For Michael North, life in aged care comes with a sense of isolation from the rest of the community.
"You feel almost like in a goldfish bowl, looking out at the world."
Mr North lives in an aged care home in the West Gippsland region of Victoria.
His wife of 62 years, Terry, lives in another section of the home with higher care provision.
"I'm free to go and see her as often as I want to, and we spend quite a bit of the day together," he said.
"But If I'm isolated in my room, or [my wife] is in hers, I can't go and see her."
As COVID-19 spreads in the community, it's also spreading in aged care residential facilities.
There are outbreaks in 857 aged care facilities across Australia, and more than 5,000 residents with COVID-19.
Mr North's home doesn't currently have a COVID-19 outbreak, but it has had lockdowns previously.
"They've been beneficial because we've had a very low incidence of COVID activity within the facility but they do impinge on residents' lives quite a bit," he said.
"There's an increasing wall of isolation going around people, primarily as a result of COVID, I think."
Mr North said visitor restrictions during lockdowns had affected the ability of residents to relate to other people, but restrictions in the community, such as density limits and time restrictions at churches, had also had an impact.
"[It's meant] cognitive inactivity. The ability to relate to people is reduced. And I think it does have an effect on mental health at times."
While Michael North can drive, and spends time reading and emailing friends, he said most residents did not have a mobile phone or computer, further limiting social interactions.
Mr North is now experiencing life inside aged care, but about 20 years ago, he was the manager of an aged care home in Melbourne's eastern suburbs.
He has no complaints about the staff at his home, who he said had gone out of their way to maintain a high standard of care, in the face of staff shortages and extra work created by COVID-19.
"I was unaware … when I was in management, and I'm quite surprised that being a resident, how difficult it is sometimes to be involved in communication," he said.
"I've come to the conclusion that circumstances have changed for residents, because of COVID and maybe the inability of staff to relate to many people for a long time — that sort of level of inter-communication and cognisance has changed."
As stories about COVID-19 in aged care ramp up again, Mr North said he was concerned about the representation of older Australians in the media and in government decision-making.
"There's no appreciation by people making decisions of what it's like to be 80 or 90," he said.
The new Minister for Aged Care, Anika Wells, said in a statement that she had been visiting aged care homes and residents and would have more to say about formal engagement with older Australians in coming days.
'It can be heartbreaking'
Alicia Shepherd is the service manager at Uniting The Marion Leichhardt in Sydney, an aged care home that has just come out of lockdown, something she says happens "once every couple of weeks".
Ms Shepherd said residents struggled with the loss of social connection during COVID-19 outbreaks.
"They will tell me, you know, 'We've been in wars, I've had car accidents, I've lived my life, I've travelled the world by myself. Why is it that you're telling me because there's this virus outside, I'm not allowed to go anywhere?'
"So it can be pretty heartbreaking to tell a very senior person to me, 'No, go back to your room.'"
She also said staff were exhausted.
"There isn't anyone to backfill — agencies don't have anyone to offer," she said.
"And although we've got the Commonwealth to refer to and request the staff, the staff aren't always available.
"So the staff are extremely stretched with working overtime and my staff here are absolutely incredible, they look at residents here as their family … [but] they're struggling, they're tired. I'm tired."
Ms Shepherd said aged care staff were not paid adequately for their work, especially compared with their counterparts in the hospital system.
"And now as we move along, because you know, 'COVID normal', well, it's not normal," she said.
"It's not normal in aged care or to continue to go through this every couple of weeks."
Aged Care Minister Anika Wells said she was monitoring the government's surge workforce capacity, and it was larger now than in January, with 1,900 shifts filled last week.
Ms Wells said the government was committed to supporting Fair Work's decision on a pay rise for aged care workers.
Catherine Sherlock, who is the residential service manager for Blue Care's Carina Aged Care Facility in Brisbane said aged care was a "tough gig" for staff at the moment.
"I think we're constantly on edge," she said.
Her home has just come out of a four-week lockdown, and staff have been wearing full protective gear.
"The air conditioning has been set to heat to keep everybody warm, but PPE makes you sweat and staff are changing their clothes three to four times a shift," she said.
"When you sweat that much you fatigue. So fatigue is a big issue.
"Add to that fatigue that they've worked two years without a holiday.
"We've had people, our complementary therapists, jump behind the counter and in the pantry and do the evening meal – so I think people jump in when they see a need.
"They are a pretty, pretty awesome crew, mate."
Residents struggled with lockdown
Pamela Bartulovic's aged care home in Snug, Tasmania currently has a COVID-19 outbreak, but she's relieved the home is allowing residents who don't have the virus to leave the home, with some requirements for testing.
"For me, when in lockdown [earlier this year], it was terrible," Ms Bartulovic said.
"I did not have my family to come and see me in the nursing home and we were locked down for quite a while."
She said the outbreak meant the dining room was closed, and activities and trips on the home's bus had been stopped until they got on top of COVID-19.
"There would be a lot of residents that look so forward to leisure and lifestyle and the activities there that would affect them," she said.
"And the [nurses] are doing the work of the kitchen staff, bringing all the meals around. They are tired.
"But when it comes to care, you can't fault them."
