The thought of Covid-19 in residential aged care can be terrifying. It’s important that you understand what your parent’s aged care facility or potential aged care facility is doing about it so you can act as their advocates. These 10 questions to ask about Covid-19 in residential aged care is part of a series written by nurses, doctors and experts with experience in aged care. The series aims to make your journey into residential aged care easier and assist you in understanding your rights. It cannot answer every question you might have but if you need further information the contacts at the end might help. They are written as if your parent is asking the facility management, but you can ask management too on their behalf.
1. How will you reduce the risk of Covid-19?
A management plan to reduce the risk of infection is a requirement and should cover things like staffing, additional precautions and equipment supply. Signage, temperature testing and regular hand washing by staff indicate a plan is in place. There must be a senior member of staff with expertise in infection control. Ask who it is and make sure they provide regular feedback on the current Covid-19 situation.
2. What are the arrangements to make sure I receive medical support if I become unwell?
Your GP will continue to provide regular health reviews, repeat prescriptions, assess your care needs and discuss concerns. GPs are trained in respiratory care so can provide advice on
Covid-19. If you become ill a doctor can arrange for you to be taken to hospital if you choose to. Ensure you have an advance care directive/plan* indicating your wishes for treatment, remembering you can amend this at any time.
3. Who will oversee my clinical care if I have Covid-19?
Your care will be managed by an expert in respiratory care, usually your GP unless transfer to the hospital is necessary. Your daily care should be provided by a separate team of experienced registered nurses supported by enrolled nurses and care workers. Outreach services delivered by the local health district such as ‘Hospital in the Home’ can also help.
4. Will my routine care and treatment stop?
Your usual daily routine might change, but all the care and services you would normally receive should continue, including access to good quality meals. Your right to safe, high quality and effective care and treatment remain the same during a pandemic.
5. How will I be supported if I am required to self-isolate?
You will be kept apart from other residents and visitors. This might mean you are asked to temporarily move bedrooms and have restricted access to areas of the home you would normally use. Once the infection has passed, things should return to normal. No changes should be made without prior discussion with you.
6. How will you make sure I still see family and friends?
Staff should assist you to keep in touch by phone or similar device which enables you to see and hear them. There’s guidance called the ‘Aged Care Visitor Access Code’. Ask for a copy and see if you can negotiate arrangements to suit your needs. You can contact trained advocates for support and advice.
7. Am I allowed to move out to alternative accommodation during the pandemic?
If there’s no Covid-19 in the facility you can take emergency leave for a period. If you take this option you don’t need to use your social leave entitlements. During your absence, you’ll still be charged usual accommodation, daily living and care contribution fees and only get up to eight weeks of the Commonwealth Home Support Program during the time you’re away. On your return, you may be Covid tested and isolated until cleared – usually within 2 days.
8. What arrangements are there to ensure I get care if the usual staff are unwell or isolating?
During pandemics, people need more hospital-like care and increased staffing levels including experienced registered nurses and enrolled nurses. Your condition may change rapidly and it’s important you have 24-hour nursing care provided on-site. The number of replacement staff required has been seriously underestimated in the past so it’s important to know there is a plan in place.
9. How will you ensure people with dementia understand what’s happening at this time and minimise distress?
Regular staff who are familiar with each person’s needs are essential to reduce anxiety and distress in a changing environment. Extra staff will be needed to provide one to one support during self-isolation, to minimise distress and avoid unnecessary restrictive practices. Dementia Support Australia is available 24 hours for advice on 1800 699 799.
10. How can I get access to information about Covid-19 if my first language is not English?
There are a range of trusted government resources and translated materials available in different languages. Use the numbers on the back of this leaflet to assist you.
Look for other leaflets on questions to ask about specific care needs. These can be downloaded at: www.10questions.org.au
You may find these leaflets useful when:
• Searching for a high-quality residential aged care facility.
• Reviewing the quality of your current residential aged care facility.
• Deciding between two residential aged care facilities that appear similar.
It’s important that there are enough registered nurses within the staff skill mix to meet everyone’s needs. You should ask questions about how your individual care needs will be met.
Many staff wear similar uniforms. Just because someone looks like a nurse does not mean they are. Here are the differences:
A Registered Nurse (RN) has undertaken a minimum three-year Bachelor of Nursing course. They can undertake nursing procedures, manage pain medication and help prevent unnecessary hospital admissions.
An Enrolled Nurse (EN) works under the direction of an RN. Both are registered by a regulatory body. Registration ensures professional standards are maintained and protects the public.
Assistants in Nursing (AIN)/Care Workers/Care Service Employees (CSE) are unregistered. They provide most of the care in residential facilities and communities but their level of training is variable.
Some useful links:
10 Questions to ask PDF article download link –
Carers Circle article on 10 questions to ask about mental health needs in residential aged care –
Carers Circle article on Visiting aged care during COVID in NSW –
Quality Aged Care Action Group (QACAG) – An independent grassroots community action group that lobbies for high quality aged care in all settings including residential and home care. QACAG is an organisational member of the NSW Aged Care Roundtable. It contributes to the development and consumer testing of the ’10 Questions to Ask’ series of consumer-facing resources for people seeking aged care – https://qacag.org.au/
The original version of this article appeared on 10questions.org.au. Reproduced with permission.
Photo credit: Planet earth wearing a mask on Rawpixel