COVID-19 has pressure-tested the nursing home system in Victoria, and it is failing.
The aged care royal commission said in its interim report last November that aged care was in a shocking state of neglect that “diminishes Australia as a nation”. This is being writ large in this demoralising second wave.
Twenty-two of the 36 deaths this month have been nursing home residents; five deaths in one day reported on Friday.
The finger-pointing has begun in earnest, but it won’t stop the growing number of deaths.
With at least 210 more aged care residents COVID-positive and facing a bleak “case fatality rate” of 35-40 per cent, the coming days and weeks will be horrendous for scores of Victorian families.
More than 200 care workers across the system are also infected, at last count. These workers, many casual and lowly paid, are the likely source of the outbreak.
Aged-care resident advocates say care workers often can’t afford to miss shifts if they become ill. And COVID cases may well have no symptoms anyway. Hence the spread.
Experts warn carers simply don’t have the clinical training required to manage the increasingly frail aged, particularly in the midst of a pandemic. Yet private and not-for-profit homes rely heavily on staff that have Certificate III training, which takes just six weeks.
They also blame the federal government, the level of government responsible for aged care, for not mandating minimum staff ratios of trained nurses. Problems already outlined to the royal commission are being magnified in this crisis.
Providers’ efforts to train care workers in pandemic control measures, including a new 10-hour video course, is woefully inadequate, clinical experts say. You can’t learn how to put on, and more importantly take off, PPE by watching a video. It requires constant, even daily, practice and reinforcement. Carers in nursing homes have told of being required by their employer to bring their own PPE.
It is instructive state-run aged care centres, which are required to have a certain number of nurses per resident, currently have proportionally fewer COVID cases.
Providers are now pointing the finger at both the Morrison and Andrews governments.
An announcement this week to ensure workers are restricted to working at one nursing home to avoid cross-infection hasn’t been backed up with any detail on how it is to be funded or implemented, they say.
Promised PPE hasn’t been delivered, they say. A call for all COVID-positive nursing home residents to be hospitalised has been ignored, they say.
Some infected residents transferred to hospitals have been turned away at the hospital door, they say, because their particular home isn’t the subject of an outbreak. Yet.
An offer to move all COVID-positive nursing home residents to vacant centres set up as COVID wards has been ignored, they say.
Residents are older and frailer than ever, needing higher levels of clinical care. Many never have a visitor, so they also need staff just to spend time with them. This combination is expensive. There is not enough public funding to pay for an appropriately skilled workforce to deliver the level of care and time required.
Aged care was failing before the pandemic. These deaths are just more visible.
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