As COVID sweeps across aged care facilities, the experiences of residents and staff can be obscured amid the focus on case numbers and deaths. Journalist Julie-Anne Davies reports on some of the stories from inside lockdown.
Julie-Anne Davies writes:
The Federal Government reports that 1,134 people have died in residential aged care homes from COVID since the pandemic began in early 2020. In the first 20 days of January 2022, 163 people have died in their nursing homes from COVID.
“Rose” lives in an aged care facility in rural NSW. Her home has been in lockdown for eleven days, as of 27 January. She wrote about her experience on a blog written by residents who live in aged care homes on Aged Care Matters, a consumer action website .
“Last night, residents were woken at midnight, by staff in full PPE, told we have a positive COVID case, needed to undergo immediate testing, people were frightened, crying, not understanding what was happening.”
“We are still confined to our rooms. A motley crew of gardeners, maintenance crew, all hands-on deck, keeping us fed + watered.
Young gardener who brought my breakfast says he’s quite enjoying the change, and it will continue for a few weeks yet. Bless him..
Nurses are run off their feet, taking care of essentials.
We had a six-day RAT on Friday, thankfully not at midnight this time..”
“Expecting another uneventful day in solitary confinement. A friend and I escorted to cafe, on premises, for coffee. Enjoyed doing crossword in SMH, sporting news. I read to vision impaired friend, then Director of Nursing came to tell us of death of another resident’s husband. His death was not unexpected but still sobering. I was permitted to individually visit friend to share commiserations…
Other residents still confined to their rooms, hopefully, restrictions will be gradually eased.”
“Still in solitary confinement. Nurse Sarah brought medication, apologised for being late, she’s filling in for RN who is off sick, told Sarah no worries, Sarah says she’s so tired, has to keep going, for all those who need her..
Sarah is one of the good ones, very conscientious, feeling so sad for her.
Received advice that we are now at day nine of our outbreak.
Isolation and no visitors rule continue.
RATs to be completed on Thursday and Friday. Depending on results, residents will be permitted to move around freely, with COVID safe practices.
Visiting will hopefully resume, subject to safeguards, on 1st February, once Public Health Unit declares outbreak is over at our facility.
We are allowed out of our rooms for short periods.”
Every Friday the Federal Government releases its national “snapshot” of COVID-19 outbreaks in Australian residential aged care facilities.
Last week’s made for sobering reading.
“As at 5:00pm 20 January 2022 there are 19,059 active cases of COVID-19 related to aged care across 1,198 residential aged care facilities,” the Department of Health reported. To put those figures in context, this represents more than 40 percent of Australia’s aged care homes.
Two weeks earlier, in the 7 January snapshot, there were 495 cases.
The January 20 “active” cases are made up of 7,861 overwhelmingly elderly people who call these facilities home. The other 11,198 positive cases are staff members, some who have been working double shifts, often seven days straight or casuals called in to back fill thousands of vacant shifts on rosters because of the crushing toll the latest wave of the pandemic is taking on the health workforce.
When Omicron emerged in Australia last November it coincided with most Australian states announcing their roadmaps out of lockdown and the relaxation of restrictions.
In the case of aged care, the sector was not ready, says Professor Kathy Eagar, Director of the Australian Health Services Research Institute (AHSRI) at the University of Wollongong.
“This no doubt reflects the lack of coordination between the Commonwealth, responsible for aged care, and states and territories, responsible for managing the pandemic on the ground,” she wrote at Pearls and Irritations, together with Anita Westera.
“While Health Minister Greg Hunt has been in the media recently stating that the vaccination booster program is ahead of schedule, it came too late for aged care homes. Residents needed to have their booster vaccinations before lockdowns and restrictions were lifted, not afterwards.”
Minister Hunt has insisted that all aged care facilities would have their boosters by the end of January.
However, the head of not-for-profit peak body Aged and Community Services Australia, Paul Sadler, told Croakey, “we’ll probably be well over 90 percent complete by next Monday, but I don’t think it’ll be 100 per cent complete.”
“Joan” lives in a Melbourne aged care home, and has been in lockdown for most of January and isolating in her room for much of it. She has also recorded her experiences.
“Yes, it feels like we are in jail except that prisoner in jail get visitors. Our ‘warders’ are the only people we see. The meals are mainly cold by the time you get them as we are not allowed out of our rooms to go to the dining room. The carers/warders are very good but because of staff shortages there is only so much they can do. What a waste of our lives. It’s not living – it’s loneliness and very boring.”
“I’m 84 and I live in what I believe to be one of the better nursing homes. Under normal circumstances I would not complain about things, only the food which I have continually complained about, but nothing changes there.
However, with lockdown seeming to be becoming the norm. I can’t say I’m very happy. I certainly have no complaints about the carers here. They do their best but as there are not sufficient numbers and they have to follow rules it’s difficult for them.
