As an aged care worker, a person’s duty is to care for the elderly resident, usually, that means acting in the resident’s best interest.

But sometimes aged care workers, as well as other health professionals, find themselves in a position of “moral distress”.

Moral distress occurs when one knows the ethically correct action to take but feels powerless to take that action.

When working in aged care, there are often issues of workload, stress, and emotional demands of caring for fragile, and often ill older people.

An example that moral distress is seen here;

Mr. Anderson, a 92 year old man living in a nursing home and has had Alzheimer’s disease for over 10 years. He reaches the stage where he is no longer able to swallow food effectively. He has been hospitalized with aspiration pneumonia four times in the last year.

The man’s eldest child, who lives in the same town, has a durable power of attorney, and visits regularly, insists that a feeding tube is inserted. He has the support of his two siblings.

The staff feels that a feeding tube would be distressing to the patient. Besides, they say, “He swats away our hands when we try to hold him down to insert the tube, and he always pulls the tube out.”

In this situation, what would the right thing to do be? Follow the childrens’ orders or to not distress the resident?

Being faced with situations where a care worker feels helpless, or that the wrong course of action is being taken, can take a toll on their physical and mental health.

Psychological effects of moral distress include demoralisation, anger and frustration, with some aged care workers noting that they became callous and bitter.

Further consequences include staff suffering burnout, and thus leaving the profession due to this distress.

Moral distress is more common than people would think. One research looked specifically at the frequency of moral distress in Australian aged care workers.

Preliminary results found that 97 per of aged care workers have experienced moral distress during their career, with 47 per cent have considered quitting or leaving a position.

1 in 6 ended up leaving a position while 1 in 5 have ended up taking a break from work.

It was also found that 73 per cent have never received education or professional development related to moral distress, indicating that education is needed to help aged care staff handle situations where they feel there is an ethical dilemma.

Addressing the situations and realities of “moral dilemma” in aged care can improve the quality of working life for the aged care workforce.

By reducing adverse physical and psychological effects that staff may suffer, not only creates a healthier workforce, but better quality of care.

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