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Practical strategies can help staff prevent mental illness in residents


Mental Health in residential aged care is a shared responsibility, writes Dr Julie Bajic Smith.

In our younger years, our emotional wellbeing is ultimately our responsibility. It is up to us to when we speak to a trusted individual about any changes in our emotions, and to determine when we may need to seek professional help.

However, as we age and face changes in our health status, support network and potentially our environment, it must be questioned whether it is still an individual’s responsibility. Particularly when older people are less likely to talk about their wellbeing.

Julie Bajic Smith

Instead, we need to ensure that the aged care workforce is well informed about emotional changes in late life, signs and symptoms of depression as well as preventative measure that can boost wellbeing in late life.

This approach could assist in improving the clinical outcomes in late life.

As an aged care psychology consultant, I am well aware of the challenges older people face when they enter residential care.

This includes the initial adjustment period, diminishing independence and days in between.

How we support the elderly through an admission can have profound effects on their adjustment, ongoing wellbeing and mental health outcomes.

We know from Government research data that one in two residents experience symptoms of depression and that the highest rate of suicidality is in men aged 85 and over.

Other Australian research tells us the elderly are the least likely age group to use mental health services with less than a quarter accessing support.

However, when we discuss mental health in residential care we still shift the focus to severe challenging behaviours. We document the referrals made and the steps taken with our local hospitals rather than look at ways to integrate evidence-based psychosocial strategies on-site.

This includes practical strategies in how to assist those clients who may experience grief and loss, adjustment difficulties and milder forms of the most common mental health conditions, such as depression and anxiety.

This gap highlights the greater need to holistically improve the quality of emotional care delivery.

This includes focusing on incorporating strength building activities, such as reminiscence during care delivery, incorporating resilience skills in group programs and looking at the ways we can ensure that clients feel they are valued and contributing to society.

Strategies need to be:

  • easy to learn and implement
  • practical and easily transferable to real case scenarios
  • used on a regular basis.

Trial new resources

I am developing a resource to help prevent and detect mental health issues among residents and provide non-drug interventions.

The manual provides a reference point in how to deal with day-to-day situations where clients are isolated, reluctant to use aids or where their mental health status is impacting their ability to adjust to living in care.

It also provides information on the outcomes of screening measures and when clients may require additional support, as well as strategies on how to work with families and maintain resilience in the workforce.

I am seeking volunteer aged care facilities to pilot this resource at no cost to providers.

Email julie@wisecare.com.au for more information.

Dr Julie Bajic Smith is an aged care psychology consultant.

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5 Responses to Practical strategies can help staff prevent mental illness in residents

  1. Kaye Mann October 24, 2019 at 6:26 am #

    Hi Julie

    Love your article in Aus Ageing Agenda. So much need for practical solutions to mental health in RACS.

    I’d like more info on your workshops & manual to refer to our clients & also self interest.

    Thanks for your dedicated work on this subject piece.

    Regards

    Kaye Mann

  2. Julie Bajic Smith October 24, 2019 at 2:02 pm #

    Hi Kaye,

    Thank you for your message. I can send you more information if you would please provide me with your email address or contact me julie@wisecare.com.au

    Warm regards,

    Julie

  3. Caroline October 24, 2019 at 6:50 pm #

    While I applaud the need to address mental health issues in older people beyond ‘challenging behaviours’, I am resistant to RACF workforce being responsible to ‘boost wellbeing in late life’. This workforce is already burdened by care responsibilities, nursing demands, administrative demands and their own internal struggles.

    When we shift responsibility for mental health of older people to RACF staff, we don’t give mental illness its right of recognition. What might be more appropriate is to recognise that older people will suffer some grief and associated sadness and depression as they experience a loss of known familiar surroundings and control of their environment for something where they have less control. That support should be the domain of counsellors who should be funded to support older people to transition into new care environments so that RACF staff can focus on what they do best, clinical or non-clinical tasks.

    I’m a loud voice for counsellors in any aged care space so I do not deem it appropriate for the aged care workforce to be responsible for the mental wellbeing of older people.

  4. Julie Bajic Smith October 25, 2019 at 1:52 pm #

    Caroline, I completely agree with you about the need for more mental health professionals in aged care. About 5% of psychologist work in aged care. The intention of training is not to upskill the workforce to treat mental health disorders.

    My project is focused on upskilling the aged care workforce to have better engagement with clients – so they know what to do when the client refuses to leave the room, how to escalate concerns to mental health professionals and deal with workplace grief and loss.

    All this comes down to better understanding on how to incorporate simple strategies into care delivery to make their job easier and more enjoyable.

  5. Anonymous October 30, 2019 at 1:40 pm #

    A needed service for families before getting into the system of aged care where many are put on a waiting list which causes more issues for not the person but all others involved in their care

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