No time to be “in the moment” with dementia residents

New research has found that aged care staff need to be 'in the moment' for residents with dementia to have quality care. However, this kind of meaningful engagement is challenging due to staff shortages, workforce demands, and time constraints.

The study, by HammondCare, surveyed a group of frontline staff caring for residents with dementia in three residential aged care homes in NSW about their experience regarding 'being present'.

The study found that being present with residents living with dementia was vital to avoid "poor care practices and resident outcomes".

Participants in the survey consistently said being present was the most enjoyable and rewarding aspect of the demanding role.

"Practicing presence and spending focused time with residents helped care workers to see different aspects in residents who were regarded as difficult to care for," the report stated.

Researchers found two main themes emerge from the respondents.

The first was meaningful engagement, which needs a connection of trust, which can then be maintained through reliable relationships over time with residents.

This is, however, difficult to achieve due to a transient workforce, staff attrition, and changes to restrictions on foreign workers during the pandemic. 

No time to be 'present'

A University of Technology Sydney report found only one in ten residential care facilities in Australia could meet the staffing requirements needed to meet quality care standards.

The aged care sector is projected to have a staffing shortfall of nearly 140,000 workers by 2024-25.

Last week, the final public hearing into the role of permanent migration in nation building looked at how migration strategies would be able to address the workforce shortages in the sector. 

Maria Jockel, global immigration leader and expert, said adopting the Essential Skills Visa was a "bleedingly obvious" solution.

"All the papers provided to government, be they from CEDA or other sources, show that the Australian demographics are such that we will continue to rely on migration as both an economic and a population tool," she said.

"The Intergenerational Report has projected a doubling of 65-year-olds, tripling of 85-year-olds, and centenarians increasing sixfold.

"Health and aged-care spending as a share of GDP is projected to increase to a total of 3.4 per cent while at the same time the number of taxpayers is halved. This is just not sustainable."

Extra staff the answer

The second theme that emerged from the HammondCare study was care workers' presence required an appropriate organisational structure, supporting resources and adequate staffing levels to ensure that care workers were able to pay attention to individual residents.

One of the participants described a noticeable improvement in resident engagement when she was an additional staff member on a two-person shift due to being on reduced duties following an injury.

Other study participants said they had similar experiences, including reduced behaviours associated with dementia when there was extra staff to help.

Researchers recommended strategies to improve the capacity of staff to be present, which included adequate staff-to-resident ratios, education, training, and coaching for care staff, and regular reminders about practising presence. 

"Regulatory bodies, governments, community groups, and residential aged care homes need to collaborate to ensure appropriate funding and resources are available to enable care workers in residential aged care homes to be more present and provide person-centred care," the report said.

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