Residential aged care staff are still struggling to manage clients with dementia, despite increased research available on the subject, due to a simple lack of time and resources.
The three most pressing issues facing residential aged care services in Australia remain the same as they have for decades: workforce inadequacies, lack of funding and challenges managing residents with dementia, revealed a survey among services in Victoria, which authors say reflects literature on the country as a whole.
The overwhelming issues around workforce were not a surprise for survey co-author Jo-Anne Rayner, but she told Australian Ageing Agenda she did not expect the management of responsive behaviours to be such a pressing clinical issue.
“I was surprised at this one because there is a lot of information and research out there on dementia at both a state and federal level and through organisations such as Dementia Australia,” said Dr Rayner, a senior research fellow at La Trobe University’s Australian Centre for Evidenced Based Aged Care.
“But I think the translation of that research is the problem. I don’t think nurses and personal care workers in aged care have the time to actually read this information and see what evidence is out there.
“And that’s down to a lack of staff and a lack of funding, so all three issues highlighted in the survey are inter-related.”
The survey was the first in Australia to look at research priorities in residential aged care. All 754 Victorian residential aged care facilities were invited to list the three most important areas where they would like more research, with 162 participating.
Findings highlight the urgent need for workforce reform, including improved nurse-to-resident ratios and wage parity with other sectors, and adequate funding to ensure this happens.
Ms Rayner said while residential aged care is becoming more complex and challenging, the proportion of registered nurses is falling and personal care workers, who provide the bulk of direct care, are inadequately trained.
“If we’re not committed to providing people with the ongoing education and training to look after people who have complex needs then we’re going to end up with problems continuing,” she said.
“Residents are older, they’re frailer and more of them have dementia. I think we need to acknowledge that aged care is a specialist area these days; most residents require 24-hour care and support.”
In this high-pressure environment, it is little wonder responsive behaviours among residents with dementia are problematic, she said.
“If you’re trying to look after elderly people who have multiple chronic diseases, including dementia, you’d can’t rush them; you need time. But staff are continually stretched to get the work done. They can’t sit down and talk with residents.”
Additional funding could provide meaningful activities for those with dementia, as well as higher numbers of experienced staff, the research found.
Even if they could afford more experienced staff, the sector is having trouble attracting them, particularly in regional areas. This, according to the survey, was down to the poor image of a sector blighted by low wages, an ageing workforce, and less-than-glamorous tasks, demanding workloads and high stress levels.
“We really are an ageist society,” said Ms Rayner. “Childcare services is much more emotive. What is being done to entice younger nurses to aged care?”
Access the research, which was published in the Australasian Journal on Ageing, here.
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