We have been in lockdown for most of January and it looks like it is going to continue as another round of isolation has just started. We are told nothing officially and mostly find out information through overhearing or a slip of the tongue.”
“The fact that we have no air conditioning in our rooms doesn’t help. The poor carers must feel like they are living in a sauna with all the plastic garb they have to wear in this hot weather. It is having a very bad effect on some of our more vulnerable residents as well.
There is not much to do when confined to a small room day after day with no one to speak to.
Yesterday I was very disturbed and upset to hear one of my neighbours crying outside my door. She was so upset. She is a lovely little lady with dementia, and she likes to wander. She escaped from her room and was trying to open a door leading into the dining room but one of the carers saw her and was trying to get her back into her room, she was determined not to go and was putting up a fight. I heard her shout ‘No’ and then she started crying her heart out.
She wanted to see her daughter who usually comes in quite regularly. After lots of wailing and shouting and with the help of another carer they managed to calm her down and get her into her room, but it was quite upsetting.
The girls were very patient and kind to her. She just doesn’t understand…
Although aged care providers claim lockdowns are done to “save lives”, what type of life is it when you are unable to be with the people you love?”
Dr Sarah Russell is a public health researcher and Director of Aged Care Matters (pictured with her mother Joan, who died after a fall in an aged care facility).
She believes lockdowns are a blunt instrument that aged care providers have been able to use with impunity until recently with little scrutiny.
“They have been able to shut the doors and turn visitors away leaving the residents locked up and families more worried their loved ones will die of neglect than COVID,” Russell said.
She has been tracking the weekly Commonwealth Health Department report since last September and found that in the last fortnight 703 homes recorded new outbreaks and 105 had a surge in numbers while 71 had no change.
“My conclusion is we need to know what factors contribute to some homes containing the virus while other homes have had a huge spike?”
“Is this due to: Boosters? Infection control? Access to PPE? Staffing levels/training? Ventilation? We need answers but history keeps repeating itself in aged care.”
Aged care nurses and personal care assistants are burnt out, exhausted, sick and planning their exit strategy. During the pandemic, they’ve been working on average for $22 an hour often for seven or eight days straight with no breaks and feeling that residents’ care is being compromised and copping abuse from distraught family members, upset they have been prevented from seeing their loved ones.
Staff speak out
The Australian Nursing and Midwifery Federation (ANMF) is due to release on 27 January a national workforce survey of members employed in aged care, showing:
- 36 percent of survey participants working in aged care said they are planning to leave their current position in the next one to five years.
- An additional 19 percent said they are planning to leave their job in next 12 months.
- 15 percent of survey participants said they are planning to leave their profession to work in another field. An additional 30 percent were undecided and eight percent planned on retiring.
“One of the comments that just leapt out at me was one nurse who said, ‘I’m ready to throw it all in and walk puppies for a living’,” the ANMF Acting Federal Secretary, Lori-Anne Sharp, told Croakey.
“At a meeting last week with Ministers Hunt and [Agec Care Minister Richard] Colbeck I communicated to them that we were seeing an increase in urinary tract infections in residents because of dehydration. This is extremely serious; this can cause a preventable death.
“This is happening because there is not enough staff to manage. Our ANMF members are reporting only three staff for up to 120 residents in some cases. This is seriously unsafe and entirely unacceptable.”
Quotes from the survey
“I have had to work several night shifts with only two care workers and one RN to over 100 residents. During a recent red zone lockdown, I had to care for over 60 residents by myself during two night shifts. I was exhausted and only paid $23.35 per hour. I’m very saddened that night shifts are taking on the heaviest loads having to do laundry and kitchen work and their usual work during a 10pm to 6 am shift.”
“I work in an aged care facility with a COVID-19 outbreak. It has been worrying at times with PPE shortages, RAT test shortages, but most of all staff shortages. Overwhelmed at times and exhausted with extra work and not enough time to do my role properly.“
“We have COVID-19 at work in our wing. The staff workload has increased 100 percent. We have no extra staff, and each shift is always short staffed. We are starting to breakdown at work and at home. Pure physical and emotional exhaustion.”
“We are short staffed, and employer is not responding to calls for aid and relying on staff doing double shifts and over hours.”
The Government responses to last year’s Aged Care Royal Commission’s recommendations have only begun to scratch the surface of longstanding problems in the aged care sector, according to Professor Lyn Gilbert, Senior Researcher at the Sydney Institute for Infectious Disease, University of Sydney.
“Measures introduced to protect the community from Omicron have been widely criticised as too little, too late and easing of restrictions too premature,” she wrote in The Conversation this week.
Aged-care residents and other vulnerable groups have been disproportionately affected by the massive surge in community transmission. They will be again, in future waves, unless their needs are considered through more nuanced, proactive strategies than either “let it rip” or lockout/lockdown, said Gilbert.
Dani is the eldest grandchild of 95-year-old Mavis, who has lived in an aged care home in NSW for five years. Mavis has been in lockdown since before Christmas and has COVID.
