Care can't wait
This first appeared in the Herald Sun
My heart goes out to all Victorians in residential aged care facilities, their families and friends, during this crisis.
As a son with an elderly mother in aged care, I understand the heartache, confusion, fear, and concern that so many in the community are going through, and offer the AMA’s condolences to all those who have lost a loved one.
But the aged care system in Australia was in crisis long before COVID-19.
What we are seeing today is the result of a perfect storm.
Our population is ageing and there are long waiting lists for home care packages. In a single year, 16,000 Australians died while waiting for a home care package.
People are entering residential aged care older and more frail, clinical care in homes is limited, and we have inadequate regulation to mandate adequate staffing numbers.
The Royal Commission’s Interim Report last October laid out in more than 700 pages how the system is failing our older and most vulnerable people. And yet, nothing was done.
Last September, I stood beside my colleague, Annie Butler from the Australian Nursing and Midwifery Federation, and called on the Government not to wait for the Royal Commission’s final recommendations to act.
We called our campaign #CareCan’tWait. But it is still waiting.
We called for minimum staff-to-resident ratios, along with registered nurse availability 24/7.
We called for increased funding to enable greater availability of home care packages, especially Level 4 packages, to keep older Australians in their communities for longer.
And we called for improved funding for GP services in aged care homes.
Our calls fell on deaf ears.
By the time the first COVID-19 cases were confirmed in Australia, we already knew from overseas experience that older people are the most vulnerable to the virus.
That should have been the red flag to ensure that our aged care homes were ready.
With inadequate numbers and training of staff in aged care, it is no surprise how quickly the virus has spread. The 2017 Pollaers Workforce report said we had a serious workforce and training problem that was only going to get worse because of the increasing demographics of residents.
An ANMF survey showed that fewer than 40 per cent of staff thought their workplace was prepared for a COVID-19 outbreak. Some aged care homes cut staff numbers even further during the pandemic, or did not increase staffing numbers in anticipation for the pandemic.
Inconsistent messaging and guidelines across the jurisdictions were causing confusion. Clearly, communication and appropriate direction from the Aged Care Quality and Safety Commission (ACQSC) was failing.
While the situation in Victoria is dire, if we act urgently we still have the chance to keep residents safe and well, and ensure that what is happening in Victoria now does not happen elsewhere.
There has been much talk this week of the blame game - of which level of government was slow to act, who didn’t ask for help, and who didn’t insist on helping.
Now is not the time for blame. It is a time for all of us to act together.
We are talking about our most elderly, vulnerable Australians who are living in a system that has been under duress for decades.
Whether we are a Premier, a Prime Minister, a doctor, a nurse, we are all on the front line. We are all trying to do the best, and now is not the time to let emotions fly at the expense of action.
We cannot work in silos. All sections of government, aged care providers, and the healthcare system must work together to improve quality of care, transparency and accountability.
The establishment of the Victorian Aged Care Response Centre is a step in the right direction.
Right now, aged care homes need more staff, especially registered nurses. This cannot be stressed enough.
They will need assistance to prevent further cases of infection entering and spreading inside homes. They need help with testing, backed with timely tracing.
We need to know how many staff members work in multiple aged care homes nationally. Studies from other countries have shown that adequate staffing and limiting the movement of workers between multiple sites are key in preventing the spread of COVID-19 in aged care homes.
All aged care staff must have complete sets of Personal Protective Equipment, not just masks, to prevent transmission of the virus, and they must be trained and regularly practise in how and when to use PPE.
All aged care staff in all States and Territories that have not eliminated the virus should ensure, at the very minimum, that they wear masks while working. Even if there is no outbreak in their workplace.
The Government must ensure that hospital outreach teams can go into the community, and particularly aged care homes, to ensure adequate clinical care is provided.
Local hospitals need to develop strong and robust levels of communication and awareness of their catchment facilities, including the local GPs who serve those facilities.
We need a stronger role and a stronger voice from the ACQSC. It must be proactive by doing more to ensure the COVID-19 guidelines are being met in each and every aged care home.
Finally, the Government should urgently implement systemic improvements in the sector already identified by the Royal Commission to prevent further COVID-19 outbreaks.
Australia’s older people should not be an afterthought in the COVID-19 pandemic strategy. They deserve action, not inaction. Their care cannot wait. Now more than ever.
Published: 31 Jul 2020