The residents of a Melbourne aged care home with no active coronavirus cases have been told that if they leave to visit a doctor, they must stay in their rooms for a fortnight upon their return.
It is one of many homes across the city to introduce strict resident lockdowns to cut the risk of infections after coronavirus swept through Victorian aged care, where 637 have died with COVID-19.
Bluecross Ruckers Hill aged care home has told families that residents who leave the home for essential medical appointments will have to go to their rooms for 14 days upon their return.
But some families and aged care experts warn forced isolation is taking a huge toll on the elderly, who are not the main risk of introducing coronavirus to homes, and may be as much about protecting the reputation of home operators as it is their residents.
And a lawyer specialising in unlawful detention said homes needed to be careful they were not falsely imprisoning residents.
Bluecross Ruckers Hill home in Northcote has had 12 deaths and 132 coronavirus infections but no longer has active cases. It informed family members on Thursday that any resident who left the home for “essential medical appointments upon return will be required to quarantine for 14 days” in their room.
“It’s quite an overreaction given the number of cases in the community is now quite low,” said aged care academic and geriatric doctor Joseph Ibrahim, head of Monash University’s Health Law and Ageing Research Unit.
The home – where 84 staff and contacts and 48 residents acquired coronavirus – was last week sanctioned with a notice of non-compliance by the federal aged care regulator.
More than 60 per cent of residents at the Estia Health facility in Keilor Downs were infected in an outbreak which is believed to have started when a resident returned to his shared room following a stay at Footscray Hospital, where he was in a room with someone who later tested positive for COVID-19.
Premier Daniel Andrews says aged care home visits will be limited until next year. Credit:Simon Schluter
Audrey Stone’s father lives in a Melbourne home, and has spent 56 days alone in his room since February over the course of four lockdowns.
Ms Stone understands the reasons for the isolation, but said it was unsustainable.
"The constant yo-yoing in and out of lockdown is difficult, mentally and physically," said Ms Stone. She has been allowed to intermittently visit her father, who has had a stroke, is non-verbal and dependent on care.
While homes provide other ways of interacting with residents, video chats or phone calls do not work for many because of dementia or other reasons.
“And there isn't enough staff or enough time to provide the one-on-one attention residents need,” said Ms Stone, who wants the federal government to impose strict staff ratios on aged care homes.
Before the pandemic, staff didn't have time to walk her father so Ms Stone came in every day. During hard lockdowns, no one walked with him. "With every lockdown, his mental and physical state deteriorates and it becomes more challenging to build him up again."
Restrictions to movement have serious consequences for residents in aged care.
“Removal of incidental exercise – walking to the dining room and back three times a day – can result in rapid deterioration in strength, balance and mobility,” said Australian Physiotherapy Association director Rik Dawson, a gerontology physiotherapist.
The Bluecross home in Northcote, when asked why families were told residents would be “required” to stay in their rooms for 14 days after medical appointments, said in a statement this would be decided on a case-by-case basis.
Asked if the requirement would lead residents to avoid medical appointments, it said: “No resident is prevented from accessing medical care.”
The company pointed to a survey finding “90 per cent of our residents and families support our restrictions”.
Jeremy King, from Robinson Gill Lawyers, has acted in matters involving illegal detention and Victoria Police, and has been consulted by a client whose parents were being kept in their room at an aged care home.
He warned some homes could expose themselves to false imprisonment or unlawful detention accusations, which he noted “does not have to be malicious”.
Some homes were going beyond what the Department of Health and Human Services specifically ordered to stop the spread of coronavirus, Mr King said, and needed to balance protecting residents from coronavirus with illegally detaining them in their rooms.
Some homes’ orders to isolate appeared to be “making it up as they go along”, he said.
Sarah Russell is director of advocacy group Aged Care Matters and said homes were making rules about not leaving rooms and visitations that were illegal because depriving someone of their liberty was serious.
“We are imposing rules on residents that we don’t impose on anyone else in the community,” she said. “It’s perfectly reasonable to take this highly contagious virus seriously and to take a proportional response – but homes are making their decisions based on fear.”
Monash University’s Professor Ibrahim said it was essential both infectious disease guidelines and human rights needs were contemplated before locking a person in their room for two weeks.
“It needs to be asked: ‘Is this proportionate and where is the risk?’,” he said. “The risk of harm from being isolated for 14 days is high. Arbitrary rules with good intentions are not good enough.”
Minister for Aged Care Richard Colbeck said it was important aged care providers continued to allow visitation, particularly for dementia patients and their families, during the pandemic.
“It is not acceptable, fair or compassionate for aged care facilities to completely restrict carers and families from visiting residents in their care, unless there is a COVID-19 outbreak, as these actions can have a negative impact on individuals in residential aged care,” he said.
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