One claim we have heard lately is that staff working in aged care have only five or six minutes in the morning on average to prepare residents before breakfast.
In that time they must shower, dry, dress, and toilet residents, and help them make their way to the dining room.
Can this possibly be true? We spoke to experts in the field to try and find out where these reported numbers have come from.
Where do these reports come from?
Dr Rodney Jilek, principal adviser, Aged Care Consulting and Advisory Services, told HelloCare that even though staff might not be given formal time limits for getting residents ready each day, if you look at what has to be done between set times and do the maths, it works out that around 5-6 minutes per resident is quite possible. He said there is “obvious pressure” on staff to get residents ready quickly in the mornings.
“It is not uncommon for care staff to be responsible for preparing eight to 10 residents on a morning shift. Some residences have more staff, but some have less”, he said.
Given that residents start waking at 6.30am and the “vast majority” of aged care facilities have breakfast at 8, that leaves nine minutes per resident, he said.
Factoring in that staff might have to sign on, receive handover, read memos, read care plans, find equipment, find someone to help them if needed, help the resident go to the toilet, wash the resident, dry the resident, apply creams or lotions, select clothing, dress the resident and get each resident to the dining room, 5-6 minutes per resident “is not out of the question,” said Dr Jilek.
“And that doesn’t take into account administration of medications, management of falls, incontinence, impaired mobility, altercations between residents and the fact that anything can happen at any time in aged care,” he said.
Many aged care staff are run off their feet, making it difficult for them to deliver proper care to residents, Lori-Anne Sharp, Assistant Federal Secretary of the Australian Nurses and Midwifery Federation (ANMF), told HelloCare.
“We are hearing from our members that due to chronic understaffing they just haven’t got the time to deliver the care that our elderly vulnerable deserve,” she said.
“This comes at a time when we know that elderly are entering nursing homes older, frailer and with multiple chronic medical conditions,” she said.
Judith Kiejda, Assistant General Secretary, NSWNMA, said it has been reported to her that some aged care workers are having to get staff ready in 5-6 minutes, and in some instances even shorter times.
“Low staff to resident ratios mean staff simply do not have the time required to care for residents’ basic needs,” she said.
“It’s impossible for someone to get someone out of bed, get them showered and get them to the breakfast table in six minutes. It’s ridiculous,” she said.
Ian Yates AM, Chief Executive of Council on the Ageing, said it hasn’t been reported to him that staff are having to get residents ready within 5-6 minutes, but he said he would be concerned if it was the case.
He pointed out that some residents may wish to get themselves ready every day, and don’t require much help at all.
The problems that occur if staff are rushed
Ms Sharp said that understaffing is leading to more incidences of poor care. Her comments echo the claims made on Four Corners this week by a magistrate who dismissed assault charges against two aged care staff because he said they were rushed off their feet.
“There’s evidence that understaffing has led to increasing episodes of missed care for our elderly,” said Ms Sharp.
“Basic individual care, like bathing, feeding and toileting is being compromised as a result of chronic understaffing,” she said.
Dr Jilek, who has worked in aged care for decades, said there’s no doubt that rushing causes adverse reactions from residents, particularly those living with dementia. Rushing increases the likelihood of skin tears, falls, medication errors, and staff burnout, he said.
Ms Kiejda said understaffing can lead to “neglect”, and can lead to increased risk of injury for both residents and staff.
“When staff do not have enough time to properly care for residents, there is limited scope to provide adequate hygiene, administer medications safely, prevent falls and mobilise residents as often as needed,” she said.
What’s the solution?
Extended breakfast hours could allow more time for those residents who take longer to get ready, said Dr Jilek.
“By extending breakfast over several hours, from 7 until 9 for instance, you effectively remove the deadline mentality that currently exists, provide staff with additional time and simultaneously increase resident choice and decision making,” he said.
Both Ms Kiejda and Ms Smith said mandating staff ratios was the key to improving the standard of care in aged care facilities.
Mr Yates said he expects the Royal Commission will look very closely at the amount of care each resident receives in aged care. Watch this space.