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Providers told to involve residents in all care decisions


Aged care providers need to focus on engaging residents in their care rather than just approaching family members, an industry conference heard.

Mark Brandon, chief policy and regulatory officer at Estia Health, says it is important for providers to listen to residents’ perspective of the care they want if they are able to communicate for themselves.

“Wherever possible, we need to go back to the resident,” Mr Brandon told delegates at the Governance in Aged Care conference in Sydney last week.

Mr Brandon said providers often spoke about family members of a resident, which excluded the resident having a say in their own care.

It is not reasonable to exclude someone from input to the care just because they are struggling to communicate, and often family members may think their loved one wants one thing, but often the resident wants something else, he said.

Mr Brandon said residents should always be involved in the care process.

Mark Brandon

“You don’t need to be able to be able to communicate with someone to know if they like the food, they usually would just push the food away,” he said.

“I don’t think there is a stop point, you always keep trying,” Mr Brandon said.

Having a sense of control over their care is important to residents, he said.

Mr Brandon said residents’ value staff skills, positive relationships with staff, the presence of permanent staff and consistent and routine care.

It is also important to see residents a partner in care, rather than a care receiver, to improve their quality of life, he said.

Aged care providers are ultimately responsible for the health and care of the resident in all instances, Mr Brandon said.

“Our first duty is to the resident, and sometimes it’s about protecting the residents from their families.”

Mr Brandon told conference delegates about a family member who demanded their loved one be restrained in a chair.

“You don’t restrain someone just because someone else has told you to,” he said.

“Aged care is a relationship-based activity where the needs, expectations and aspirations of residents are paramount,” he said.

The Governance in Aged Care conference took place at the Sydney Boulevard Hotel on 29-30 May.

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7 Responses to Providers told to involve residents in all care decisions

  1. Frances Hessing June 7, 2019 at 1:33 pm #

    Nice words Mr Brandon and very easy to say, you have managers that don’t want to listen to staff or residents so as your making the statement look to yourselves firstly.

  2. Rosemary June 7, 2019 at 2:46 pm #

    Yes residents.should be consulted about their care ,unfortunately many are not able to communicate appropiatly but efforts need to be made to explain treatment and residents must be treated with respect and not talked down to.also the practice of holding conversations with other staff while attending the resident and not including them in the interaction is unprofessional and has to be addressed.

  3. Jenny Tarrant June 8, 2019 at 5:22 pm #

    As a manager in residential aged care for many years I have become exhausted advocating for residents against their families, often daughters who believe that now that mum or dad has entered a residential care facility they get to make all the decisions. Often if you go on the side of the resident, the family member will then make you the enemy and try every trick in the book to bog you down in complaints, and even though the complaints section of the agency can see the vindictiveness of the family members, they still need to cover themselves and make you jump through the hoops. Often it is easier to let families do what they want, as it saves you the angst, but this is not in keeping with resident rights or our roles as advocates. This is a huge issue across the industry, and the Accreditation staff often look at your complaints record and speak to vocal families who are out for payback may then develop a biased attitude, not realising of course that you have gone into battle for the residents. Doesn’t pay to stick up for your residents sometimes against these families who have nothing better to do after retirement than feel guilty about not being able to care for mum or dad themselves, expect one on one care, then nit pick and create some action for themselves by abusing staff, managers, and playing games with the Quality Agency.

  4. Janet Pearce June 8, 2019 at 6:18 pm #

    Thank you Mark, ask the resident, yes, people first.

  5. James June 9, 2019 at 2:49 pm #

    In my experience the vast majority of staff try to always involve the resident. The problem is bullying from families, not all of course, but you always have the few that cause all sorts of problems if you try to stand up to them. In a hospital you may only deal with these people for a few days, in residential care it can be a few years until the person passes away, and the staff are sad to lose the lovely resident but not the family. Often residents have said to me “just do what my family want, not what I want, as I don’t want them to get cranky with me or you”. Even senior managers have said to us, to not upset difficult families by doing what the resident wants as they will make something up and make a complaint to the Quality Agency, who have to follow it up, even though all know it is false, but it still red flags you with the Agency, who then may lob in on your door one day because of it. Damned if you do, Damned if you don’t.

  6. Robyn D June 10, 2019 at 9:06 am #

    I totally agree with ensuring residents get the choices, unfortunately many families take it upon themselves to try to make all the decisions, and staff end up in a daily struggle to know what to do, this continual bullying tactic can have very negative effects on staff and cause manager burnout. The example used of the resident being restrained in a chair at family request, I guarantee that if staff refused on the grounds that the resident didn’t want it, and the resident fell and broke a hip, then the facility would be hauled through hours of paper and time by the complaints unit and any other venue the family member could get hold of. They may be vindicated in the end, but at a huge cost in time and emotions to the manager and staff.

  7. Rosemary Blayney June 12, 2019 at 1:13 pm #

    I strongly agree with most of the above comments.I am a resident myself and am able to observe the attitudes of some families and heir unrealistic complaints.In my working life I worked in aged care and have never seen some of the disgraceful treatment of residents as seen on some programmes other staff would not have allowed it and shows lack of supervision on the part of those in charge,however generally the care in many places is good and when problems arise they can be addressed.Relatives need to spend a full day in a unit, particularly in a Dementia area, and. Observe the effort that is put in to care for the residents.Some of us as we age become demanding and unresionable and much time and patience is required.Hopefully with proper training this is dealt with but time is always an issue when staff numbers are limited. We tend to expect perfection and it will never be achieved.

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