Dani tweeted last weekend that her “relative” had been confined to her room in aged care for more than a month and had now tested positive. She agreed to be interviewed when Croakey contacted her for this story.
“I’m the closest to Mavis – her eldest grandchild – and I have found it very very difficult,” she said.
“Early on during one of the first lockdowns my grandmother fell and fractured her femur. She hasn’t walked again. We also became aware of chronic dehydration and lack of oral care, so it has been a big worry because a lot of knowing an elderly person on aged care is ok is actually spending time with them and sighting them. In a year she lost 20 kilograms.
“They are short staffed ordinarily, and it can be very hard to get through on the phone. Not to mention her fluctuating mental state – she becomes confused.”
Dani told Croakey that Mavis’s wing has been in lockdown since the week before Christmas and relatives were advised via letter of one positive case. The home was designated code red and visiting was banned effective immediately, and the facility was meeting with the public health unit.
“They have previously been referred to the health department for serious failures of care, within the last five years. I am very worried given that if my grandmother has contracted COVID-19 that she won’t be adequately hydrated,” Dani said.
Croakey received this message from Dani not long after: “Just this morning we were advised Mavis has tested positive to COVID.
“I think my grandmother deserves better on her very old age. She just wants to see her family – she’s caught COVID anyway. On Anzac Day we treasure our oldies and relay our appreciation of the sacrifice our diggers made. Many remaining will be locked in care facilities in sure. My grandmother’s husband fought in WW2 and died aged 67. He has been gone a long time. She had a very lonely childhood and it’s sad she’s alone now. I just hope she doesn’t get worse with her symptoms, and I get to see her soon. There doesn’t seem to be any plan or commitment to getting relatives in there.”
A few days later, I check in with Dani to see how she is.
“I’m ok thanks but for someone who can be a bit anxious, it’s nerve wracking and my health isn’t great, and it feels honestly that there is no light at the end of the tunnel for age care visiting. We got another letter saying there has been more cases and they remain closed.”
In South Australia
Sharon’s father is recovering from COVID in a nursing home in South Australia. She spoke to Croakey over emails about her dad’s situation because she was angry about the way the Federal Department had managed the booster program
“Dad is improving, just fatigued now. If he tests negative on Sunday, he’ll be free to leave his room again,” she said.
“Not sure total cases, but I was told last week that three out of the five units had positive cases, and at the time of Dad’s positive result, he was the fifth one in his unit.
“After my query on when the booster vax was coming in December, [it was due in November after their 2nd dose in May], manager rang me for a chat, saying it was impossible to get info from the Federal Department of Health, they had no info on a schedule of which facilities were due boosters, no plan to roll out boosters. Manager went on to say that they might even be told that Dept Health were sending a team on just hours or a day’s notice. Apparently, the Federal Department of Health had no list or schedule with dates or facilities yet to receive boosters.
“A couple of days into this current outbreak, Dept Health finally provided with a date: Jan 27th. (Although there’s now a question over whether my dad and other positive cases can have their booster so soon after having COVID).”
Sharon said that her personal take is that the Federal Health Department panicked over outbreaks happening in facilities with overdue boosters and gave them a date.
“Re staffing, Dad said staff are in and out as quickly as possible, as they’re having to don and doff full fresh PPE after entering each positive case room, which is of course extra workload,” Sharon wrote.
“Dad mentioned his favourite carer was on her eighth or ninth day straight the other day, as they were too short staffed to take regular days off.
“One thing I’d like to stress is: the staff have been fantastic. Even before Dad tested positive, I was getting calls and updates from staff on the outbreak. Since Dad tested positive, I’m getting daily calls from a nurse about Dad’s temp and oximeter readings, etc.
“Communication has always been great. Their COVID outbreak in 2020, I was getting daily updates from staff. Dad said the occasional meal has been delivered a bit late, and staff aren’t stopping for much of a chat, but he understands it’s because they’re so busy.
“From this experience, the issue is fairly and squarely in the Federal Department of Health disorganisation over the booster rollout to aged care. I’m staggered that the Department didn’t even have a basic list of facilities and dates that they could provide to aged care providers. Just seems unbelievable, but that’s the case.”
A few days later Sharon contacted Croakey to report: “Dad is improving, just very tired still but all other symptoms now gone. He tested negative on a RAT on Monday, so is now allowed to leave his room.”
While Sharon’s father is on the mend, the problems for the aged care sector are far from fixed. With a federal election due by May, voters may also be wanting answers as the casualty rate ripples throughout the Australian community.
The Guardian: ‘Covid has spread like wildfire’: 703 aged care homes across Australia battle fresh outbreaks
Sydney Morning Herald: Outbreaks exceed 170 cases in four Sydney aged care homes
Croakey thanks donors to our public interest journalism fund for supporting this article.
See Croakey’s archive of stories on aged care.
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