When Grace Poland tumbled over, banging her head, twisting her leg and praying that someone would respond to her panic alarm, she felt anything but lucky. But that was six days ago.
Now Poland, a 36-year-old cerebral palsy sufferer, may be the only Australian who feels blessed to be in hospital, a place most are avoiding due to the risk of COVID-19 infection.
Grace Poland, who has cerebral palsy and requires intensive support, says she is lucky to have ended up in hospital.
Poland’s predicament underlines a crisis looming in Australia’s huge disability and home aged care sectors. Poorly paid and often casual workers in both sectors travel from house to house performing an essential service – assisting the elderly and disabled with the most vital and intimate tasks so they can continue to live independently.
Last financial year more 957,000 elderly Australians received help to remain in their homes under the Commonwealth Home Support Program or a Home Care Package and hundreds of thousands more were funded by the National Disability Insurance Scheme.
But with an extreme shortage of personal protective gear such as gowns, masks and gloves and the added risks that some clients may lack cognitive ability to follow social distancing rules, workers are finding it difficult to minimise personal contact or self-isolate if they, a co-worker or a client displays symptoms.
The Opposition's disability spokesman Bill Shorten said he had been "absolutely inundated" with pleas from service providers for protective wear and greater testing.
“They are testing across aged care but why aren’t you testing disability workers? They say aged care workers and clients at a higher risk, but plenty of disabled Australians are at higher risk as they have depleted immunities. It is a crisis. This argument that disabled people are less at risk than older people is a dangerous hoax."
Grace Poland in better days.
A manager of one large disability services provider said on condition of anonymity that her organisation might soon face the choice of directing workers to no longer attend disabled people with lesser needs and concentrate instead only on critical cases.
And Nick McDonald, the chief executive of Prestige InHome Care, admitted the options for aged care services were limited in the event a friend or family member could not step in to care for the elderly person.
"The last resort is to take them to hospital," Mr McDonald said. "But my fear is, who is going to help an old person, pick them and take them to a hospital if it's already overflowing with people who are far more critical? That's what keeps me up at night."
“In a weird way, I am quite fortunate that I did fall over and ended up here. Because at my apartment block, they have no plan.”
Mr McDonald was also dubious about a government guarantee to give the sector access to stockpiles of personal protective equipment if supplies ran out.
"It seems a bit ambitious to say we’ll make sure you’ve got what you need, they don't have any idea about the quantity required, and if you don't have PPE … you're back to the original scenario where no one can go and see this person or get them out of bed and take them to the toilet."
His organisation, which services clients across NSW and Victoria, is investigating what non-essential tasks could be delegated or deferred altogether.
If Poland, who requires intensive support funded by the NDIS, was to return to her Melbourne apartment block which she shares with five other disabled Australians, she fears her support might disappear, placing her at risk of further injury. Poland’s mother has cancer and is unable to provide back-up.
Staff at the Austin Hospital have quietly told Poland she’s better off there, though if the disability sector workforce is overwhelmed it will increase pressure on the already strained health system.
“I don’t know what is going to happen to me or what is going to happen to the system,” Poland says from hospital. “In a weird way, I am quite fortunate that I did fall over and ended up here. Because at my apartment block, they have no plan.”
NDIS minister Stuart Robert has unveiled a number of measures including funding to extend NDIS support plans and efforts to ease the financial pressures facing service providers as staff fall sick or self-isolate.
National Disability Services chief executive David Moody welcomed the changes but said it was simply not enough. Mr Moody is banking on the minister adhering to his promise to keep responding as the situation deteriorates.He also worries that if a disability support worker from a small service provider in the bush falls ill, it might lead to that provider closing, forcing clients into the mainstream health service.
“It is imperative that further measures are taken so we can retain the workforce and not lose it to other sectors during the pandemic,” said Moody, who warns he’s been swamped with reports of support providers at risk of shutting down
Minister Roberts declined an interview, but his office stressed it and the department was on a war footing, responding as need arises. However, a senior Victorian official told The Age and The Sydney Morning Herald the state government was already examining urgent measures to take over services as disability support businesses collapse.
“We will have to go back fully into the sector. It’s dramatic. The feds don’t know how to deliver services. Look at Centrelink,” the official said.
Mr Shorten said that, “Once the spread of the virus in China started happening, the government should have been working to handle the surge in demand. And they just haven’t. The needs are straightforward. More protective equipment, more testing, more workers, more guaranteed funding to providers.”
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