May 13, 2020

Visitor code calls for compassionate approach to aged care visits during COVID-19

Aged care providers and consumer groups have agreed to an industry-wide code of conduct for visits to loved ones living in residential aged care during the COVID-19 crisis.

The code came into effect on Tuesday, 12 May, but was under consultation during the previous week. It will be reviewed three weeks after implementation, on 29 May.

The agreement represents a new phase in the debate between providers and some consumers over the best way to protect vulnerable elderly residents during the pandemic.

Some facilities that were ‘locked down’ failed to provide compassionate exceptions, raising concerns providers were going above and beyond the government’s guidelines, being “rigid and inflexible”, and causing residents and families distress.

The code, which has been put together in only a matter of weeks, will cease to apply once it has been deemed the crisis is over.

It has been developed in consultation with a range of aged care industry bodies, including seven aged care peak bodies – Aged & Community Services Australia (ACSA), Aged Care Guild, Anglicare Australia, Baptist Care Australia, Catholic Health Australia, Leading Age Services Australia (LASA), and UnitingCare Australia.

Consumer peaks were also involved in the consultation, including COTA, Carers Australia, Dementia Australia, Federation of Ethnic Communities Council of Australia (FECCA), National Seniors Australia, and Older Person Advocacy Network (OPAN).

Visits should reflect resident’s needs

Under the code, aged care providers must work with residents and visitors to find a balance between protecting residents from COVID-19 and providing them with “vital social connections and support”.

It specifies a number of ways visits can be made, for example in rooms, in common areas, or outside a window. Visits should be at least 30 minutes long and should be supplemented with additional ways to connect, such as online.

Longer visits should be permitted in certain circumstances, such as when a resident is dying and for residents who receive regular help from carers or loved ones.

“The length, frequency, and nature of the visits should reflect what is needed for the person to be supported,” the code states.

Council on the Ageing chief executive, Ian Yates, told HelloCare, the code has been strongly welcomed by all sectors of the industry although there are still some “niggling” issues.

Aged care providers have been taking a more flexible and consultative approach to visits ever since the draft code was released, Mr Yates said. 

However, Mr Yates said that in the last 36 hours he has heard from consumers that some facilities are still in total lockdown, insisting the code makes “no difference” to them. But Mr Yates said these homes are in a minority, and he suspects they are mostly smaller homes.

Consequences too serious if visitation balance isn’t right

Aged and Community Services Australia CEO Pat Sparrow told HelloCare the balance has to be right between keeping COVID-19 out of aged care facilities and keeping people connected.

“We can’t afford to be complacent about it. The consequences are too serious if we haven’t got the balance right.”

There is “support” for the code, but it’s too early to tell how successful implementation is at this stage, she said.

A lot of the measures laid down in the code were already in place, although some questions remain. The situation is still evolving, she said.

Ms Sparrow said she had just got off a call with around 60 providers who generally said the code is “positive”.

Code is the correct response 

Hall & Prior CEO, Graeme Prior, told HelloCare his organisation had begun to put changes to visiting guidelines in place before the code was introduced.

“The code validates our procedures that we already had in place,” he said. “It’s the correct policy response to the situation.”

In the first week of May, Hall & Prior introduced a range of measures to allow for increased visitation, including greater capacity for virtual visits.

Hall & Prior’s Policy and Projects Officer, Emily Preece, said the code supports their policies, and at this stage they won’t be suggesting any changes when the code is reviewed in three weeks. 

However, she said she would like clarification about the possibility for longer visits in the circumstance of end of life or for other compassionate reasons. Hall & Prior currently permits visits in these circumstances to be as long as the resident and their loved ones require.

Families understand visit restrictions

The CEO of New South Wales aged care facility, Vietnam Veterans Keith Payne VC Hostel, Justin Dover, told HelloCare the code will require a change in processes for their facility, but it won’t impose a significant administrative or cost burden. 

“We have been practising what is generally already in the code since COVID-19 outbreak,” he said.

Mr Dover said it was too soon to know if there would be “unintended consequences” from the code, but he said most families have been “completely understanding” of any changes to visits that have been put in place during the COVID-19 crisis.

“As long as we can try and be accommodating to requests where we can, response is generally positive,” he said.

He will take a “wait and see approach” to determine if he will suggest changes to the code when it is reviewed in three weeks’ time.

Provers have invested millions to comply with new code

LASA CEO, Sean Rooney, said aged care providers have invested millions of dollars in additional technology and staff to ensure they are prepared to implement the code.  

“The code provides guidance for every approved aged care provider and serves to clarify the obligations of aged care homes, their residents and visitors,” he said.

Visitor screening is “thorough”, he said, and some homes are hiring staff to help with the vetting of visitors.

“Providers have told LASA the Code is comprehensive and they welcome the opportunity to apply it in practice and give feedback over the next few weeks.

“As rates of coronavirus in the community are reducing, many aged care homes are increasing visitation, within government guidelines, while still monitoring local risks,” he said.

OPAN will establish a process to record and codify any issues that arise from the code, and those will be reviewed on 29 May.

You can read the code in full here.

 

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