WE need to resurrect our aged care sector.

OK. Please take few moments to look at this. It is as important as heck.
The Australian Nursing and Midwifery Federation (ANMF) responds to the recent study into preventable deaths in the aged care sector:

New research showing that the number of deaths in nursing homes from preventable causes has increased by 400 per cent over the last 13 years again highlights the urgent need for mandated nurse and carer to patient ratios, according to the Australian Nursing and Midwifery Federation (ANMF).

The research, collated from the Coronial investigations into nursing home deaths over the past decade, was carried out by Monash University Professor Joseph Ibrahim and published in the Medical Journal of Australia. It showed the most frequent causes of death were:

Falls (81.5%);
Choking (7.9%);
Suicide (4.4%).

[…] Unfortunately, the findings of Professor Ibrahim’s research do not come as a big surprise to the ANMF or to our members working in the residential aged care sector, who have been telling us how much worse the sector has become and how difficult it is for them to provide the care they know their residents need. There just simply aren’t enough nurses or carers to ensure that every resident receives quality care.

“This is a situation that is increasingly distressing for our members as well as for residents and their families and it’s one we are battling to change. However, the more evidence, such as this research, we have, the more politicians will have to listen. They cannot continue to treat Australia’s elderly in this way.

“If we had this level of preventable deaths occurring in our hospitals there would be a public outcry. Why is it that we don’t care the same way about our elderly, choosing instead to lock them away and forget about them? As Professor Ibrahim says, we owe older people a better place to live out their lives because they’ve given us one of the best countries in the world to live in.”  — ANMF media release.

Understaffing, under-funding under-skilling,  of the aged care sector has been going on for far too long now. And without much identification or accountability. It is absolutely no surprise that things have gone to shit.

As a nurse who has worked in a large emergency department for over 33yrs I have seen the direct results of the dilution in the capabilities of the aged care sector. From patients sent in by ambulance (at considerable taxpayers expense for the round trip alone) to have minor procedures that used to be done by registered nurses in-house, to increased incidences of falls and pressure injuries, to miscommunications and misunderstandings over the patients need or desire for acute, invasive hospital management when it finally comes time for them to die.

And then there are the anecdotal stories of specific incidents and general environmental conditions coming from facility staff as well as from families of those in their care. 

I have no doubt that there remain many pockets within the sector that continue to deliver excellent care (a garland of respect and appreciation to the nurses and other carers achieving this), but looking at the big picture,  the feeling that I get talking to colleagues, feelings hardened by reports such as this, is that overall…..things are now beyond grim.

Those mothers and fathers and grandfathers and great grandmothers and younger people too, who all find themselves relying on compassion and care and provision of some sort of day-to-day quality of life within this silo of the health system are often the most vulnerable, disenfranchised and ignored.

As a profession this is a crisis that requires us to unite and mobilise, to raise our considerable collective voice to ensure this SPECIALITY (for that is what it is) is supported and given the funding and experienced quality nursing resources that those people needing it are deserving of.

It is already too late. So now we have to do our damndest to resurrect it and to heal it.

Please share your own thoughts, comments and experiences…..


Journalalert

9 thoughts on “WE need to resurrect our aged care sector.

  1. I have worked both as an Assistant Nurse and a Registered Nurse in residential aged care. When residents and their families rightly bemoan the lack of staff, I tell them that the government needs to introduce ratios. Can you imagine having 10 babies to one staff member in child care (at best)? This does not happen as the care would be substandard and everyone would be up in arms. Residents often actually require MORE assistance than a baby would (babies are much smaller and don’t require regular repositioning to prevent pressure areas, it is much quicker to change a nappy than it is to assist someone to slowly hobble to a toilet, etc). I think this problem has been hidden away for too long (out of sight, out of mind) and as more people are coming to require residential aged care services, serious issues (notably, staffing levels) are coming to light. The media are currently reporting that a percentage of deaths are preventable in aged care. You cannot eliminate falls from occurring as residents will try and mobilise of their own free will 24 hours a day- you cannot stop this unless you tie a person down. However if there were an increased staff presence, more residents would be detected trying to walk around unassisted and more falls could be averted (not eliminated).

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  2. Thank you fellow nurses for uniting in this cause. A crisis is an understatement. Us aged care nurses all welcomed the Introduction of the Aged Care Act back in 1997. Finally our beloved clients had rights and voices. Sadly however the associated standards are incredibly hard to meet if not impossible with current staff ratios. I’ve been nursing in this industry for 27+ years now and it’s really dangerous in my opinion. We need staff ratios like they have in other care sectors in order to protect ourselves professionally and our clients’ rights to quality care and quality of life. Please support our cause fellow nurses and stop seeing us as “lesser” than you.

