“Consultation on draft Aged Care Visitor Access Code”
INTRODUCTION: On May 1, 2020, Aged Services announced the development in consultation with the public, a “COVID-19 Residential Care Visitor Access Code”. Aimed to “facilitate safe and regular communication between residents and their family, family of choice or friends during the COVID-19 pandemic, while minimising the risk of its introduction to a residential care home”. As part of the consultation, Capacity Australia constructed a response including the following comments:
SUBMISSION: CONSULTATION ON DRAFT AGED CARE VISITOR ACCESS CODE
The below is an excerpt from the full submission. To read the full submission, click here.
General
We applaud Aged Services for the timely development of this Code, and strongly encourage its rapid publication, notwithstanding the tragedy of the recent spate of nursing home deaths in NSW. It is perhaps one of the strengths of this Code, that it highlights the dual importance of achieving “the right balance between protecting residents from COVID-19 and providing them with vital social connections and support from loved ones” as you have outlined in the Background to the Code. We also applaud the prioritisation of the first Principle being:- “Providers must actively facilitate connections between residents and family, families of choice and friends, consistent with the Charter of Aged Care Rights”.
Suggestions
We make these suggestions mindful of the excellent brevity of the Code which increases its readability and impact. We suggest only one or two lines addressing the following issues:
We applaud Aged Services for the timely development of this Code, and strongly encourage its rapid publication, notwithstanding the tragedy of the recent spate of nursing home deaths in NSW. It is perhaps one of the strengths of this Code, that it highlights the dual importance of achieving “the right balance between protecting residents from COVID-19 and providing them with vital social connections and support from loved ones” as you have outlined in the Background to the Code. We also applaud the prioritisation of the first Principle being:- “Providers must actively facilitate connections between residents and family, families of choice and friends, consistent with the Charter of Aged Care Rights”.
Suggestions
We make these suggestions mindful of the excellent brevity of the Code which increases its readability and impact. We suggest only one or two lines addressing the following issues:
- We suggest, in the opening lines of the second paragraph, that reference to higher order human rights preface discussion of Aged Care Quality Standards and Rights. The human rights “anaemia” in Australian aged care frameworks and policies has been a focus of concern for some time. This is not unique to Australia. Invisibility of older persons in human rights systems and the implementation gap between the articulation of
- human rights values and principles in human rights frameworks, and the actual enjoyment of such has led to discussions by the UN Open Ended Working Group about a new UN treaty on the rights of older people. We therefore feel that explicitly acknowledging the human rights to (i) the highest attainable standard of health without discrimination, on the basis of free and informed consent, with respect for specific needs that arise on account of disability (Article 25); (ii) the expression of will and preferences (Article 12); (iii) liberty and security of the person (Article 14); and (iv) the family, relationships and connectedness (Article 23) should preface the rationale for the Code. This is especially important for the edification of families and carer advocates.
- We recommend the addition of a Principle regarding the implications of the Code and the complexity of achieving these objectives for people with cognitive impairment or dementia. This would recognize the specific vulnerabilities of these residents and the multiple human rights at stake. Implicit in this is helping staff, families and carers understand that violations of the human rights to the expression of will and preferences (Article 12) and the meeting of unmet needs (Article 25) associated with pandemic- imposed social isolation, loneliness and deprivation of intimacy (Article 23) are likely to drive changed behaviours in dementia. At the same time, there needs to be an acknowledgement of the difficulty in enforcing social distancing and hand hygiene in people with cognitive impairment, challenging the equitable rights to health (Article 25) and to liberty and security (Article 14). In line with additional support that may be required in the instance of changed behaviours, we would suggest reference in the Code to the encouragement that facilities seek specialist input from available services such the DBMAS/ SBRT (with contact details) and/or their local specialist mental health services for older people. Telehealth means that access to these services continues.
On a final note, we congratulate the consortia on a Code that stands out amongst global initiatives for supporting human rights of older people in the pandemic and we look forward to disseminating this Code internationally as soon as it is finalised. We also might be of assistance in implementation of the Code locally in Australia.
Source: Peisah, C, & Jessop, T 2020, Consultation on draft Aged Care Visitor Access Code, Aged Services Submission, viewed 5 May 2020, <https://capacityaustralia.org.au/wp-content/uploads/2020/05/Capacity-Australia-response-to-visitor-access-code.pdf>
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