The aged care sector needs to recognise the effect compliance measures are having on workers’ wellbeing, a psychologist has told Australian Ageing Agenda.
“There is an impact of regulation on workforce mental health,” said Sue Jauncey, founder and CEO of Appellon – a provider of research-backed workforce engagement programs.
In a position paper, Ms Jauncey argues that government regulation can generate both positive outcomes and “unforeseen negative consequences”.
“Everything is all about the compliance and the task – ‘you must do this’ and ‘you must do that’ – and that compliance has been increasing over a period of time,” Ms Jauncey said.
Highly regulated and compliant environments can affect job satisfaction, she added, which creates issues with staff retention and higher rates of staff turnover.
“Regulation can cause staff to feel they’re under continuous scrutiny, producing a sense of fear and anxiety.”
Ms Jauncey told AAA: “As you increase legislation you also increase the phenomenon called learned helplessness.”
This, explains Ms Jauncey in the paper, manifests itself when workers experience repeated stressful situations, “where, depending on predisposition, individuals feel unable to control their environment, no matter what they do.”
Learned helplessness most notably occurs in highly audited industries such as aged care, said Ms Jauncey.
Not that she’s against compliance. “Should we have some regulation? Yes. You’re always going to get people who make mistakes with medications – it’s going to happen because it’s human beings. And we are going to have some people come into the industry that don’t treat people in the way they should.”
However, Ms Jauncey told AAA there’s a danger over-regulation of the aged care sector will increase cases of learned helplessness – “And what risks are associated with that?”
As Ms Jauncey lists in her paper, the risks include:
- workers normalising stress and operating in a fight or flight mode
- workers disconnecting from their colleagues
- lower job satisfaction
- loss of self-esteem
- burnout and fatigue.
Rather than overly focus on compliance and complaints, Ms Jauncey would like to see the sector instead focus on all the good that’s being achieved.
“If I went into a site and I showed you all the positive events that are occurring and what residents were saying versus the number of complaints that have been recorded against sites for whatever reason, the positive events far outweigh the number of complaints.”
What is needed, said Ms Jauncey, is a shift in narrative. “If we just start to change some of that story there will be a natural adjustment and if we do that, will we need to keep piling on the regulation? No, we won’t … The more we show what is being achieved on a daily basis residents’ wellbeing goes up, staff wellbeing goes up, performance starts to improve.”
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I am all for “positivity”. However the issue which impacts aged care staff the most is that the expected tasks or workload in aged care far exceeds the time allowed for it to be carried out. The pace at which staff are expected to work is dehumanising for both staff and their care recipients. That, above all, is what causes stress and a lack of job satisfaction. Until staff are allocated full 8 hour shifts instead of short shifts and the clerical/charting and administrative tasks are factored into the care workload staff stress and dissatisfaction will remain a factor in staff attrition and burnout.
This is a timely reminder for providers of aged care services to shift both practice and narrative regarding regulation: as the Royal Commission so clearly demonstrated, there are good reasons for regulation! In the case of residential aged care, people enter when their health and care needs are no longer able to be met living in the community, they don’t enter as a ‘lifestyle choice’ like so much of the rhetoric and branding suggest. Why do we never hear the level of complaints about regulation from those working in traditional ‘health’ services, which are far more highly regulated? Perhaps we need to accept that aged care is really health care – non-acute, perhaps, but health care nonetheless – particularly given the high levels of dependency in the resident population, and the estimated one-third of residents each year who require end-of-life care.
Thank you, Sue Jauncey. Where can I find a copy of this position paper?
Fantastic article, well done. Absolutely correct. Not that anything will change, as more gets piled on and the quality agency gets more punitive. Managers and staff are now so bogged down in this stuff that it is stifling innovation and a more relaxed environment to work in.
The previous comments are right; aged care IS healthcare. We’re looking after very frail and very unwell people at the end of their life (even though all the brochures would have us believe they’re couples in their 60’s casually strolling along the beach)
The latest ACQSC review has identified exactly what all previous reviews have found…they’re just not up to the task. Their response? Typically, they’ll ramp up the noncompliance findings and punitive actions (Look! We’re doing great work!).
The report identifies a siloed, toxic culture that lacks the skills needed for their remit…and we’re all bearing the brunt of this dysfunctional regulator. There’s no point in changing the acronym if the main players remain the same.
Aged care regulation is farcical; the ACQSC’s helpful guide to the standards is 198 pages long! A result of successive governments’ hand-wringing and misguided attempts to ‘fix’ aged care.
The latest round of reforms (really?) are just window dressing. It looks like ‘something is being done’, but it’s just bashing us over the head with more regulation that will keep us off the floor for longer. Personally, I’d be happier knowing my mum was being cared for by well trained, competent and compassionate professionals rather than how the provider is stacking their Board