Are our older Australians worth a cappuccino and a good pastry?

OPINION.

Allambie Heights Village Residential Aged Care Facility on Sydney’s Northern Beaches or ‘Fortress Allambie’ as it is being referred to following the installation of a banner there in mid-April, went into Restricted Access for relatives’ visits about mid-March 2020. It then went into a status of ‘Elevated Restricted Access’ on the evening of 31 March 2020 after relatives left and wished their loved ones and staff well. An interesting term “Elevated’. It means, to raise to a more important level.

“Communication has been so important and keeping residents, relatives, staff, volunteers as well as our Members, Directors, Consultants, Contractors and elected representatives at Federal, State and Council levels aware of what we are doing has been key”, says Ciarán Foley, Chief Executive Officer of Allambie Heights Village Ltd., that operates the Residential Aged Care Facility and Retirement Villages on the Northern Beaches.

“’Lockdown’ is not a word that we want or should be using anymore’, says Foley. “Politicians have been using the word carelessly, it’s emotive and misleading , it causes anxiety, it is not an appropriate term to be using in the context of what Australia’s 360,000 Aged Care workers are doing to assist 1.3 million people in its care and ultimately in saving lives”.

“We kept our residents and their nominated relatives engaged prior to going into restricted access and then elevated restricted access. It meant that everyone could prepare in the way that they wanted or needed and it meant that relatives could visit more before restricted access arrangements. Some ensured that their mother had a smartphone. Families organised their own technologies at home so that they were ready to communicate digitally with their loved ones and able to communicate through SKYPE for our residents to use”.

“We have continued to have compassionate visits in respect of families visiting our residents who are being palliated (non-COVID-19 related). This is so important and our relatives operate all our infection control measures to ensure that everyone is safe, they cannot have any contact with another resident when visiting and must be escorted by a staff member to and from the resident’s room”.

Foley says that his entire Company’s staff were prepared weeks before COVID-19 started its attack on our most vulnerable across Australia. It set up a ‘COVID-19 Action Team’ which began to meet on a weekly formal basis with regular interactions each day. The Team consists of Ciarán Foley, Chief Executive Officer; Jim Murray, Facility Manager (Registered Nurse); Belinda Donkin, Education Coordinator; Cathy Higginson, Recreational Coordinator and Minimol Varghese, Registered Nurse.

The COVID-19 Action Team makes important decisions about the actions that need to be taken and it is a focus point for discussing the range of information that is being provided by so many authorities about COVID-19 including the Department of Health. There are 3 conference calls with the North Sydney Local Health District weekly too which has about 110 residential aged care facilities in its geographical area. Relevant information from our Action Team is disseminated to staff.

“The first thing we did within hours of the first meeting was to commence a program to upskill every staff member in Infection Control measures by demonstrating at the start of every shift over a 2 week period, knowledge and awareness about washing hands and the use of Personal Protective Equipment (PPE)”. “Staff were already knowledgeable and skilled in these areas but preparation in a calm and confident manner and, of course, time benefited us”. “We had a video uploaded in minutes of that first COVID-19 Action Team Meeting to one of our TVs located in the most central area of the Facility showing a brief demonstration about effective handwashing which every resident, staff member, relative and visitor had to pass and watch and the film was repeated for a few weeks”.

Since then, everyone who enters the aged care facility has to be checked for temperature which is recorded and they need to complete a questionnaire about their health, contact with anyone who has had symptoms of colds, flu or COVID-19. Since 1 May 2020, no one can come into the aged care facility and that includes contractors and tradespersons if they have not had a flu vaccination.

“ Our residents received the flu vaccination 3 weeks ago and 100% of our Company staff have received the flu vaccination too”, says Foley.

“We followed the Government directives to go into Restricted Access. We then learned afterwards from our North Sydney Local Health District and its many participants, Residential Aged Care Facility Managers and Directors of Nurses that an increasing number of Facilities were in ‘lockdown’. Soon afterwards over a matter of weeks, all of the Facilities in the local health district area, 110 Facilities had gone into ‘lockdown’, says Foley.