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  3. Have been an aged care worker for aprox 34 years. Can no longer work due to a bad back, shoulders, and in need of both knees having to be replaced and i have seen it all over the years. Hours cut, staff not turning up for shifts not being replaced. Two carers cannot adequately care for 20 residents with high care dementia needs. Finished up on night shift due to my body problems and i used to try and care for 20 high care dementia residents by myself, with another worker doing the same in an adjoining area. This is ok provided nothing goes wrong or someone is dying, and needs extra care. One rn on duty for 130 residents. Soooo tired of hearing that we had adequate staffing levels. I loved my job, loved the residents, but trying to get something to change is like bashing your head against a brick wall. All comes down to the mighty dollar. At one place there were no RNs as looking after the residents was like looking after your grandparents, including doing meds and giving s8 meds. We cooked, cleaned did dressings and showers and were totally responsible with few staff with adequate qualifacations. That was ok till something went wrong and they had to change their practices. Am very weary and disheartened as residents deserve better. And as for our wages, took me all those years to finally get 20 dollars an hour as a base rate.

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  4. Aged care has become a very difficult area to practice in. I am fortunate to work in an environment that does have registered nurses 24:7 but there are many times that more care workers are needed to give the standard of care that is expected. I have found that many residents and their families expect a degree of care which is far above the scope of the staff available, as a result many residents end up sent to hospital because 1) the family and/or resident expect it 2) staff do not know how to deal with a situation 3) even the new grad registered nurses who come to aged care when they can’t get into graduate programs do not have the experience and knowledge to deal with many situations (including caring for someone who is dying – the first thought is to resuscitate not palliate) 4) the increasing difficulty of finding GPs who will attend home visits to nursing home residents 5) increased age and therefor higher care needs when residents are admitted, multiple co-morbidities leading to complex medical care needs 6) no mandated education level for care staff – it has been talked about for years that all staff should have at least a certificate 3 to work in aged care, but this has not happened. Added to that, the number of staff with inadequate english language, both written, verbal and understood, Changes need to be made! Just as an aside – do the falls statistics take into consideration the fact that restless residents who are more likely to fall are no longer restrained, making falls more likely?

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  5. It would be great if the whole nursing sector got behind supporting aged care and the nurses that worked there particularly RNs. Even if the best facilties i have worked in, one RN for 34 high care residents with multiple comorbidities is a hard ask and often only must need care is delivered because there is only one of you. Something will get missed or not done. He sectir is under resourced from both a human and material point of view. I used to work in aged care nut would not return to the sector given the high demands on RNs and the atress of knowing you cannot provide the care required.

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  6. As manager in a residential care facility that provides evidence based exceptional, progressive, and dedicated care to our district’s aged, these figures come as no surprise. Our contribution to those figures are very minimal but even with full community support, excellent staff and many volunteers our facility still struggles under the lack of available funding, the difficulty recruiting quality staff to replace an aging workforce, the stigma of being aged care specialist RNs and (sorry) the difficulty accessing acute care for our residents. The last one has many facets. Rurallity which has issues of its own, emergency departments that are resistive to our residents needs (not all elderly people wish to be NFR/Palliative), limited access to investigation routes available to acute patients (path, radiology specialists etc.) The list goes on…..
    My concern is that instead of promoting aged care as a rewarding and fascinating place to work with many professional opportunities, the debate surrounding these figures is accusatory and bitter and frustratingly generalising for the entire sector.

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    1. While I agree with you Rebecca I feel the issue is far greater than what you portrait. As a former RACF care manager and now ED nurse I have seen both sides. The federal government which funds residential care and the accreditation standards do not clearly define the clinical role of residential care facilities. In fact if you look at the government’s descriptors on the MyAgedCare website residential care facilities are defined as just that- residential care. You are absolutely spot-on that RNs in aged care do not have access to diagnostic and assessment tools available in acute care. Many residents who present to my emergency department after a fall usually do so with a concurrent medical condition- UTI, delerium from another source, pneumonia or sepsis. These would not be easily picked up by nurses in the aged care facility due to the lack of diagnostic resources and lack of time to spend assessing residents properly.

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  7. That is so true, I myself worked in a nursing home a few years ago. I was appalled at the lack of qualified nursing staff per shift, carers who “supposedly” had their cert 3 but couldn’t write English to write their reports and asking others to write for them. Carers run off their feet trying to get residents showered, fed and hydrated. The list goes on. Not enough time to check residents or sit and talk to them while giving them drinks or food. Toileting Etc. Residents falling or getting skin tears, some of this could be avoided if residents weren’t so rushed.

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