Locking down residential aged care facilities (RACFs) has been seen by many providers during the pandemic as the only means of shielding residents from the incoming tidal wave of COVID-19 infections.
But it is an intervention with serious side effects: residents have been deprived of their basic liberties and, as a result, have sustained ongoing degradation to their mental health and sense of independence.
For aged care workers, implementing this no-win situation has been heartbreaking.
Madison*, an aged care worker in a Melbourne RACF, tells Aged Care News that balancing COVID-prevention policies with residents’ mobility and mental health needs has been a stressful ‘Catch-22’.
“It really is an impossible situation,” she says.
“We have taken every preventative measure we can and wear full PPE almost full time [but] it’s been so difficult with outbreaks that it unfortunately has been necessary to keep residents in their rooms during visits with family.
“If one person gets COVID every resident on the same wing has to isolate in their rooms for 14 days for the safety of staff and residents.”
“It has been rough, but so important.”
New international research suggests the toll on healthcare workers has been significant: one in two healthcare workers have PTSD symptoms after working through COVID.
And Australian research findings paint a similar picture.
A study published by Bond University in August, which surveyed 425 Australian workers across both private and public RACFs, found that 63 per cent of workers had suffered from work-related stress due to COVID, with 28 per cent having ongoing mental health concerns.
The report confirmed visitor lockouts to be uniform practice, implemented in 98 per cent of respondents’ facilities at some point throughout the pandemic.
Apart from causing distress to residents and families, lack of visitation resulted in the bulk of emotional caregiving duties being transferred to aged care staff.
“I felt like a ‘sponge’ absorbing all their anxieties, sadness and grief,” one respondent said.
“Although I endeavoured not to bring this home to my family, it did have an impact.
“I would spend time readying and preparing myself mentally to enter the facility each morning to ensure I had a ‘happy face’ and the same again at the end of the day prior to entering my home.
“I found myself waking throughout the night and waking early, thinking of ways to bolster the residents and staff.”
Madison notes that the stricter the conditions, the more likely it was for hostile situations to eventuate, with staff often made the scapegoat.
“We had a resident who often defied restrictions and was meant to be in isolation, who yelled at all of the staff and got super upset, saying, ‘who brings the COVID in? It’s always the staff, so why punish us?’
Madison says these encounters were incredibly distressing and wondered whether there could be an alternative.
“Aged care workers can’t be expected to live at the homes as well, and the government can’t go as far as stopping workers from going out and socialising.
“It’s all a bit of a catch 22.”
Looking ahead, Madison is trying to remain positive.
She says that despite the “rough” period, “90 per cent of residents are very patient” and high vaccination rates has allowed her facility to resume social activities for residents.
“It has been so nice recently: I went back to work today and lots of families came.
“Some residents even went shopping and were so stoked.”
The question remains now whether vaccinations will provide the necessary immunity to render COVID related injury and death, and thus lockdowns, a thing of the past.
As the race to provide third doses commences, latest data suggests that 33 active outbreaks persist within residential aged care.
Sadly, these latest outbreaks have so far resulted in 44 resident deaths.
If you are in crisis or need someone to talk to, call Lifeline: 13 11 14
*name has been changed for anonymity