Caring for aged patients during winter
GPs are increasingly consulting an older demographic in their practice, with currently more than one in three of their patient encounters being with people aged 65 years and older.
The care of older people, whether living in the community or residential aged care facilities (RACFs), is often complex. The challenge is to provide appropriate care of the highest quality to these patients, regardless of where they live. In addition to liaising with the family of older patients, GPs are often required to collaborate with the patient’s broader multidisciplinary healthcare team, including RACF staff, carers, nurses, other specialist medical practitioners and allied health professionals, in a way that focuses on the patient’s individual needs.
The elderly are particularly vulnerable to the severe outcomes of COVID-19, RSV and the flu, and RACFs are a high-risk transmission setting.
Treatments for COVID-19
Two antiviral medicines, Lagevrio (molnupiravir) and Paxlovid© (nirmatrelvir plus ritonavir) were provisionally approved for use in Australia for the treatment of COVID-19 in January 2022. (Jump to sub section: oral antiviral treatments for COVID-19) As with all medicines, patients or carers will need to provide informed consent for these medicines to be prescribed.
GPs working with patients in RACFs may find it helpful to pre-emptively discuss these medicines with their patients, even if they do not have COVID-19, to determine eligibility criteria and obtain pre-consent for these medicines to be prescribed in the event they test positive for COVID-19. A subsequent discussion is advised at the point at which the patient requires the medicine to confirm the pre-consent is still applicable.
Influenza vaccination for RACFs
Aged care providers must comply with the Aged Care Quality Standards and have arrangements in place for the delivery of flu vaccines for residents and staff, including:
- ensuring processes are in place
- engaging with immunisation providers
- discussing the program and arrangements with staff, residents and their families.
Influenza vaccination is a nationwide requirement of anyone entering RACFs and proof of vaccination must be shown prior to entering.
Deployment of Tamiflu for RACFs
Tamiflu© is an oral antiviral used for both post-exposure chemoprophylaxis and to treat Influenza A and B infections. Tamiflu’s main effectiveness has been shown in preventing influenza in Residential Aged Care residents exposed to influenza.
The Ausralian Government is placing advanced supplies of Tamiflu in RACFs ahead of the expected increase in flu cases this winter. Packs of the prescription-only medication will be deployed to RACFs, multi-purpose services and National Aboriginal and Torres Strait Islander Flexible Aged Care Programs for both residents and staff from mid-April.
The Department of Health has further information on Preparing your service for influenza vaccinations and treatments.