Supporting staff to cope with adversity

As part of their role supporting older people, aged care workers are being exposed to trauma daily. That’s because most aged care recipients are experiencing something traumatic – such as health issues, behavioural challenges, feelings of loss or grief or nearing the end of life.

Adding to the challenges is a lack of awareness about the impact this trauma has on aged care staff and support to cope.

Concerns about how another person’s trauma was affecting her staff were front of mind for Milly Kuranage – residential aged care manager at Brotherhood of St Laurence Aged Care – who took some of her team to a training session on preventing vicarious trauma with The MacKillop Institute earlier this year. She’s recommending others do the same.

“It creates a respectful, kind and consistent workforce and better care for the people in our care,” Kuranage tells Australian Ageing Agenda. “It promotes kind, respectful and honest behaviour, keeps people receiving aged care from harm and lowers risk of staff burnout, work-related stress and personal leave.”

At the provider’s Clifton Hill aged care facility in Melbourne, many clients have come from a homeless or low-income background and many have one or multiple mental health conditions.

Kuranage says something happens every day and, while it comes with the job, there should be support for staff. “It’s not very well spoken about and it’s not very well recognised,” she says.

Which is why she felt inspired and hopeful when she heard The MacKillop Institute’s Cameron Burgess speak about the training at a conference.

“We do a lot of work around combating vicarious trauma in the community services sector. But the royal commission into aged care and Covid identified that within that sector they’ve been through an awful amount of adversity,” Burgess tells AAA.

“We thought there’s probably a good need for their workforce to be resourced in understanding this idea that they’re involved in emotional labour. And there are impacts of that emotional labour.”

Burgess is the professional learning centre’s national program director of Sanctuary – a workplace culture-change program that teaches people how to cope more effectively with adversity and stress. The model also aims to prevent trauma symptoms and incorporates the program Kuranage and her team participated in.

The program – Combatting Vicarious Trauma in the Workplace – is not specific to aged care but sessions are tailored to participants. Ideally the training is delivered face-to-face over one day, says Burgess.

“The aim is to help staff understand that they are exposed to trauma and adversity in their roles.” he says. For aged care residents, for example, that might include losses of physical environment, autonomy and identity, and rumination on unresolved and troubling experiences.

“The people that often hear those ruminations are, of course, the aged care staff themselves. So when you couple some of these dynamics of a fairly stressed workforce, people coming into aged care having experienced trauma and loss, ruminating on their [past] and the end result for any resident that they’re going to pass on, you’ve got a workforce who are facing some fairly unique challenges.”

The day involves naming the things that come up in a bid to empower staff, adds Burgess.

“We talk about the fact that, in the same way that residents might be experiencing stress and behaviours that result from some of that adversity, staff can find themselves behaving in the same ways.”

Such as feeling like they never have enough time or control over their circumstances, he says. This leads into talking about vicarious trauma.

“And that’s this idea that the impact of hearing someone else’s story or the impact of seeing someone else go through a traumatic event can have the same impact on the worker, as if they’ve experienced that themselves.” This can be “incredibly validating for staff” because no one usually talks about it, says Burgess.

There are impacts of that emotional labour

Cameron Burgess

But key to the day, he says, are the strategies and tools for staff and management to manage, moderate and potentially mitigate the risks of vicarious trauma. And that’s all residential and home aged care workers – not just care staff – stresses Burgess.

“It’s for anyone working in aged care,” he says. “We know from some research often the people that residents feel closest to in an aged care facility is the cleaner,” he says by way of example. “And they’re often the forgotten staff members who benefit from understanding some of these dynamics.”

With legislation and laws around managing psychosocial risk changing, it is also particularly helpful for managers to understand these dynamics and how to create a healthy, well-resourced workforce, Burgess adds.

Strategies for coping

Among the learning outcomes is being able to identify the signs of vicarious trauma early – in themselves and their co-workers – and intervene to protect against it.

“One of those strategies is strong peer support, which is critical,” says Burgess. Others include good supervision or resolution of personal issues. “But of all of those proven intervention strategies, the most powerful is the social support experiences within a team.”

That’s about “feeling empowered to say ‘Look, I’m finding this pretty challenging’ and have your peers validate that, but then direct you to a personal safety plan.”

During the session, trainees develop a personal safety plan with three activities they can do in the moment to regulate themselves when they’re feeling overwhelmed.

“We encourage teams to adopt a safety plan across their team on the back of the day that we’ve spent together. Because it is that ability to have shared language and say, ‘Hey, can I cover you while you activate your safety plan?’ Or ‘is there something in your safety plan that could help you, right now?’”

They’re simple things, says Burgess, like stepping away and using breathing strategies or looking at a photo of family or something to help ground the individual.

I can see them prioritising acts of self-care

Milly Kuranage

The second tool trainees take away is a self-care plan. That looks at the holistic health of the worker, and begins a conversation around resilience, says Burgess.

“People observe areas where they’re strong and where they’re weak. And then we encourage them to build some actions into strengthen areas where perhaps they’re not looking out for themselves,” he says. “That act is going to help them have sustained, longer careers in this sector because they’re looking after themselves first and foremost.”

The training has been well received by Brotherhood of St Laurence Aged Care staff, says Kuranage – who has seen participants put the strategies to use at work.

“I can see most of my staff who attended the session wearing the safety plan card that we created during the training; having it documented was something they really enjoyed. We have a park just outside the facility, I can see them going for walks more often and I can see them prioritising acts of self-care.”

Everyone benefits, says Kuranage – who personally got out of it “confidence knowing that support systems are available, ability to manage workplace challenges and increased flexibility in work schedules.”

She tells AAA her team members who participated have “increased confidence in support systems, ability to depend on each-other for support and increased confidence to utilise personal safety plans.”

For the residents? “A happy confident workforce caring for them, meaning that they receive better care.”

We hope you enjoyed this article – please add your comments below
Visit our features section for more in-depth stories