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Protecting aged care residents

Aged Care Direction (No. 7)

This content was last updated on 17 June 2020.

The restrictions on residential aged care facilities have been eased, with the risk of COVID-19 being balanced against the personal welfare and mental health of residents.

Who can visit a residential aged care facility? Family or support person, aged care staff, emergency workers and police, volunteers, health workers, a visitor who is providing end of life support

Residents can have up to two visitors at any one time. There is no limit on the number of visits allowed in a day or the length of each visit.

What has changed

  • Residents can have up to two visitors at any one time. There is no limit on the number of visits allowed in a day or the length of each visit.
  • Children under the age of 16 years are now able to visit residential aged care facilities.
  • Service providers may visit the facility, including but not limited to:
    • hairdressers
    • legal advisors
    • mental health providers (e.g. diversional therapists and music therapists)
    • allied health providers (e.g. podiatrists).
  • Residents may now leave their residential aged care facility for a range of reasons, including but not limited to:
    • exercise
    • attending small family gatherings of up to 20 people (as long as physical distancing can be maintained)
    • receiving or accessing health care
    • attending a funeral
    • visiting another residential aged care facility.
  • Residents who are part of a family group (e.g. couples or siblings) or close friends can leave the facility together.
  • Groups of residents cannot go on external excursions (e.g. a group of residents cannot be taken on a day trip to the beach).

From 17 June 2020, the restrictions on visitors have been eased. Residential aged care residents can have two visitors at any one time. There is no limit on the number of visits allowed in a day or the length of each visit.

A support person can provide care and support to the person they are visiting, including physical care and support.

Visitors, aged care staff, health workers, volunteers and anyone else entering a residential aged care facility will still not be allowed to enter the facility if they have not had the 2020 flu vaccine. There may be some exemptions, as outlined in the Australian Government’s Flu Vaccination Requirements for Aged Care Facilities.

From 17 June 2020, the restrictions on residents leaving the facility have also been eased. A resident can leave the aged care facility for a range of reasons, including but not limited to:

  • exercise
  • attend a small family gathering of up to 20 people
  • receive or access health care including mental health and allied health services (e.g. podiatrists, diversional therapists, music therapists)
  • receive end of life or palliative care
  • visit a service provider, including:
    • hairdressers and beauty therapists
    • legal advisors
  • visit another residential aged care facility
  • attend a funeral.

For full details read the Aged Care Direction (No. 6).

Visitors should:

  • visit a resident in the resident’s room, outdoors or a specified area in the aged care facility
  • avoid communal spaces
  • make sure the resident has no more than two visitors at a time, including doctors
  • wash your hands before entering and leaving the facility
  • stay 1.5 metres away from residents where possible
  • stay away when unwell

Visitors should not be anyone who:

  • is unwell
  • has returned from overseas in the last 14 days
  • has had contact with a person with COVID-19 in the last 14 days
  • has travelled to a COVID-19 hot spot in the last 14 days
  • has a fever (37.5 degrees or more)
  • has a cough, runny nose, sore throat or breathing difficulties
  • after 1 May 2020, has not had the 2020 flu vaccination (unless it is unavailable to you).

Whether you are a visitor, worker or volunteer, if you have visited a COVID-19 hotspot in the last 14 days, you must be in quarantine, so you must not enter an aged care facility.

Flu vaccination requirement

After 1 May 2020, a person must not enter a residential aged care facility if they do not have a 2020 vaccination against influenza, if the vaccination is available to the person.  

Recognising there may be individuals who, for medical reasons, cannot be vaccinated against influenza, there are some limited exemptions to this requirement. These exemptions follow the recommendations and clinical advice provided in The Australian Immunisation Handbook.

If a vaccine is unavailable at the time of vaccination, the person is exempt from the requirements until the vaccine becomes available.

Questions and Answers about this Direction

Who can visit a residential aged care facility?

