vulnerable and those who care for them to ensure we meet their needs and keep them safe,” Mr Rooney told AAA.

Technology has been key in ensuring residents continue to experience social connection during the pandemic and will likely remain a feature in residential aged care, he said.

Access the research Safe visiting at care homes during COVID-19: A review of international guidelines and emerging practices during the COVID-19 pandemic here.

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2 Comments

  1. Q. How many COVID-19 outbreaks in residential aged care in Australia were as a result of introduction by a visitor?
    A. None reported

  2. Damned if you do and damned if you dont. We dont know if an infected staff member didnt contract Covid from a visitor. How were facilities supposed to manage visits, the days of having only local visitors are long gone. People hop on planes and take long car trips to visit family in and out of facilities so how do facilities know if that interstate visitor has been in a covid area.
    If facilities had allowed unchanged visits and didnt go into lock down the situation could have been much worse. Facilities have done an excellent job managing covid, a shame we cant say the same about state governments that say to facilities “residents are a commonwealth problem, not welcome in state run hospitals”. NSW, VIC and ACT Governments saw best practice in QLD and SA where facilities with suspected covid were evacuated, residents tested and returned to a cleaned facility safely. NSW etc effectively killed residents by banning hospital access and insisting residents not be moved within facilities. Those facilities that had covid didnt have a chance when they were up against covid and the sate.

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