More education, training and advocacy is needed for the aged care sector to care for those with mental health issues and improve their quality of life, a leading expert has said.
Elizabeth Beattie, director of the Dementia Collaborative Research Centre: Carers and Consumers, said that despite recent reports and some promising action by government, mental health remained a critical concern for aged care, and one that would only become more pressing as the population aged.
Professor Beattie, who is also the director of the Queensland Dementia Training Study Centre at Queensland University of Technology, spoke on mental health and quality of life within residential aged care at the University of Wollongong this week, at an event hosted by the Australian Association of Gerontology.
The move to residential care was among the most significant and distressing life transitions, and one that could predispose people to depression, said Professor Beattie. For those with an existing mental health issue, or cognitive impairment such as dementia, the transition was arguably even more confronting.
Older people with a mental health diagnosis were often in double jeopardy, stigmatised by both their age and diagnosis. For those with additional issues of homelessness or substance abuse, the situation was likely worse, she said.
“While additional capacity is needed in the specialist mental health services, it’s critical primary health care and residential aged care also keep pace with population need and ensure people with mental health issues are identified and responded to appropriately,” she said.
Caring for those with mental health issues was complex, said Professor Beattie, which was not aided by the fact the industry lacked high quality data about who was currently living within aged care with mental health issues – including and excluding those with dementia.
Professor Beattie’s recent research looked at the quality of life for people with dementia within residential aged care and explored how a deeper understanding of the factors influencing quality of life may lead to sustainable improvements in care.
Presenting initial findings, she said staff in residential aged care often rated residents’ quality of life lower and depression higher than the residents themselves, and held fairly low levels of hope for people living with dementia, which may lead to poorer care outcomes.
She said investment in further training and education for all levels of the workforce was required for staff to have deeper understanding of mental health issues, and thus be able to offer high quality care and improve quality of life.
While the philosophy of person-centred care was positive, Professor Beattie said she took issue with its ‘uncritical uptake’ within residential aged care and said it was different to forming the sorts of therapeutic relationships that accompany high quality psychiatric and mental health care.
“Kindness is an extraordinary human quality; we must have that. But you also have to teach people where these diseases come from: what they are, how they manifest themselves, what are the histories of people who come in, what are the likelihood of these developing in certain environments if certain things don’t happen,” she said.
Unfortunately, Professor Beattie said that the current workforce climate made it difficult to facilitate the provision of high quality emotional and therapeutic care outside of the demands of providing physical care.
“How often do we know that people interact at any emotional level with people in residential aged care? How can that happen when the average nursing time, for example, is less than 11 minutes now per RN?
“We have to meet those fundamental needs, those physiological needs, while at the same time doing great emotional care.”
Professor Beattie said radical advocacy and strong leadership was needed on mental health within the sector, which must occur alongside peak organisations and professional bodies. In particular, she expressed concern that psychiatric and psycho-gerontology training seemed to be increasingly overlooked within university nursing studies, where future leaders would come from.
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