By Dato' Dr Amar-Singh HSS / Vivienne Yong / Dr Liew Tuan Hock

It is increasingly recognized that the COVID-19 pandemic may last for a number of years and that cases will rebound episodically. Aged residential care facilities (ARCF) that house older persons (vulnerable individuals) are high risk locations for severe COVID-19 infection and death. Hence these facilities will have to make major long term adjustments to maintain a safe environment for its residents and staff.

As the ARCF residents are unlikely to venture outside of the ARCF to mingle with other potentially infected people, it would thus be obvious that any infection introduced into the ARCF will be from visitors or health care workers. It is thus of paramount importance that these two sources of infection must be minimized.

Older individuals in residential care need to be shielded from the risk of getting coronavirus infection. The key will be to try and create a bubble (a shield) in which the residents and staff live and operate, so as to minimize new individuals and infection entering the group.

This guide and standard operating policy (SOP) aims to help offer ideas and initiatives that could be taken. The guide covers the areas to consider with suggestions for improving COVID-19 Prevention. It looks at policy, staff, residents, healthcare workers/therapists and visitors policies. The guide will be useful for Nursing Homes, Old Folks Homes, Retirement Villages, Palliative Care Facilities and also relevant to other residential care facilities for any age. It is relevant to non-governmental, private and governmental facilities.

The full Aged Residential Care Facilities Guide is available for download and use from this link.

Attention to detail and adherence to a strong routine of standardized measures will help us through these difficult times. Some of the changes suggested here may need to be implemented as long term measures that out-live the COVID-19 pandemic. In particular it is important to better design aged residential care facilities to offer more space for residents, better ventilation and smaller resident per room and toilet ratios.

We hope this guide will be useful to all centers and facilities housing vulnerable individuals and support our older Malaysians with increased safety.

(Dato' Dr Amar-Singh HSS is Consultant Pediatrician; Vivienne Yong is Physiotherapist involved in nursing homes; and Dr Liew Tuan Hock is a General Practitioner.)