industry & reform
Doctor’s advice
GPs say some aged care facilities
have ignored PPE warnings.
By Conor Burke
tell us what to do’ was
the message Victorian GP
‘Don’t
Sachin Patel received from
aged care facilities.
Patel says his practice, Aged Care GP
– which services 70 aged care homes
in Victoria – has been writing letters to
facilities since January about the dangers
of COVID-19 and the importance of proper
PPE usage, but Patel and his GPs still faced
pushback when they turned up in full PPE
to conduct check-ups on residents.
“[We said to providers] we’re coming in
full PPE and we’re going to double down
on it now, and we encourage you to get
your staff to use PPE wherever possible,”
Patel tells Aged Care Insite.
When his GPs would show up in full kit –
which often included hooded APR masks
– they were told that it wasn’t a good look
and that the appearance of the full PPE
might scare people.
Patel said the comments from CEOs
and management were often informal, but
the message was clear: they thought PPE
wasn’t needed.
Aged Care GP has been involved with
eight of the Victorian aged care homes
that have experienced large outbreaks in
this second wave of COVID-19, and Patel
and his GPs have observed an overall lack
of training when it comes to PPE use and
infection control in the sector.
“I think it’s a training issue. You might
learn about PPE early on but the thing is
this is different to say the flu, because with
the flu there is some immunity around,”
Patel says.
“In this situation, unfortunately if PPE isn’t
used 100 per cent right, then there’s a risk
of spread.”
Patel also questioned the readiness of
some facilities for an outbreak of the virus
and criticised the self-reporting nature of
the COVID response plans in the sector.
“I presume the question would have
been, ‘Have staff had PPE training?’ You
might tick yes to that, but if I learned PPE
four years ago and then today I’m expected
to just remember exactly how to do that,
then it’s a tall order.”
Dr Kaval Patel, who also works for Aged
Care GP, says it was often the atmosphere,
more than anything said, that would tell
him the facilities he went to didn’t approve
of masks.
“You’d get the odd looks as though [they
were thinking], ‘Why are you worried?
We’re not wearing anything and we’re
dealing with the patients more regularly
than you,’” he says.
“I don’t think they quite got that … we’re
actually protecting everyone else rather
than ourselves, and if we wanted to protect
ourselves we would go full telehealth.”
Patel says that he sees this issue as a
result of a larger lack of knowledge about
PPE and its efficacy in fighting infectious
diseases in aged care. And he says that
GPs have a moral obligation to point out
potential issues they see within aged care,
not just during a pandemic.
“Sachin has been in constant
communication with facilities, so has our
team, and when we think something’s not
going right, we give them clinical direction
and advice and say, ‘This is what we need
to be doing and following.’
“I think we do have an obligation to do
that, and if we don’t, then we’ll probably be
doing our patients and clients a disservice.”
Both GPs say that the pandemic has
been incredibly hard for their patients. As
specialist aged care GPs, they spend all day
every day with aged care residents, and
although the introduction of telehealth
has been a good workaround, it cannot
compare to the usual one-on-one time
they have with patients.
“It’s very difficult because you want to go
in and see your residents and patients that
you look after, but it’s difficult to do,” Kaval
Patel says.
“It’s not as easy to do telehealth
consultations, particularly with residents
who have hearing impairments, have visual
impairments, who may have dementia.
“You do your best, but on a personal
level, I think I find that difficult. I feel so sad
for my patients that they don’t get to see
me when they want to all the time.”
For Sachin Patel, the relationship
between a GP and patient is very important
as we age, as is the relationship between a
GP and an aged care facility.
“General practice in aged care should
be specialised. It shouldn’t be done in the
normal framework of a normal practice
… because the needs of aged care are
completely different,” he says.
“It’s ‘prevention is better than cure’. But
suddenly you go into a nursing home and
it’s just, ‘Oh if there’s a problem, we call the
doctor’, but otherwise the doctor doesn’t
come. That’s not right, I don’t think.” ■
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agedcareinsite.com.au