Submitted by Anonymous
The single most important issue facing aged care residents and care workers looking after the elderly is without a doubt, resident to staff ratios.
Having been employed in the industry over the past 5 years as a residential care worker on night shift and seeing more complex nursing needs of residents admitted into care, the one over riding factor that hasn’t kept pace is the staffing levels and mix to make the job easier.
If anything the “for profit providers” are making it more difficult by trying to find ways of reducing hours of care per resident.
I have observed it happening at my workplace my co workers on the different shifts often comment now that it’s just becoming to hard to achieve the daily activities that they are required to preform on a daily basis.
An important sign of workplace stress is absenteeism, which currently at my facility is quite high and at times is quite difficult to replace absent staff.
I know casual staff that when asked to fill in a night shift in my unit decline the shift if it’s the unit I work in due to the workload if they have done previous shifts in the unit.
Even regular staff decline fill in shifts and it’s all down to the workload.
Team Leaders often complain about the agency budget blowing out, but it is happening due to workload stress that is being put on the regular staff.
I dread a night when I work with an agency, and it’s not t fault but not only I have to heir organise the night with all the duties required to perform but then all the computer work as well so the workload doubles.
It’s hard sometimes seeing the am staff come in for handover before they start and already looking tired knowing what’s in front of them.
It is a hard unit to work in given the number of dementia residents with all sorts of behaviours to manage and we do need more support from management in a practical sense but has never and nor likely to happen.
And talking to others working in the industry it is happening right across the board, which considering the funding they receive is disgraceful.
More than once we have been asked to document behaviour whether it happens or not or embellish progress notes so more funding can be applied for under ACFI, but we never see that funding helping us in a practical sense in terms of staffing.
I am often asked why do I continue to work, why not find something easier, and my response is always if we all gave it away because it was too hard who would do the job.
I am always very protective of the residents I care for and we do have little victories and wonderful moments albeit not often but really enjoy them when they happen and that’s what keeps me going
Residents who are now being admitted to care are coming in with higher and more complex cognitive and medical issues due largely to the government’s in-home care packages.
This, in turn, is placing more strain on staff. Staffing ratios and training has not kept pace with the more complex needs of the residents.
Training for PCA’s does not appear to have changed in the past 10 years. In my experience working night shift, I care for 38 residents in a dementia dedicated unit with one other PCA.
On a typical night, a shift includes 40 plus pad changes (all needing 2 staff assist), approximately 7 residents who need assistance with toileting (with 2 staff, 10-15 times a night), 38 jugs filled with either water or thickened fluids and put into rooms for the following day.
Other issues may include a quick decline in residents health which require prompt attention from div1 but unable to attend when needed due to her quota of residents they are responsible for.
And the falls, wanderings, verbal and physical assaults that occur. We have long advocated for one extra staff member to ease workload and give residents more care time but always been denied or not raised due to not wanting to cause problems with management.
It’s been a long time since I did my course to qualify as a PCA but one component I believe that is missing is dementia training which is such a critical component of care now with increasing dementia clients coming into care.
The funding successive governments have provided for aged care facilities is great but we must question the level of accountability of where and how this funding is allocated.
There seems to be an increasing inability to attract new staff and encourage them to continue long term, the main reason for giving it away is the workload, “ so much harder than I thought” or “too heavy”.
The residents need consistency and familiarity with staff who know how to manage them to get the best and safest outcome.
Anecdotally working with staff working at multiple facilities, stories of pads being locked up at nights, a memo being circulated asking staff to bring in used plastic shopping bags, residents not being checked for incontinence overnight, no staff being on duty certain times of night – these are of course unconfirmed anecdotes.
In summary, ratios need to be addressed as a matter of urgency to give our elderly residents and their families the care and dignity they have rightfully earned giving a lifetime to our country.
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This is by far the most accurate piece of reading I have read in regards to job description. I too work nights and have not just resident based needs but, mopping floors, cleaning dining areas, setting tables, washing linen, drying linen, folding linen and putting it away for the next day. These are just a few jobs done over night along with taking care of our residents when needed. All this is done with little to no thanks and nothing but complaints from the powers that be. Its a low paid job for all the work we do. My family ask why I do it. I can honestly say that it takes a special kind of person to do this job, we are abused at times and take it on the chin. But, I really love what I do and find it rewarding. A plumber gets paid triple what I do due to dealing with some icky things and I’m sure I deal with more icky stuff than a plumber on a daily basis. The mind boggles.
When I worked in the secure unit of an aged care facility, many years ago, I was expected to look after 17 residents with Dementia, on my own on the afternoon shift which was 8 hours(The morning shift always had 2 carers on the full 8 hr shift) This went on for several weeks while I kept informing management of the unacceptable work load and safety issues as well as documenting incidences. I kept being told that the budget didnt allow for an extra worker on the afternoon shift. Eventually, management gave in and there was a 4 hour shift created to assist the afternoon shift.
