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How One Aged Care Facility is Keeping Their Doors Open Amid COVID-19

COVID-19 has forced many industries to drastically change the way they operate. Aged care facilities in particular have become the latest subject of much media scrutiny, as the Newmarch House in Western Sydney has seen a rise in infections resulting in 15 deaths so far. At the time of this writing, a total of 56 people at the Newmarch House have contracted the coronavirus—including some staff members.

In fact, the problem started when an ill staffer worked six shifts despite showing symptoms.

In the resulting chain of events, we’ve seen a sweeping lockdown of aged care facilities, with staff denying residents the ability to receive visits from family and friends. The majority of homes insist it’s a necessary measure to mitigate risk—except one. Bruce Tually, the general manager at St. Andrew’s Village in Ballina, joined us to explain his facility’s unique approach to risk assessment in light of COVID-19. At the end of the show, we discussed ways in which technology may enable us to fight against a pandemic.

How does COVID Spread Among Aged Care Residents?

It turns out that visits by relatives may be the least of their concerns.

While reading through a number of academic journals, something caught Mr. Tually’s eye.
The deaths rates from CoVID-19 in a Wuhan hospital were highest for dementia patients followed by a list of other comorbidities. 

Dementia patients in China who also suffered from other ailments were more likely to die of those ailments than those who were neurotypical.

Mr. Tually says this study of comorbidity death rates caused him to realize that dementia goes beyond physiological status; it affects a patient’s behaviors and, therefore, their ability to perform basic self-care. In other words, dementia patients cannot practice social distancing or hand hygiene the way most people can—and that puts them in a significantly higher risk category than other aged care residents who have a range of cognitive ability.

Additionally, Mr. Tually noted that staff are more likely than visitors to bring the virus into an aged care facility. Employees are vulnerable to financial pressure to return to work, even when in dubious health, if their only alternative is to suffer loss of income from taking time off. Visitors, on the other hand, are solely motivated by the wellbeing of their relatives in residential care.

A Different Approach to Risk Mitigation

St. Andrew’s did adopt screening and social distancing guidelines from both the federal government and the New South Wales Department of Health. Further, they suspended all visits to dementia wards (except in cases of bed-bound patients, who logically cannot transmit the disease to other units).

Their facilities, however, remain open—and are currently offering greater flexibility in leave policies. In ordinary circumstances, unwell workers are expected to use their entitlements (paid and sick leave), but these are not ordinary circumstances. Now, staff at St. Andrew’s have the option of taking leave without pay if they’re experiencing possible symptoms of coronavirus.

Even for a large organization like Anglicare, with multiple locations and access to agencies, rostering is a challenge. “We let people extend shifts when they’re willing,” said Mr. Tually. “In cases of shortfall, split shifts. Come in the morning, leave, and come back in afternoon.” Because St. Andrew’s is a standalone facility without a corporate office, they’ve found flexibility in self-governance. “Our multi-disciplinary team is such that we can handle it.”

Amalgamation in the healthcare industry, despite its benefits, may lead to a loss of procedural adaptability to public health emergencies. Sustainable independent facilities may be able to react more quickly to unforeseen situations such as the spread of COVID rather than anxiously awaiting instructions from above.

Balancing Risk Mitigation with Mental Health Maintenance

The wellbeing of the resident as well as his or her family members, who are distraught if told that they cannot see their relative, mustn’t be ignored. Yet of course, nobody wants coronavirus introduced into the microcosm of an aged care facility. So, Mr. Tually and his staff made their goal to go as far as possible in preserving their residents’ quality of life.

He emphasized that although there is nothing blameworthy about the decision to close down whole facilities for the sake of public health, here he saw a real chance to provide care and minimize disruption despite the chaos of COVID-19.

Families have been grateful—and even upper management has been open to his suggestions. Qualified as a biomedical microbiologist, whose thesis on bacterial infections of the upper respiratory tract included an epidemiological component, Mr. Tually has certainly been well-equipped to examine known facts of coronavirus and begin fostering discussions about how to handle them.

Technological Role in Fighting Coronavirus

Refining data, rather than panicking, seems to be our best bet. Now, Mr. Tually predicts, “A lot of thought will certainly be going into how we monitor residents via technology. I’ve developed a little software in my life, and the key is to have something complex and be able to present it as simple.” No matter how many bells and whistles a product has, it needs to crunch the numbers and then deliver relevant, useful and usable information in an accessible manner. Here are some innovations we’ve found that are already being employed in the fight against COVID-19:

● In Canada, a company called BlueDot is utilizing artificial intelligence to scan the internet each day for news updates—in multiple different languages—relevant to the public health crisis.
● In North America, a robot called “Vici” is involved in caring for at least one patient with coronavirus, which may go far in preventing the spread of germs. There is also a robot by the name of “GermFalcon”, which was developed to sanitize the environment inside of airplanes. This has the potential to make travel substantially safer now and in the future.
● In Israel, washable and reusable masks made with antiviral agents could soon start to replace disposable ones.
● In China, infrared thermometers are already in use to keep track of people’s body temperatures from a safe distance.

From new technology around the world to Bruce Tually’s improved methodology in caring for the elderly, innovations like these make us hopeful for what the future will bring. Hopefully, technological development will, in time, allow us to design solutions that can enable us to better manage crises in the future. 

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