Aged care workers say inadequate time to complete tasks, lack of supervision by skilled registered nurses and poor training can all contribute to elder abuse in residential care.
That’s according to Helen Macukewicz, senior professional officer at the Australian Nursing and Midwifery Federation NSW Branch.
“Our members consider that a chronic shortfall in staffing numbers and inadequate skills mix means that elder abuse is prevalent in residential aged care,” Ms Macukewicz told Australian Ageing Agenda.
Ms Macukewicz is offering a workforce perspective on elder abuse in residential care at this month’s National Elder Abuse Conference in Sydney.
Three quarters of surveyed members said an insufficient number of staff increased the risk of elder abuse in their aged care workplace, according to the ANMF NSW branch 2016 report on elder abuse in residential care.
Nearly half of respondents said the wrong mix of registered and enrolled nurses and care workers (47 per cent) and inadequate training on elder abuse (46 per cent) also increased the risk of elder abuse in their workplace.
Last June the Australian Law Reform Commission’s elder abuse inquiry proposed a new benchmark for adequate staffing levels in aged care and more extensive employee screening among 43 recommendations, 14 of which involved changes to the laws governing residential and community aged care (read that story here).
Ms Macukewicz said the ever-reducing presence of registered nurses in aged care coupled with the rise in unlicensed care workers, who are often lacking in sufficient training, was “a recipe for disaster”.
“It is impossible to disassociate safe staffing from safe care,” Ms Macukewicz said.
“Our members tell us they are often the only registered nurse for up to 200 people across multiple sites. There would be an outcry if this situation was occurring in a public hospital, yet our elderly, with complex care needs, are seemingly unworthy of equivalent staffing requirements,” Ms Macukewicz said.
Unsafe medication management practices in aged care is another area of concern, according to a recent member survey, she said.
The Commonwealth Aged Care Act 1997 was meant to underpin safety in residential aged care but its use of terms such as “sufficiency” and “adequacy” provided little guidance to assess compliance in the absence of mandated quality benchmarks and was open to challenge by providers, Ms Macukewicz said.
She said the law needed to clearly mandate the staffing and skills mix requirements for facilities, including for the management of medications.
“There must be clear evidence-based benchmarks to determine the level of staffing at which the facility must not operate below, to ensure medications are overseen by registered nurses, and to determine individual quality care markers,” Ms Macukewicz said.
“Unless there are mandated staffing and skills mix requirements for aged care, any system designed to enhance quality and reduce the incidence of abuse will fail.”
The 5th National Elder Abuse Conference takes place on 19-20 February at the Sofitel Sydney Wentworth.
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