Well said, i honestly thought you must be one of our staff members, i have been spruking what you have just put into words, for a long while now, i thank you for that. Our memory support unit has 25 residents with an array of behaviours with one carer worker overnight. Only just recently has a mobile duress alarm been implemented for that carer when physical behaviours(from some dementia residents) are in progress. Recently all workers carers&nurses alike have been spoken to about not finishing all tasks aloted to them throughout their shift. Some have been known to work up a couple of hours over their shift to get tasks (that earn ACFI dollars) completed, so they don’t get accused of not caring about their job or the residents form management. Staff to resident ratio and constant up grading work knowledge should be made law.
Very good read and very true, the quality of care is not being delivered because of the quantity of care needs. Staff ratio to resident needs to be addressed. As mentioned in the article residents are coming into care with higher care needs which increases the amount of time required to attend to their basic needs
I too can relate to this problem of being understaffed and also being provided with inadequately trained carers. I am sure this in part was due to the extreme shortage throughout the industry. This does not excuse the very poor standard of care provided. We as nurses were usually the ones to wear the blame. NOT OUR FAULT!
Something needs to be done to rectify these ongoing problems. It will not get any better until the government takes ownership.
Spot on I can testify to this, its about time someone did something to help the workers instead of bagging them. I have worked in aged care for the last 14 years in several roles and I know too well what its like. Staff ratio needs to increase to allow proper care to happen. But no the care facilities just keep lining their own pockets by getting staff to document stuff to get more funding, weather it happens or not.
Having a parent in a high care dementia ward, I can fully understand how you feel. It’s easy for us looking in to get upset to find a family member soaking in their own urine, or sitting in their motions, smelling the unit out. I don’t get to see my parent very often, living in a different state, but my sister does and she sees the difference when a non-trained carer fills in for an absentee. As the saying goes, some people just shouldn’t be in their job! I do know she has one carer who is an absolute dream.. Leanne is an amazing nurse, coping under extreme conditions. These companies need to stop cutting corners and use their PROFITS to help staff do what they train years for.
Very well said and so true. The people who own the nursing homes and the management as well should be ashamed of themselves. It is all about the money and not the residents and workers. I really do not know how these greedy people sleep at night.
Submitted by Annonymous – Accurate account of Aged Care today in Australia. I have worked a night shift as a RN responsible for 100 residents, wth only 3 carers to assist. Start work at 9 pm and you literally run from 9 until 3am medicating, settling, toileting residents and doing turns and personal hygiene. As well as this managing falls, wandering or any challenging behaviours. Then it all starts again. If you have Resident who is sick or passes away, this adds extra strain on night staff.
Now having a frail and unwell parent in Aged Care, I have to go daily to ensure the basic care is being done, medication is given in a timely fashion etc etc…. but it all looks good on paper. As long as the documentation is up to date that’s all that matters.
Accreditation is a joke! All hands on deck in the lead up to the audit, then it’s back to the usual sub standard care due to lack of staff.
I challenge all family members who have a loved one in Aged Care, look carefully at your loved ones care plan. Can the facility verify that EVERYTHING set out in the care plan is being completed daily?
I doubt many could due to lack of staff! Is this fraud or negligence? If the care plan states 2hrly turns for example, and it’s not being done, challenge this. Challenge anything on the Care plan that is not being completed for the Resident!
I’ve seen staff (esp the carers) take sick leave periodically because they are physically exhausted. Staff start work at 7 am and run all day. It’s not unusual for carers to still be showering Residemts at lunchtime due to a heavy work load. Residents and family can be demanding.
Aged Care is in crisis!
All true, I’ve been working in aged care doing night shift only from 9pm till 7am other then a few short breaks for 18 to 20 year I’ve seen a lot of changes not all good for the worker sorry I’m a CSE or an AIN .
Caring for about 45 residents and oncall to residents in our villas , as the residents needs got higher we lost some of our duties eg cleaning main kitchen changing cooking oil and doing the laundry But to be replaced with other duties. Well fast forward to now residents are all high care management are still adding to our duty list they must think night shift is easy mentally and physically we’re getting worn out . But don’t forget ACFI and do the filing that is left from all the other shifts and if not completed the email from the care Manager with WHY and explain . SORRY seems like a rant but for all our night shift worker I feel very sad
I work nights in a nursing home, we have 29 residents most with dementia, all of them are for 2 carers, some of them have challenging behaviour, 4 residents can walk with frames, usually we have 3 carers on duty at night but this week we have had 2 nights with only 2 carers, the home on those nights was an accident waiting to happen, thankfully we didn’t have any accidents. My colleague and I were dead on our feet at end of shift. All we got from management was a thank you sent by whats app.