Any person may now visit residents in aged care facilities, unless you:

  • have returned from overseas in the last 14 days

  • had contact with a person with COVID-19 in the last 14 days

  • visited a COVID-19 hotspot in the last 14 days

  • have a fever (37.5 degrees or more)

  • have a cough, runny nose, sore throat or breathing difficulties

  • have not had the 2020 flu vaccination (unless it is unavailable to you, for example, you are allergic to the vaccine).

Can I visit a loved one in a residential aged care facility?

Yes. Residents can have two visitors at any one time, for any length of time. Residents can have multiple groups of visitors per day.  A support person can provide care and support to the person they are visiting, including physical care and support.

Can people under 16 years of age now visit an aged care facility?

Yes. Children under the age of 16 years are now able to visit residential aged care facilities.

There is limited evidence of transmission of COVID-19 occurring in children, in Australia. Only two per cent of confirmed cases have occurred in school aged children. Based on the emerging evidence supporting the limited role of children in transmission of COVID-19, visitation of children to residential aged care facilities is likely to pose a low risk to residents. All visitors should observe appropriate hygiene and social distancing measures.

How can we support our loved ones if we are unable to visit them?

It’s important to stay connected with residents. If you are unable to visit your loved ones for any reason, you can keep in touch by:

  • phone calls

  • video calls

  • sending letters and postcards

  • sending artwork

  • sending home videos.

What should I do when I enter a residential aged care facility to work, volunteer, visit, or to provide end-of-life support?

You should:

  • stay in the resident’s room, outside or in a specified area

  • avoid communal spaces

  • make sure the resident has no more than two visitors at a time, including doctors

  • wash your hands before entering and leaving the facility

  • stay 1.5 metres away from residents where possible

  • stay away when unwell.

Can a resident of an aged care facility leave the facility?

A resident may leave the facility for a range of reasons, including but not limited to:

  • exercise

  • attend a small family gathering of up to 20 people

  • receive or access healthcare including mental health and allied health services (e.g. podiatrists, diversional therapists, music therapists)

  • receive end of life or palliative care

  • visit a service provider, including:

    • hairdressers and beauty therapists

    • legal advisors

  • visit another residential aged care facility

  • attend a funeral.

Residents who are part of a family group (e.g. couples or siblings) or close friends can leave the facility together.

Residential aged care facilities should conduct a risk assessment for each family gathering a resident attends.

Groups of residents cannot go on external excursions (e.g. a group of residents cannot be taken on a day trip to the beach).

Why are external excursions for groups of residents not permitted?

Although restrictions are being eased, it is still important to remain vigilant. Residents may leave the facility for a range of reasons, including to access health care services, exercise or attend small family gatherings. At this stage, it is recommended that external excursions not be organised with groups of residents to protect the health of our most vulnerable.

Does everyone entering a residential aged care facility need to be vaccinated against the flu?

Yes. You need to have had the 2020 flu vaccination to be able to enter a residential aged care facility. There may be some exemptions, as outlined in the Australian Government’s Flu Vaccination Requirements for Aged Care Facilities.

This applies to aged care staff, visitors, health care workers, volunteers and others (e.g. cleaners, tradesman, gardeners and maintenance staff).

What if I am unable to be vaccinated against the flu?

If you are unable to have the flu vaccination you can continue to work at or visit a resident in a residential aged care facility provided you:

  • stay for a short time in the resident’s room, outside or in a specified area

  • avoid communal spaces

  • make sure the resident has no more than two visitors at a time, including doctors

  • wash your hands before entering and leaving the facility

  • stay 1.5 metres away from residents where possible

  • stay away when unwell.

What is an up to date flu vaccination?

The flu vaccine is formulated differently each year depending on the circulating influenza virus strains. You are not adequately protected against the flu until you have been vaccinated with the current year's vaccine. The 2020 flu vaccination is the most up to date flu vaccine available.

My loved one has dementia and doesn’t understand what’s happening.

Talk to the residential aged care facility and discuss ways you can safely support your loved one.

What happens if there is a spike of COVID-19 cases in the community?

If there is a spike in cases in the community, the residential aged care facility may need to limit when residents can leave the facility and restrict visitors such as hairdressers or allied health professionals.  These measures will be needed to protect the health of our most vulnerable.