“We were not the first and we were not the last to enter into Elevated Restricted Access. We did not take this decision lightly. We discussed it at senior management level, with our managers and with our staff, with our Board Directors and we communicated particularly with our residents and their nominated relatives. We did it to keep people healthy, our residents and staff. We did it to save lives, it’s that simple and it’s that essential”, says Foley.

“ At 30 April 2020, after 30 days in Elevated Restricted Access, our residents have had no colds, no flu and no COVID-19. That’s real evidence as to why we needed relatives to cease coming to our residential aged care facility”. It is compelling evidence when 50% of all deaths due to COVID-19 across Europe and in the US are in aged care facilities. These facts are widely known by Australia’s politicians and by their health advisors.

“We have received overwhelming support from our residents and their relatives upon entering into Elevated Restricted Access. Residents are communicating with their relatives by phone, by smartphone, by our staff using the Company Smartphones and even staff using their personal Smartphones in some instances to ensure that residents and relatives can speak and see each other. We have staff setting up and assisting SKYPE communication between relatives and residents every day”.

“Without our 20 plus volunteers, fewer GPs attending, no Church services by religious celebrants, no visiting entertainers (normally weekly/twice weekly), our staff, in addition to their normal duties as registered nurses, managers and care staff have become personal beauticians, pastors, priests and religious sisters as they arrange ecumenical Church Services and become innovative recreational, entertainment and exercise gurus. Many have taken on leadership in these roles. Our visiting physiotherapists are with us throughout the week as are our podiatrists and some other allied health professionals. Our nurses are spending increased hours each day engaging with GPs who have decided not to attend”.

“We have not received a cent in support finance or subsidy from the Federal Government to date in spite of their many public announcements.

Imagine the additional cost that we are experiencing with the additional duties identified above, the employing of more staff for cleaning, sanitation, recreation; the screening of staff, contractors and visitors; the purchase of extra technology to keep people connected; the diversion of staff to respond to Government Departments and their public servants who require us to complete additional audits and forms.”

“These are all costs to our Company, coming out of our cash reserves that we have planned for use elsewhere to benefit our residents. It is important that we have been a successfully well-run and operated Company to have cash reserves”, adds Foley. “It’s a disgrace and it is shameful the way the Government is treating our Aged Care Industry. A year ago, 42% of all residential aged care facilities across Australia were operating at a financial loss and were in financial distress. As of February 2020, that percentage has now increased to 56% of Operators overall. It’s even worse for our regional colleagues where 71% of Operators are operating at a financial loss. And this was before COVID-19. This position cannot continue. Operators are going broke and residential aged care facilities across Australia will close this year”.

“Our Peak Industry Bodies among which Leading Age Services Australia represents the majority of Operators have been lobbying the Government and the Minister of Health and Minister of Ageing for as long as I can remember”, says Foley. “The urgent rescue measures required during COVID-19 are:

$15 per resident per day to protect residential aged care residents;
$10 per client per day to provide flexible support for home care recipients
$500 million pool of funds for information technology measures to keep older people, family and community connected
Support and expansion of the aged care workforce
Making sure that aged care is there when it is needed, keeping Operators viable”.

“$15, that’s the cost of a cappuccino and a good pastry! Are our older Australians who have sacrificed so much for us worth that? They certainly are”, says Foley.

“I encourage everyone who reads this to forward this to their elected representative and to whomever you like and demand that the Government starts paying for our older Australians fairly and to start doing so now. Enough with the public announcements, pay up. In the meantime, we are going to do what we do expertly and do best, looking after our residents, keeping them well and saving lives”, says Foley.

Ciarán Foley
Chief Executive Officer
Allambie Heights Village Ltd.
Email: CFoley@alhvillage.com.au

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