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Why vulnerable COVID-19 infected Australian aged care patients are better off being kept in homes

Vulnerable coronavirus patients are often better off being kept in isolation in aged care homes than being transferred to hospital which would risk them spreading COVID-19, a leading medical researcher has said.

Medical experts on Wednesday expressed outrage at revelations infected patients are being kept in care homes rather than being moved to hospital for treatment.

But Professor Henry Brodaty from the Dementia Centre for Research Collaboration and Centre for Healthy Brain Ageing at UNSW Sydney said nursing homes should have their own facilities capable of treating coronavirus-positive patients.

‘Every nursing home should work out if there a section of the building where they can isolate infected patients,’ he told Daily Mail Australia.

‘It depends on the architecture of the nursing home but I think most can corral off a section for that purpose.’

He added infected cases could be effectively sealed off as long as staff also isolated themselves away from their colleagues for their entire shift.

‘It requires the nurses to be isolated and have proper PPE – it’s quite difficult to do – staff cant go for tea or have lunch with others,’ he said. 

Doctors have criticised hospitals cancelling the transfer to hospital of elderly patients with coronavirus, but Professor Brodaty said often nursing home residents on palliative care wanted to end their lives in aged care facilities.

‘The argument is they will be more comfortable and not distressed by going to a hospital. If someone is in palliative care and wants to stay in a nursing home then that should be respected,’ he said.

‘But if someone is very ill they need to be in hospital. The ratio of staff to patients is much lower in a nursing home.’ 

Medical experts have meanwhile told of patients who have conditions like dementia being kept bed-bound in care homes using morphine and the sleep-inducing drug midazolam. 

University of Sydney Professor Vasikaran Naganathan from the Centre for Education and Research on Ageing said care providers faced a huge challenge preventing highly-mobile elderly residents from spreading the virus.

But he said there were other ways to stop patients moving around care homes – including having a better spread of infected residents within the facilities.

‘Most people would agree you need to think about having the right layout – can you find somewhere where this person can wander around safely?’ he told Daily Mail Australia.

‘It’s difficult to find a space like that though – can you find staff and can you find a layout? I’ve seen facilities with wings where they can move the person to and allow them to walk around.’ 

‘Sedating patients should not even be a last resort though. You want to avoid it,’ Professor Naganathan said.  

Professor Brodaty agreed sedation was not the answer to dementia-suffering residents with coronavirus.

‘The best answer is to have segregated areas within the facility for COVID positive residents,’ he said.

‘The major types of sedative medications used are benzodiazepines and anti-psychotics – both increase risk of increasing confusion and falls.’

Doctors have said sedating infected patients – which sources said included aged care home residents in only their 40s – was ‘inhumane’.

‘You can’t imagine higher-priority patients. What’s happening is they are wanting to keep beds free in case — but in case of what? This is the ‘in case’,’ one source told The Australian.

One physician who works at the Glenlyn Aged Care Facility in the north Melbourne suburb of Glenroy, Robert Hoffman, said the Royal Melbourne Hospital had cancelled plans to move residents to hospital.

He said patients infected with coronavirus who were being prescribed for palliative care treatment – or who were prone to wandering – were being heavily sedated. 

‘One of my patients with no symptoms but is positive for COVID and can’t be isolated was heavily sedated,’ he said.

The wife of another Glenlyn resident Jose Silvera, 80, said she was concerned her husband was being sedated ‘to keep him quiet in the nursing home’.

Monash University physician Joseph Ibrahim said the practice of sedation could leave elderly sufferers both scared and frightened.

‘If we want to be humane we would look after them, reassure them and provide more support, we would not simply resort to sedating them,’ he said.

Daily Mail Australia has contacted the Glenlyn aged care home and the Victorian Department of Health and Human Services for comment – which have both so far declined to speak on the matter.

The Royal Melbourne Hospital said sedatives were prescribed in residential aged care home but would not comment further. 

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