Disaster strategies for the aged-care sector

A recent forum held at the Leading Age Services Australia (LASA) Tri-State Conference provided an opportunity for aged-care stakeholders to share tips on emergency preparation. Following Australia’s unprecedented bushfire season, aged-care providers need to ensure appropriate measures are in place, including evacuation plans, flexibility for staff and understanding what is covered under their insurance policies.

ACT Emergency Services Agency Territory Emergency Management Officer Rob Kilpatrick explained that, with resources stretched during catastrophic emergencies, aged-care providers should not rely on the emergency services being able to attend. He urged providers to be prepared in their business continuity planning in case emergency resources are not available.

Bush Nurse Centre Manager Anne Brewer from East Gippsland, Victoria, explained that when her community was threatened by catastrophic bushfires, the centre faced challenges evacuating elderly Australians, who were reluctant to leave.

“Older community members don’t believe they should leave town because it has never happened before. Many of the fire plans had never been fully tested and people thought they could manage, but later found — mentally and physically — they could not.

“We do not have the power to make people leave, but we can use tools to help them understand the practicality of their decisions.

“Elderly Australians often have cardiac or respiratory problems. I advise them that if they have a medical event in the face of a fire, help may not be available or accessible.”

Brewer highlighted the importance of providing support to staff as well as seniors and residents. She said that allowing staff to have flexible work arrangements was an important part of the support strategy in addition to providing staff with access to counselling services.

Planning for workforce disruption should form a key part of disaster planning.

“Because we were so widely impacted, the situation took out almost our entire workforce. A lot of our younger ones really stepped up because of the intensity and longevity of the emergency, which was fantastic to see.”

Brewer said that emergency planning is key.

“Our fire seasons are getting earlier and longer and we must factor in staffing issues in the context of firestorms, floods and even illnesses.”

Emergency planning considerations:

• Consider the likely effect of an emergency situation on your ability to maintain business continuity.
• Think beyond 1–2 days and consider what the situation might look like 1–2 months down the track.
• What changes need to be made? What happens if water is contaminated or power is out for longer than a day or so?
• Are fuel stores in place for generators?
• In the case of bushfires, check access to masks and air purifiers.
• Know who and where resources are but don’t solely rely on them. Resources may not be able to access affected areas or plans may change.
• Maintain control over as much as you can but ask for help early.
• Logistics is a vital and time-consuming job — identify someone for that job and give them the lead to do just that.

Learning from experience

Buckland Aged Care Services CEO Liz Roberts said that the Blue Mountains facility — home to 420 residents, including 144 in residential care and the rest in retirement living — was fortunate to be the only aged-care facility in the Blue Mountains that did not have to evacuate.

“We’ve evacuated twice previously — in 1994 and 2013. Having had two previous evacuations and the lessons learned, we felt we were safe to remain on our site.

“Since 2013, we have put enormous resources into protecting the site, in order to be able to keep our people at home. We feel that we can manage our people best within our facility,” she said.

“There is enormous pressure in evacuating — it is enormously disruptive for elderly people to have to move out of their homes.

“During evacuations, a small number — who we didn’t expect to have negative outcomes — passed away and we believe this was stress-related from people being moved and put into uncomfortable circumstances.

“So we have learnt a lot of lessons over time but from our perspective, a lot of it is about the resilience of our staff. They are people we need to rely on but, at the same time, we need to care for.”

Roberts explained that many staff are dealing with their own personal circumstances — including fire threatening their own homes and worry about their children, partners, animals and wildlife.

“It is absolutely useless to make people feel like they must be at work when they just can’t cope. The first thing I say to people is if you don’t feel you can be here, please don’t be. If you need to be with your family or your home, that’s where your first responsibility has to be.

“I often reflect that I do not know how we can expect our staff to care for people if we, as managers, don’t care for them.”

In the wake of the bushfire crisis, Brewer said that the Bush Nurse Centre was undertaking more home visits in order to connect with those who may not be accessing services and check on their mental wellbeing.

“We are running, with quite a few clubs in the town, a number of social activities with a variety of counsellors in the crowd, just listening out for people.

“There are people feeling ‘I lost everything’ and feeling ‘I lost nothing’. The guilt of feeling that they lost nothing may well be worse than for those who have lost everything. These people can easily isolate and fall through the cracks in the busy time of the community trying to recover. Certainly, there’s an awareness that home aged-care providers should take this on board.

“There was a huge amount of variation between the service offered by home care providers during the fires and we will be advocating on behalf of our clients that this changes for the better,” Brewer said.

Insurance: vital yet overlooked

Vikki Karatovic, health and community services manager at corporate insurance broker Lockton Companies Australia, said that under-insurance is always the biggest issue when it comes to property claims.

“An ISR policy provides cover for an insured peril. It is split into two sections, Section One on property loss. Section Two is the consequential loss and the business interruption. There needs to be damage to insured property to trigger Section Two business interruption cover.

“The biggest issue that loss adjusters have found is that the ISR policies specifically exclude pollutants, so it does not typically include smoke or soot because that is considered pollution. So if you are evacuating a facility because of smoke and there is no damage to your property, you will not have cover.

“It is also important to understand what you are covered for in the case of being unable to get in or out of your property.

“If access to your property is via a road or bridge, you need to have your policy endorsed to cover that,” she said. “Bushfires also need to be within a certain distance of your property for it to be covered.”

She advised providers to speak with their insurance brokers to ensure they fully understand their policy.

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