More than 90 per cent of aged care staff had been subject to some form of aggression from residents, such as hitting, kicking, pushing or verbal abuse, according to a survey by the New South Wales Nurses and Midwives’ Association.
Some 29 per cent of 282 respondents said they had witnessed resident-to-staff abuse as often as once or twice a week, while 20 per cent said they saw resident-to-resident abuse at the same frequency.
The survey did not ask respondents whether they had witnessed staff-to-resident abuse.
The union said its findings were consistent with rates reported in research in Europe and Canada, suggesting the phenomenon was not unique to Australia.
In 2014, a survey of 269 nurses by Australian Catholic University found that 36 per cent of respondents reported being physically assaulted by a resident or family member in the past five shifts, a similar number reported experiencing a threat of assault and 29 per cent reported being emotionally abused.
The union’s report survey said staff who were constantly at risk of abuse from residents could become emotionally distressed and detached from residents, reducing their ability to provide person-centred care which was essential in the management of challenging behaviour.
Some 61 per cent of respondents said they feared repercussions if they reported an incident of assault, which the union said was consistent with previous research undertaken with assistants in nursing that found they feared they would be blamed for the incident or found management unresponsive to their concerns.
Resident-to-resident aggression could have a significant impact on both residents and staff. While it was acknowledged that managing aggression was one of the most challenging areas for staff, many facilities lacked guidance in this area, the report said.
While screening tools had value in the identification of the risk of aggression, and could be undertaken as part of the admission process, there was little evidence they were being used to inform staffing and skill mix within aged care, it said.
The reporting of elder abuse required urgent change, the report concluded. It called for better staff training and the establishment of a “federal regulatory framework” to give aged care providers clarity in what constituted elder abuse and the expectations for staff training and reporting systems.
Initiatives such as the Dementia Behaviour Management Advisory Service added value in this area but more could be done to identify, assess and manage complex behavioural issues associated with dementia within the workplace.
“Increased staff awareness through the development of specialist training and support roles within facilities and through peripatetic services could have value in assisting aged care providers and staff to manage challenging behaviours. However, good care comes at a cost and appropriate staffing resources are required to ensure strategies are effective and residents are adequately assessed and supervised.”
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