Stories and media coverage of poor quality aged care has become far too frequent, raising the question on what can be done to improve the state of aged care in Australia.
Both the community and the industry talk of more training, more staff and more funding, but one of the most basic things that existing staff and residents need is more time.
Earlier this year, the Australian Nursing and Midwifery Federation (ANMF) released the National Aged Care Staffing and Skill Mix Project Report which stated that aged care residents were a only receiving two hours and 50 minutes of nursing care every day.
This is considerably less than the recommended four hours and 18 minutes that the ANMF report suggested for aged care residents.
The report suggests this comes down to one thing – poor staffing numbers. Because of a lack of aged care staff and nurses, many residents miss out on needed time for their care.
In fact, it was calculated that they were missing out on approximately one hour and 28 minutes on average each day.
As published in QNMU’s Inscope Journal, time could be the difference between poor and good care – tasks such as nursing, showering, feeding, personal hygiene could be better done in those extra 88 minutes.
And with better care, there is also a decrease in the chance of falls, weight loss, dehydration and pressure sores.
What and extra 88 minutes per day per nurse looks like;
- 4-5 more residents being showered before breakfast, if a single shower equal 15-20 minutes
- 10-12 more residents having their teeth cleaned, if 1 cleaning is 5-8 minutes
- 4 resident who require feeding eating lunch at their own pace, if dinner is 20 minutes
- 8 more resident being turned in bed to prevent pressure sores, if 2 staff take 10-15 minutes to turn one resident
- 5-6 residents having their fingernails clipped if it take 10-15 minutes to do both hands
- 8-9 residents enjoying a 10 minutes bedside chat and a check with a nurse
See what a difference 88 minutes can make.
Nurses have their say
Aged care workers and nurses say that having more time for their resident would make a world of difference to not only them, but the resident and their families.
QNMU aged care member Pam* said an extra 88 minutes would be a ‘godsend’.
“Eighty-eight minutes per resident is the difference between doing the best you can and doing everything they need,” she said.
“I could get more people showered and I could spend time with them, trimming their nails — even spending a few minutes talking with them rather than rushing through the tasks and dashing off to the next resident.
“It’s about that personal contact — that’s when you notice things, you are more attuned to their condition and you can identify changes a lot earlier and pass that on to the RN.”
Another member, Mau*, said short staffing led to unreasonable schedules which is unfair to the residents. More time would mean a huge improvement in the quality of life for the residents.
“I could keep on top of nail trimming and brushing teeth which would be great. I often don’t get a chance to do more than a couple at a time.”
She said she’d also take more time with residents who need help eating, “some of these people take half an hour to eat a meal and if I’d like to let them eat at their own pace.
“But sometimes you don’t get a choice, it’s like an assembly line and it’s awful.”
Mau also said that it’s not just the residents that need more time, but the new staff too, “at the moment, because we are so short staffed, sometimes they get only one buddy shift before they have to strike out on their own,” she said.
“It’s nowhere near enough and one shift doesn’t cover off on all the different areas of the facility and the differing needs of the residents… so you can get someone who has never worked in dementia going in cold.
“That’s a recipe for disaster — it’s bad for the residents and for the new carer, and the chances of something being overlooked, something serious, is real.”
Both Pam and Mau said they loved their jobs and found the work rewarding, but at the same time they were worried that they were letting the residents down.
“You come home feeling guilty and heartbroken because you can’t do any more for these lovely people and you think ‘am I in the right job?’,” Mau said.
How can aged care get those 88 minutes?
There are a number of aspects that need to change in order to get better care for aged care residents. This includes, staffing, training, wages, better standards, just to name a few.
So where is the best place to begin? QNMU’s report recommends:
- Mandating a minimum staffing and skill mix for the safety of residents and to ensure enough time for proper care.
- Ensuring that there is a Registered Nurse round the clock at every aged care facility.
- Increasing wages for aged care staff so that it is in line with the public sector, which will, in turn, attract and retain skilled staff.
- Comprehensive standards for aged care, like those in the hospital sector, need to be developed and implemented.
- Aged care accreditation processes need to be made more effective – more thorough checks more frequently.
- Ensurance that staff are adequately trained. Unlicensed carers must be subject to a registration scheme with minimum standards of training for the safety of residents and staff.
* Names have been changed for privacy reasons
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