Experts warn of hidden toll on aged care residents in lockdown

Health experts and advocates have warned the effects of almost six months of preventative lockdowns in aged care may have a worse impact on elderly residents than coronavirus infections.

The claim came as 16 more Victorians in aged care homes died from coronavirus infections, and as people working in the sector warned of the dangers of using sedatives to control COVID-positive residents with dementia.

A patient leaves St Basil’s Homes for the Aged in Fawkner last month during an outbreak at the facility.Credit:Justin McManus

The Australian Physiotherapists Association, which has thousands of members working in aged care homes across the country, told the royal commission on aged care about the terrible side effects from lockdowns adopted by most centres since March to stop COVID-19 transmissions.

The lockdowns have meant residents are asked to stay in their rooms and visits from family are banned or minimised. About one-third of homes have had the withdrawal of all physiotherapy and visits by speech therapists, dieticians, occupational therapists and podiatrists.

Rik Dawson, a gerontology physiotherapist and director of the association, said this had increased residents’ social isolation and accelerated physical and cognitive decline.

And in some cases it meant life-threatening falls and other injuries in aged care had almost doubled.

"We don’t have much data on falls, but we do know that the number of hip-fracture presentations has doubled at one hospital and others are noting similar trends," he said.

He said preventative lockdowns meant many older people were confined to their rooms and wards "for weeks on end" and unable to exercise. "Without their usual support to get exercise and socialisation, the condition of older people is deteriorating."

He said the archaic way residential aged care was funded needed to be changed urgently so more specialist help could be provided to all homes.

While there have been hundreds of coronavirus deaths in aged care nationwide, flu and gastro outbreaks have plummeted due to social distancing and infection control measures implemented by homes.

New data released by the Victorian Health Department on Wednesday showed there were 137 outbreaks and 2453 coronavirus cases in aged and residential care between June 1 and August 11.

Craig Gear is chief executive of the Older Persons Advocacy Network, which works with residents in aged care and their families. He said there had been marked side effects as homes tried to protect residents from coronavirus.

"There is the physical deterioration because people are being kept in rooms, or they are not allowed to go out in their wheelchair or to walk outside as they usually would," he said.

Without families visiting care homes regularly, residents missed out on their greatest advocates, he said.

"Particularly for people with dementia or mental health issues, where the family member has been part of the care team … so often the family goes in and will then, having seen something out of the ordinary, raise issues with their carers."

Mr Gear also warned there was an issue with some homes sedating residents who had dementia and had tested positive to coronavirus.

The alarm on sedation was raised on Wednesday by Melbourne doctor Robert Hoffman, who specialises in aged care. He told 3AW’s Neil Mitchell that residents of two homes he worked at were being sedated when they would have been better off in hospital.

A letter from one home, Glenlyn Aged Care Facility in Glenroy, where most residents have underlying psychiatric conditions, said it had been told by a hospital to sedate patients rather than try to get them admitted to wards.

"The idea that we can sedate people and monitor them safely in nursing homes is wrong, it’s untrue. You need equipment and you need staff," Dr Hoffman said. "And left in aged care, sedated COVID patients are far more likely to die than in hospital."

Mr Gear said he too was concerned about "chemical restraint", because many sedatives used on residents often failed to work.

"We need to solve the workforce issues. Right now we are so short of people to work in facilities, but it can’t be that we put lives at risk by sedating residents so that they don’t wander," he said.

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