National Cabinet changes its advice on aged care visits – one day after Queensland scrapped restrictions

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The Australian Health Protection Principal Committee (AHPPC) has issued an update to aged care homes to lift their restrictions on visitor numbers and social gatherings – following Premier Annastacia Palaszczuk’s announcement yesterday that her state would immediately allow families to recommence visits.

You can read the full statement here.

Given the low levels of community transmission in Australia, the AHPPC has changed its advice to recommend:

  • children of all ages be permitted to enter aged care homes (provided they adhere to restrictions on visitor numbers, social distancing and personal hygiene);
  • visiting service providers such as hairdressers, diversional therapists and allied health professionals be allowed to enter when their services cannot be provided via telehealth or other adaptive models of care, and the resident cannot leave to receive these services (again, social distancing and hygiene practices apply); and
  • spouses or other close relatives or social supports are not limited in the number of hours that they spend with their spouse/relative;
  • Visits to small family gatherings be permitted in the company of family and friends (group excursions are still banned).

The advice also recommends homes implement measures to limit the risk of transmission to residents, including:

  • limiting visits to a maximum of two visitors at any one time per resident;
  • visits should be conducted in a resident’s room, outdoors, or a specified area in the home, rather than communal areas with other residents;
  • no large group visits should be permitted at this time – however gatherings of residents in communal or outdoor areas which adhere to social distancing and current requirements for gathering size may be permitted
  • Visitors must practise social distancing where possible, including maintaining a distance of 1.5 metres, practising hand hygiene and respiratory etiquette and complying with directions given by staff.

The rules that people who have returned from overseas in the last 14 days; have been in close contact with a confirmed case in the last 14 days; are unwell, particularly those with fever or acute respiratory infection (for example, cough, sore throat, runny nose, shortness of breath) symptom; and have not received a current influenza vaccination should be excluded still apply.

Homes also still need to screen visitors by asking questions and checking their temperature on their arrival, though the advice adds that staff should not be required to supervise visits.

There is also no requirement for routine testing of new or returning residents on admission, unless “clinically warranted”.

“Clinical judgement should be applied – for example, where a patient is coming to the RACF from an area with known community transmission,” it states.

The AHPPC says homes should only return to a higher level of protection – such as restricting visiting service providers – if there are recent cases of COVID-19 acquired in the local vicinity of the facility.

However, it also stresses that residents are still at high risk.

“AHPPC continues to emphasise the significant health risk of COVID-19 for the elderly and individuals with co-morbidities or low immunity,” it states.

The updated advice is unlikely to be met with open arms by operators.

CEOs we have spoken to have stressed the need for restrictions on physical distancing and hygiene to stay in place for months – and even years ahead.

While the updated advice recommends homes maintain these procedures, how do you tell family members that they cannot hug a loved one? Or they cannot take their elderly relative to a birthday with 50 guests?

Queensland has fines of up to $13,345 in place for those who breach the guidelines, but that will require facility managers and staff to ‘dob in’ family members.

A situation that is unlikely to improve relationships between families and the provider.