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Dealing with difficult pasts

A new resource helps staff better care for the growing number of residents from different cultures who have experienced torture and trauma.

The need for new resources and supplemental training around trauma is great. In Western Australia, where the material was developed, nearly two-thirds of providers initially surveyed had assisted culturally and linguistically diverse residents who had experienced the effects of trauma. These had shown up in a number of ways, the most common being depression, anxiety, aggression, withdrawal and sleeplessness.

The Department of Health and Ageing funded a partnership of the Association for Services to Torture and Trauma Services (ASeTTS) and the Multicultural Aged Care Service WA (MACSWA) to research and then develop information, training and consultancy to aged care providers and health professionals about working across cultures, and recognising and managing symptoms of trauma in their clients.

Based on the evidence gathered in the initial survey, a training module was developed and trialled in WA with residential aged care workers to ensure the information was pitched at the right level and that the combination of activities and teaching methods was suitable.

Following this, the department provided funding to conduct training workshops with trainers from the Partners in Cultural Diversity in Ageing (PICAC) agencies, trauma agencies and aged care service providers in each state. The draft training materials were piloted for further development in August 2008 in Brisbane and national workshops with the training package followed.

Jan Mantell, from ASeTTs, says feedback from workshops was useful and positive.

“Participants reported the increase in knowledge and awareness had a direct impact on client care,” she says. “There had been a shift in attitudes towards culturally and linguistically diverse clients with challenging behaviours, and staff were more willing to take time and develop rapport with clients.”

The workshop participants developed an understanding of the differences and similarities between dementia and Post Traumatic Stress Disorder, which resulted in staff looking at behaviours in more depth, Mantell says.

“Often feedback comments were to the effect that the training should be made compulsory for all staff and volunteers to complete and some even thought it could have been longer and in more depth.”

The training workshop developed for aged care providers is consistent with the principle of continuous quality improvement promoted by the Forum of Australian Services for Survivors of Torture and Trauma (FASSTT) National Standards (3.9) and those of the Aged Care Standards and Accreditation Agency.

The workshop will assist staff to meet expected outcomes established by the Accreditation Agency, particularly the expected outcomes included in Accreditation Standards two and three.

The training package aims to:

• provide materials for trainers in the health and aged care sector to facilitate education and staff development consistent with expected outcomes of the Aged Care Accreditation Standards and FASSTT standards

• challenge attitudes towards diversity through raised awareness of cultural differences and similarities

• provide information and activities which build on participants existing skills; and

• assist participants to provide appropriate support to people from diverse backgrounds who have experienced trauma.

The materials are aimed at raising the awareness of aged care providers including those working in residential and community care and assessment of older people requiring services.

There are two workshops: the three hour workshop is suitable for residential and community services workers providing direct care including residents of aged care facilities, while the two hour session is designed for allied health professionals involved in assessing the needs of older clients including residents of aged care facilities.

The question of workshop facilitation is important. “As the main focus of the training workshops is on trauma and its ongoing influence in the lives of those who have experienced it, we recommend a partnership approach to ensure that the skills, experience and knowledge of aged care providers and torture and trauma services contribute to the workshop,” says Mantell.

“The nature of trauma is such that triggers to traumatic memories may occur in everyday events including participating in training. This needs to be considered when conducting the training workshops. A facilitator with clinical experience is particularly useful when conducting the allied health workshop.”

This led to the Partners in Cultural Diversity in Ageing (PICAC) agency and the member of the Forum of Australian Services for Survivors of Torture and Trauma (FASSTT) in each state facilitating the national training sessions.

Co-presenters Mantell and Sheryl Stone from MACSWA conducted the training sessions in WA and nationally. These took place between February and April, 2009.

The training materials are at www.culturaldiversity.com.au. Organisations wanting to access training for their staff need to do so through the PICAC agency in their state.

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