Flu vaccination

What does this mean for RACF operators?

RACF operators are responsible for ensuring compliance with this aspect of the Direction. As such, how this is performed may vary between facilities. For example, some RACFs may request any person entering the facility complete a questionnaire or signed declaration, while others may ask to see written evidence (e.g. letter from a GP) of vaccination/exemption from vaccination.

What medical reasons are grounds for influenza vaccination exemption for the purposes of entering a RACF under this Direction?

Exemptions follow the recommendations and clinical advice provided in The Australian Immunisation Handbook.

The Handbook lists the following two medical contraindications to influenza vaccination:

  1. Anaphylaxis following a previous dose of influenza vaccine; or
  2. Anaphylaxis after any component of an influenza vaccine.

If a person has one of the above contraindications, they are exempt from the Aged Care Direction (No. 6).

While some other medical conditions or allergies may warrant further specialist advice, the influenza vaccination is generally still recommended (refer to the Handbook for advice and clinical recommendations pertaining to individual conditions).

Are there any exceptions to this rule?

People with a history of Guillain-Barre Syndrome (GBS) whose first episode occurred within 6 weeks of receiving an influenza vaccine. The Australian Immunisation Handbook recommends influenza vaccination for people with a history of GBS, whose first episode was not after influenza vaccination.

However, influenza vaccination is generally not recommended for people with a history of GBS whose first episode of GBS occurred within 6 weeks of receiving an influenza vaccine. It is recommended a letter be provided by a general practitioner or specialist outlining grounds for an exemption.

People receiving immune-oncology therapy are exempt from the requirements if the person’s treating oncologist recommends in writing, that the person not be immunised for influenza.

What proof is required to comply with this part of the Direction?

While this is a decision for each RACF operator, it is recommended that written evidence be provided to the RACF operator.

Example: notice of vaccination from the dispensing pharmacist/health practitioner; letter from general practitioner advising of medical contraindication and therefore exemption from influenza vaccinations requirement.

This information should be collected as part of the RACFs routine immunisation record keeping so that written evidence only needs to be provided once and staff can look up records.

The Handbook lists other precautions in relation to influenza vaccination. Are the following considered exemptions under the Direction?

  1. People with egg allergy, including those with known anaphylaxis to egg allergy
  2. People with latex allergy

No. Please refer to the influenza chapter of The Australian Immunisation Handbook for further clinical advice and recommendations regarding specific conditions/allergies. https://immunisationhandbook.health.gov.au/vaccine-preventable-diseases/influenza-flu

Some people have a philosophical objection or religious/cultural beliefs about immunisation. Can an exemption be granted for this?

No. Given the vulnerability of our older Queenslanders, we are asking RACF operators adhere to the recommendations and clinical advice outlined in the Australian Immunisation Handbook.

An Ambulance Officer needs to enter the facility to treat or transport a resident to receive medical care. Do they require an influenza vaccination to enter the facility?

paramedic

Yes. All health workers including ambulance officers must have had the 2020 influenza vaccination to enter the facility if the vaccination is available to them. The Queensland Ambulance Service has a strict vaccination policy in place, therefore QAS Officers are not required to produce evidence of vaccination.

An emergency service (e.g. sewage, water, telecommunications, electricity) is urgently needed to be carried out at my RACF, but the technician on call does not have their 2020 influenza vaccination. What happens in this situation?

wildlife, animal, control

If an emergency service is necessary for the effective and safe operation of a RACF, or to protect the health and safety of residents and staff, a person may enter to provide that service regardless of whether they’ve had their influenza vaccination.

Example – A plumber may make emergency repairs if an employee or contractor with an up to date vaccination against influenza is unable to attend.

Note – Health workers must have had the 2020 influenza vaccination to enter a RACF unless the vaccination is not available to them.

It is important that the person providing an emergency service only stays on site for as long as necessary to undertake the emergency service. During this time, the person must also practise social distancing wherever possible.

Where can I find out more information?

The Australian Immunisation Handbook

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Questions and Requests for exemptions

If you are seeking clarification on a Direction or have any questions, please call 134 COVID (13 42 68).

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