Elderly in lockdown: the backlash

Complaints about nursing homes surged to ‘unprecedented’ volumes in the past three months.

Maria Sampey is only allowed to visit her mother, Vittoria, 98, twice a week in her in her aged-care facility. Picture: Aaron Francis

Complaints about nursing homes surged to “unprecedented” levels in the past three months, propelled by families upset about being ­denied access to loved ones during the COVID outbreak, the nation’s aged-care regulator says.

And the leading advocacy group for older people, the Council on the Ageing, has ramped up pressure on nursing homes that continue to flout a national industry code on visits, prioritising face-to-face time between residents and loved ones, saying it will start to name and shame them.

Aged Care Quality and Safety Commissioner Janet Anderson said there was a 16 per cent spike in nursing home complaints year-on-year across March, April and May. “We have experienced an unprecedented volume of complaints overall,” Ms Anderson told The Weekend Australian. “And of the key themes coming through, No 1 by a long margin was the (COVID) visitor restrictions.

“As an example, an individual, often a spouse, might have visited their loved one in a home every day for years, and that was no longer available to them and the level of distress was palpable.’’

Ms Anderson said since the code was introduced on May 11 complaint numbers had been falling, but some aged-care providers continued to be stricter on visitor access than the code provided for.

“The disposition is more risk-averse than the general setting of the code and that is something that I will need to engage with,” she said.

“If (providers) cannot demonstrate a reasonable understanding of the code, an engagement with its provisions and a justification for the settings they have adopted, then I can consider taking further action and that is generally understood in the sector.” The balance between protecting the physical health and the mental wellbeing of highly vulnerable nursing home residents has been a policy conundrum during the course of the pandemic.

As cases mounted, some facil­ities opted to keep visitors out in all but exceptional circumstances, ­offering alternative communications such as Skype or access only through a closed window, even after the national cabinet recommended that residents be entitled to see up to two visitors a day.

In late April, Scott Morrison threatened to step in and require facilities to seek an exemption should they wish to have different arrangements, before the industry visitation code, instigated by COTA, was quickly agreed halfway through last month. “Having people stuck in their rooms, not being able to be visited by their loved ones and carers and other support people, that's not OK,” the Prime Minister said.

On the other side of the argument, aged-care providers were looking to the northern hemisphere, where in some countries half of all coronavirus deaths were occurring in aged-care homes. Closer to home, there were outbreaks such as in Newmarch House, where 17 residents died from the disease.

Many nursing homes said a significant majority of residents and families preferred tight visitor restrictions. But COTA chief executive Ian Yates said too many prov­iders had given insufficient weight to residents’ social and emotional wellbeing, as they sought to make their facility a fortress.

“We will be starting to name and shame providers who offer window visits as the only option, or where the duration and frequency of visits is significantly less than the code,” Mr Yates said.

“For instance, if a provider only allows visitors a couple of days a week, or not on weekends, or are not sympathetic to people who can only visit at other hours, they will be on our radar.’’

Maria Sampey, a councillor in the City of Greater Dandenong on Melbourne’s outskirts, has just made the difficult decision to move her 98-year old mother Vittoria out of the John Hannah Villa Maria Nursing home in Mulgrave. She wants to see her mother, who has dementia and no longer speaks, almost every day but feels Vittoria is being shut away.

“They have set rules that say I can only visit her every third day for an hour. I had a discussion this week about changing that to every second day, but they wouldn’t do it,” Ms Sampey said. “I would like to spend more time with her, every day if I can. Before this I would bring in food most days. I would make her a chicken cacciatore the way she likes.

“I”m from an Italian background and the thing is you don’t put your mum in a nursing home. Every European has guilt about this. I just want to be there to know she is hydrated, comfortable, being looked after. If she gives me a smile then I feel I can go, knowing she is OK for another day.”

Sonya Smart, chief executive officer of VMCH, which owns and operates the facility, said it eased restrictions in the wake of the industry code to allow two visits per resident per week on weekdays. “We understand restrictions on visiting loved ones can be distressing and have taken each decision with the greatest of compassion, but most importantly safety, in mind,” Ms Smart said.

“We will not risk the chance of a COVID-19 infection within one of our residences; jeopardising the health and safety of our residents and staff and potential lockdowns, resulting in loved ones unable to visit their relatives.”

Aged-care advocate Sarah Russell said social media traffic showed anger and frustration remained rife among family members of people in nursing homes being denied access. "Many people are more worried about their parent­s dying of malnutrition, of dehydration or of neglect rather than they are about them dying of COVID,” Dr Russell said.

Patricia Sparrow, chief executive of provider group ACSA, said balancing mental health and the risk of COVID-19 “is exactly why we need the visitor code’’. “We understand it's been difficult and stressful for everyone, but our members are doing everything they can to look after the mental health of our residents while keeping COVID-19 out,” she said.