Adequate staffing needed to combat resident abuse: workers
Aged care workers say inadequate time to complete tasks, lack of supervision by skilled registered nurses and poor training all contribute to elder abuse in residential care.
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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Here we are still talking about mandatory staffing levels in residential care. Senator Derryn Hinch attempted to introduce this in parliament and received no backing at the time. It’s a disgrace what is rife throughout many residential facitilities to the point that I would not place any member of my family in a residential facitily. I’ve heard first hand that a staff member was the only one rostered on to look after 60 residents and many are two person lifts. The EN on duty was on a 457 visa and had limited english and training. It’s disheartening to hear that residents are not able to receive adequate care and are neglected. My question is WHO is accountable? Does anyone honestly think that the management of the residential facility would do anything – No because they get away with it. It’s about time the Government realised that they need to do something now or there will be more ‘Oakden’ cases. Until there is mandatory staff levels which are checked with a minimum of two unannounced visits by the Accreditation Team every year and BIG fines imposed on those who don’t abide, then we are all wasting time and energy.
How many words must we listen to until we see action on the disgrace that is called Aged Care in Australia? Everyone in the industry, from RN’s to the newest careworkers , KNOW what is wrong – there is not enough staff on the floor. There is not enough trained supervision. There is little or no training being offered to care-workers new to Aged Care. And there is not enough funding from the government to address these issues. STOPTALKING and ACT, you people with the power!!!!!!
Totally agree with you Deidre
The real question is how much is the Australian public wanting to pay. How much more is the union rep willing to be taxed to provide the funding to meet the public hospital staff ratio? Anything is possible, One-to-one staff ratio if the Australian public agree to pay higher taxes to pay for it why not?
Until then I suggest the union rep for the Australian Nursing and Midwifery union either gets a part-time job in aged care to fill the shifts that no Australian nurse wants to fill or even better volunteer her time from her busy union rep duties to a under-staffed aged care facility so they could employ more.
End of the day no one wants to ask the real question “how much as a society are we willing to pay” for aged care.
I support the items from Helen Macukewicz’s letter.Adequate staffing levels & skill mix needs to be improved 100% to ensure residents receive quality care also staff should have training in falls prevention to reduce the incidence of residents admtted to hospital with fractures .Plus residents should have falls risk assessments. I also agree with & support Deidre ‘s comments of 2nd feb 2018.
I visited a nursing home on a daily basis for an extended period of time when a family member was a resident. I observed that safe care depended upon staffing skills and staffing levels. The residents had multiple health issues and often dementia prevented them from expressing their symptoms. A skilled and experienced Registerd Nurse was the vital link to interpreting a resident’s situation and obtaining appropriate treatment. Without this support residents would be extremely vulnerable.
I noted that many nursing assistants and aides appeared to have few skills and strategies , therefore no training , in dealing with dementia patients. For example , residents were often approached in a rushed and loud manner, provoking a startled reaction and or aggression.
The number of staff available at any one time greatly influenced the level of safety. I observed numerous situations in which there were falls because no staff supervision was available; residents were left in discomfort due to lack of staff; residents had to wait to be fed until the food was cold because no assistance was available
A skilled and appropriate staffing mix and an established ratio of residents to nurses is the only way in which vulnerable nursing home residents can be protected.
I know someone very close to me who works in a nursing home, high care, always short staffed, even when management is asked at residents’ meetings they make up some excuse just to keep everyone happy. 24 residents with 2 staff to attend to all needs – hygiene, feed and put to bed.
Our older generation deserve better………much much better! Their basic human needs are not being met, It seems that those in power no longer value our older people, because they no longer contribute to society. Shame……Shame……Shame on those who dictate what they believe is sufficient for them! Our older geneartion have lived their life honourably, many through very hard times paving the way so that we have it better. In childcare established ratios exist between workers and children….why not so in aged care? Please, please, please we need to look after the ones that looked after us!
Excellent review
I am committed by being a registered nurse who worked in nursing homes for 30 years to raise awareness of the issues of concern to government, media and the community.
Just talk, but nothing is done. Aged care workers are poorly paid compared to tradies even though the job is much tougher and mentally challenging. Aussies are selfish – they want to earn big money for themselves and have all the fun time, leaving others to take care of their elders with little compensation.