As many nations experience significant second waves of Covid-19 infection, a panel of international aged care experts will highlight clear lessons from their national experience of the pandemic which they say must be integrated into the continuing and future pandemic response.
Representing the United Kingdom, the Netherlands and Australia, the panel – chaired by journalist Leigh Hatcher – will debate the topic, ‘Care in the time of Covid’, during HammondCare’s International Dementia Conference, on World Alzheimer’s Day, September 21, live streamed from 6.35pm (AEST) or 9.35am (BST).
In a preview of the panel debate:
Aged care not seen as important
Prof Wilco Achterberg, an elderly care physician from The Netherlands, said in the early part of the pandemic, aged care homes were not seen as an important part of the health care system and so missed out on vital planning and resourcing.
“The pandemic exposed an existing issue that our care home network, while providing very good care, was not taken seriously by the wider health sector,” Prof Achterberg said.
“All the focus in the early days of the pandemic was on hospitals, what was needed in ICU, with no thought given to what could happen in aged care. As a result, we were short on PPE and had problems with testing.”
The Netherlands has about 125,000 aged care residents of whom about 3000 have died from Covid-19.
UK’s rushed transition to free up hospital beds
Dementia expert, Prof June Andrews, representing Scotland and the UK, said one of the biggest challenges had been the number of older people in hospitals, waiting for a move to aged care, when the pandemic hit.
“In the UK there was rushed response to suddenly move older people from hospitals into aged care, often without the normal transition processes,” Prof Andrews said.
“In Scotland that was about 1,000 people. There was a mistaken view across the UK that very many hospital beds would be urgently needed by acutely ill younger people with Covid, as had been seen on TV news from countries such as Spain.
“But discharging these older patients without enough time to prepare was a recipe for disaster that could have been predicted by care home operators because they know and understand care homes and how to care for older frail people.”
Workforce decisions key
HammondCare’s Prof Chris Poulos, who has helped provided clinical governance during the pandemic, said one key lesson was the importance of screening staff from the beginning to prevent outbreaks.
“Someone in aged care is not going to catch Covid-19 unless someone brings it into the care home. We didn’t learn early enough that staff may not show symptoms. They present the biggest risk to vulnerable residents, requiring high levels of vigilance for screening, and restricting staff working across care homes.
“And while some have called for the transfer to hospital of every resident who tests positive, I don’t think that a blanket approach like this is the best.
“Decisions about hospital transfer need to be based on many factors: clinical need; how well the design of the care home allows for proper isolation and cohorting; staffing capacity and competency and availability of PPE; and, importantly, the wishes of the resident and their family,”
Prof Poulos said. “I don’t think blaming governments or providers is useful. By world standards the Australian response to the pandemic has been excellent. This is about lessons learned and moving forwards.
“And we don’t need knee-jerk reactions now such as insisting all care homes need to become like hospitals – these are still people’s homes and we should be able to make them homelike as well as clinically sound.”
No more ‘corridor model homes’
Architect David Hughes, recent Chair and CEO of Pozzoni Architects, Manchester and London, said a key learning from the pandemic was that the small household design for aged and dementia care, had proved effective for infection control.
“I heard a developer of care homes say he would never again design ‘corridor’ model homes but would only build ‘household’ model homes from now on, because of the problems he saw during the pandemic,” Mr Hughes said.
“But we should perhaps reflect that when, for instance, hospitals are designed they are designed with significantly higher budgets per square foot than care homes. Budgets which also anticipate the incorporation of measures to enable infection control.
“When it comes to aged care homes the budgets bear no relation to hospitals in this regard. Design has to be careful to consider the usage of every last square inch.
“That is a societal issue as to how we regard the needs of older people.”
For more information about the ‘Care in the time of Covid’ debate, and to register, please click here.