Pic Credit: De Plattekloof Lifestyle Estate in the Northern Suburbs of Cape Town
WORDS: DEBBIE LOOTS :: PHOTOS: SUPPLIED
With no vaccine available yet, the coronavirus will continue to affect the way we live our lives in months and possibly years to come. Masks, handwashing and social distancing are fast becoming the norm. Evidence shows the elderly are most vulnerable, with global death rates rising sharply among those aged 70 or higher. Retirement estates play a significant role in keeping residents safe by strict adherence to prescribed lockdown measures while reassuring them of swift assistance in case of emergency.
The Chinese Center for Disease Control and Prevention analysed 72,314 patient records, focusing on 44,672 confirmed cases of the virus in mainland China from February 11 2020. It found that 80.9% of all confirmed cases were classified as mild, 13.8% as severe and 4.7% as critical.
Out of the total confirmed cases, 1,023 deaths were recorded, which amounts to a fatality rate of 2.3%. No deaths were recorded among children up to the age of nine, and among those aged between 10 and 39 the fatality rate is 0.2%. The rate rises to 3.6% in the 60-69 age bracket and even further to 8% among people between the ages 70 and 79. For those aged 80 and over it is 14.8%. In Italy, 82% of the 827 deaths that occurred by March 11 fell into the 60-plus age category.
According to Statistics SA’s 2019 midyear population report, SA has the highest number of older people in Africa. The disease is spreading rapidly across the country, and with several residents at an upmarket Cape Town retirement estate recently testing positive for Covid-19, there is a sense of urgency among these community-focused estates to take extra care.
Exclusive retirement lifestyle estates do not always have medical facilities on their premises but in the case of De Plattekloof in Tygerberg Hills in Cape Town, with the Panorama Clinic 1.5km down the road, access to emergency care is close. Like many other retirement estates, De Plattekloof has its own strict Covid-19 action plan in place and it is following the World Health Organization’s (WHO) prescribed procedures. The estate’s clinic also offers appointment services where residents can be checked by doctors. We look at what is being done at other retirement estates countrywide:
In Gauteng, Central Developments’ retirement estates are managed by CSi Property Management. To help combat the spread of the virus, access to all its estates is restricted and no visitors or deliveries are allowed. Residents observe the lockdown regulations, whereas employees wear protective gear and have their temperatures scanned twice a day. All Central Developments’ estates have frail-care facilities. Although these are not considered to be medical facilities, they are prepared to deal with Covid-19 cases. Each estate’s nurse monitors the residents’ health. Should it be suspected that a resident has contracted Covid-19, the estate’s doctor would test them and upon return to the premises, the village nurse would ensure that the patient and anyone else they have been in contact with self-isolate for 14 days.
Residents in self-isolation are able to contact the village nurse on an emergency number at any time. Meals from the restaurant, groceries and medication would be delivered to the front door or porch of their unit. The nurse and general manager also check on them regularly to ensure that they are coping. Should their health deteriorate, the nurse would arrange for them to be taken to hospital.
The frail-care residents’ temperatures are taken twice a day and they are checked frequently for any other symptoms of the virus. These facilities are sanitised regularly. Should a frail-care resident display symptoms of Covid-19, the same procedure is followed as for residents of the rest of the estate. The general manager often updates all the residents on the estate’s Covid-19 status and developments through the estate’s newsletter and is available to address residents’ concerns directly.
Medwell SA manages MSP Developments’ retirement facilities – Buh-Rein Retirement Village and Zevenwacht Lifestyle Estate, both in the Western Cape. Medwell SA monitors the impact of Covid-19 infections in SA closely in order to guide MSP’s decision-making continuously. It follows the proposed guidelines and policies recommended by the WHO and the department of health to prevent the spread of the coronavirus. “We are ready to manage patients with suspected infections as well as those who have been diagnosed,” says MSP project liaison manager Werner Scheffer. “We follow all general hygiene measures, which includes the roll-out of self-quarantine and self-isolation in a doable way.” The workers at these two retirement estates are also reorientated on the impact of the virus and consulted and screened on an ongoing basis. They are also equipped with personal protection equipment for use when coming into contact with patients who have overt Covid-19 symptoms.
Mount Edgecombe Retirement Village
Totalcare is the medical service provider at Mount Edgecombe Retirement Village in KwaZulu-Natal. Because its residents are considered high risk, infection prevention and control (IPC) protocols were created and are updated often in line with current guidelines. These protocols deal with staff and residents of the care centre as well as the independent village. Staff are trained on the nature of Covid-19, including early symptom recognition. Their temperatures are taken daily. During lockdown, all employees stay on the premises and healthcare staff work 10-day shifts to minimise contact with residents (these extended shift cycles also correspond with the average incubation period of the disease).
The health status of new residents is assessed and physical distancing is practised while taking care not to contribute to feelings of isolation. Twice daily, all residents’ temperatures are taken and those with a fever or respiratory symptoms are reported to management. If a resident is suspected to have contracted Covid-19, they would be isolated in a single room, complying with all IPC practices. A clinical assessment is conducted and severe cases are transferred to an acute health facility. If that is not necessary, the patient would be isolated and cared for at the Totalcare facility. The village nurse will continue providing home nursing services and check-ins during this time. This service is essential to ensure the physical and psychological health of all village or estate residents by checking for any symptoms of disease and combatting feelings of isolation.
As the overall wellbeing of every staff member and resident is important, care will be taken to provide healthcare while maintaining a calm and comfortable environment.
Evergreen Lifestyle Villages
Evergreen Health, which forms part of Evergreen Lifestyle Villages, has prepared its villages for any unforeseen medical crisis such as Covid-19, says Evergreen Health MD Elize Porter. The Evergreen Lifestyle Villages were locked down even before the official nationwide lockdown and residents at the care centres are not allowed to receive any visitors. The majority of nurses and carers are being accommodated on site in the villages during this time. Everyone who enters the village offices undergoes rigorous daily screening in keeping with workplace health and safety regulations. Those with high temperatures are referred for testing by Evergreen health nurses.
The village management has built-in support structures that include assistance with shopping for groceries and other supplies such as pharmacy items to protect residents from exposure at shops. A counselling hotline has been established to provide mental-health support to the residents of all the villages. A team of volunteers also conducts daily check-in telephone calls to residents who may require assistance in alleviating loneliness and possible mood disorders. In addition, nursing staff check on villages regularly to assist with any home healthcare procedures and daily routine activities.
Evergreen Lifestyle management prepares regular forms of communication to keep in contact with residents. These include updates on the virus, home exercises designed by its physiotherapy partners, as well as brain teasers and crossword puzzles. Recently a booklet with details on the new Covid-19 Level 4 restrictions was also distributed to those who are able to return to work. The health management team has liaised with expert epidemiologists to develop an elaborate plan for a “basket of care” in consultation with medical aids, should the need arise to offer clinical care to Covid-19 patients. Collaboration with two medical emergency assistance companies should further reassure residents that ambulances will be dispatched immediately in case of a medical crisis.