Understaffing is leading to residents missing out on recreation

A landmark study reveals leisure in aged care homes has become a last priority as an understaffed workforce struggles to meet residents' basic physical needs.

In surveying three aged care homes, researchers found that unbalanced staff-to-resident ratios resulted in residents being excluded from joining in with recreational activities.

Lead researcher Sharon Stoddart from the University of Tasmania says leisure needs to become a matter of priority again.

"Physical care is great, and it's vital, but psychosocial care is equally as important.

"And leisure is related to that."

The study investigates a rarely researched topic, showcasing people's experiences at the coalface of care.

Leisure in aged care homes can include large events such as bingo, art classes and dancing, and as small as having a casual five-minute chat with another resident. 

Yet, staff voiced that high workloads, competing role demands and staffing issues formed significant barriers to providing leisure for residents. 

"There's no time, according to the participants," Stoddart says.

"One said, 'by the time you start … by the time you get everything done, it's almost lunchtime, so there is no room [to provide leisure activities]'.

"Our research shows that staff had multiple responsibilities and were overworked, so leisure was not a priority to them – physical care, nutrition and hygiene was."

CompliSpace's recent report backs up Stoddart's finding that staff are toiling to meet residents' primary care needs, with nearly 60 per cent claiming it's impossible to achieve the recommended care minutes. 

A staggering 94 per cent said their workload had increased due to Covid regulations.

"So, given that prioritisation for leisure was low, the thing that was missed when they were short of time was leisure delivery," Stoddart says.

"In particular, residents who need assistance were likely to miss out on leisure activities." 

Staff identified transportation issues as a barrier for residents to engage in activities, especially those living with dementia or who are wheelchair-bound.

They said the combination of a resident's ability and the limited time available to staff caused some residents to lose the opportunity.

"There was this sort of hidden task of transporting residents from their room to the venue where leisure activities were being held," Stoddart says.

"In particular, at the end stages of dementia, when capabilities are greatly reduced, staff reported that some residents had nothing to do. They did not have leisure."

Still, most staff agreed leisure was an essential part of providing care.

The Royal Commission's 2021 report recommended that, as part of high-quality care, staff should 'support the person to participate in recreational and social activities and engagement'.

Stoddart says that leisure can be undertaken in an incidental way, such as a five-minute conversation or looking through a newspaper.

"If you conceive leisure in that way, then it can be done in five minutes by somebody who only has five minutes to spare," she says.

Stoddart says that when activities were scheduled in advance and management and staff were provided with resources, it also enabled recreational activities.

"When volunteers were present, or staffs' role was solely focused on leisure, people could prioritise these activities," she explains. 

"Which, I think, fits in with the way residential aged care is funded – the bottom line is funding."

Stoddart says residential care is fixed on clinical needs and dependency, whereas it should shift towards psychosocial care and become more needs-focused.

"When funding is focused on clinical needs, you will see that emphasis all the way down to residential care and how they deliver care."

Stoddart suggests we should rethink what leisure consists of and how it needs to be provided.

There's a lack of knowledge about what's going on for leisure in residential aged care at the moment, she says.

"It's an invisible field, and what needs to be done is to have light focused on it.

"Leisure needs to be highlighted. It needs research. It needs to be understood for what it is." 

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