Infection prevention and control (IPC) is one of the most critical challenges in aged care. According to the Australian Institute of Health and Welfare (AIHW), over 244,000 people lived in permanent residential aged care in 2023, and that number continues to rise with our ageing population. Notably, infectious diseases are among the leading causes of hospitalisation and death in older Australians, with respiratory infections alone accounting for 21% of all hospitalisations due to communicable diseases in those aged 65 and over[1].
Given the vulnerabilities associated with ageing, such as weaker immune systems, chronic diseases, and increased exposure in shared environments, proactive infection control practices are essential. Whether you are a nurse, carer, facility manager, or concerned family member, understanding the risks and implementing effective strategies can make all the difference.
What Are the Most Common Infections in the Elderly?
Older adults, particularly those in aged care facilities, are more prone to infections due to physiological changes and communal living conditions. The most prevalent infections include:
1. Urinary Tract Infections (UTIs)
UTIs are the most common bacterial infections in elderly residents. They often go unnoticed until they lead to serious complications like delirium, fever, or kidney infections. Catheter use, incontinence, and reduced mobility significantly increase the risk.
2. Respiratory Infections
Pneumonia, influenza, and COVID-19 are particularly dangerous in aged care settings. Shared airspace, inadequate ventilation, and comorbid conditions increase transmission and severity. Vaccination and respiratory hygiene (masks, coughing into elbows, etc.) are key to reducing the spread.
3. Skin and Soft Tissue Infections
Pressure ulcers, cellulitis, and fungal infections frequently occur due to immobility, incontinence, or poor skin integrity. Maintaining skin hygiene and ensuring regular repositioning are critical in prevention.
4. Gastrointestinal Infections
Norovirus and Clostridioides difficile can spread rapidly, especially during outbreak seasons. Proper food handling and rigorous hand hygiene are essential barriers.
5. Bloodstream Infections
Sepsis can develop from other untreated infections and is often life-threatening. Early detection is vital; watch for confusion, fever, rapid breathing, and low blood pressure.
How Can Nurses and Elderly Individuals Maintain Personal Hygiene?
Personal hygiene is foundational to infection prevention. Good hygiene practices not only reduce the risk of transmission but also promote dignity and comfort for aged care residents.
For Elderly Individuals:
- Daily bathing or assisted cleansing using gentle, pH-balanced products helps prevent fungal or bacterial buildup.
- Oral care twice daily is vital; poor dental hygiene is linked to pneumonia in older adults.
- Hand hygiene before meals and after toileting should be encouraged, using either soap and water or alcohol-based hand sanitiser.
- Foot and nail care helps prevent infections like athlete’s foot and ingrown toenails.
- Proper continence management, including changing pads promptly, protects against UTIs and skin breakdown.
For Nurses and Carers:
- Perform hand hygiene before and after every resident interaction, including after glove removal.
- Keep hair tied back, nails short and free of polish or artificial nails.
- Use single-use gloves and aprons during tasks like wound care or toileting support.
- Sanitise equipment like blood pressure cuffs, stethoscopes, and shower chairs between each use.
- Change footwear when moving between high-risk and low-risk areas if facilities allow.
These practices align with the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2023), and are further reinforced by the Aged Care IPC Guide[2].
How Often Should Nurses Change Their Scrubs?
Uniform hygiene is a surprisingly overlooked but essential component of infection control.
- Nurses working in aged care should change their scrubs daily, or more often if visibly soiled or exposed to bodily fluids.
- Uniforms should be washed at 60°C or higher, using a suitable disinfecting detergent to kill pathogens.
- It’s best practice to leave work uniforms at the facility or change before leaving to reduce the risk of transporting germs home.
- Footwear should be cleaned weekly and worn with a high-quality disposable shoe cover, designated for work use only, to reduce the risk of transporting germs home
Facilities may consider onsite laundering to further control cross-contamination. This recommendation is supported by national infection‑control policies from the Australian Government Department of Health, which offer tailored guidance for aged‑care uniforms and hygiene[3].
Are People More Likely to Get Sick Working in Aged Care Facilities?
Yes. Working in aged care inherently comes with increased exposure to infectious agents due to:
- High resident density and shared spaces
- Frequent physical contact with residents
- Airborne and droplet transmission of respiratory viruses
- Risk of needle-stick injuries or contact with body fluids
Workers in residential aged care, part of the healthcare and social assistance sector, face significantly higher rates of physical and psychological injury than the general workforce. According to WorkSafe Victoria’s “Injury hotspots – Aged care” data, common issues include musculoskeletal injuries to the shoulders, back, and knees, along with significant rates of stress, anxiety, and depression[4]. These challenges contribute to burnout, impaired judgement, and weakened immunity, increasing the risk of illness among staff. To protect themselves, workers should:
- Stay up to date with all vaccinations, including flu and COVID-19
- Report and isolate symptoms early
- Follow PPE protocols strictly
- Engage in regular IPC training and audits
Building a Culture of Prevention in Aged Care
Infection control in aged care isn’t about isolated actions—it requires a culture of continuous vigilance and accountability. This includes:
- Routine infection surveillance and outbreak management protocols
- Resident and staff education on hand hygiene, cough etiquette, and signs of infection
- Environmental cleaning schedules that prioritise high-touch surfaces
- Collaboration with general practitioners, pharmacists, and pathology services
Organisations like the Aged Care Quality and Safety Commission set regulatory expectations that facilities must meet, particularly around outbreak response and hygiene practices.
Final Thoughts
Preventing infection in aged care is not just a healthcare requirement—it’s a moral obligation to protect some of the most vulnerable members of our community. With the right knowledge, hygiene practices, and workplace culture, we can create aged care environments that are not only safe but dignified and compassionate.
References
- Australian Institute of Health and Welfare (2023) Older Australians. https://www.aihw.gov.au/reports/older-people/older-australians
- Australian Commission on Safety and Quality in Health Care, 2023. Australian Guidelines for the Prevention and Control of Infection in Healthcare. [online] Available at: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/australian-guidelines-prevention-and-control-infection-healthcare [Accessed 19 Jun. 2025].
- Australian Commission on Safety and Quality in Health Care, 2024. Infection Prevention and Control in Aged Care. [online] Available at: https://www.safetyandquality.gov.au/our-work/infection-prevention-and-control/infection-prevention-and-control-aged-care [Accessed 19 Jun. 2025].
- Australian Government Department of Health and Aged Care, 2024. Infection prevention and control in aged care. [online] Available at: https://www.health.gov.au/topics/aged-care/managing-respiratory-infection/infection-prevention-and-control-in-aged-care [Accessed 19 Jun. 2025].
- WorkSafe Victoria, 2024. Injury hotspots – Aged care. [online] Available at: https://www.worksafe.vic.gov.au/injury-hotspots-aged-care [Accessed 19 Jun. 2025].
- Aged Care Quality and Safety Commission, 2024. Aged Care Quality and Safety Commission – Home. [online] Available at: https://www.agedcarequality.gov.au/ [Accessed 19 Jun. 2025].