The other day I came across a very interesting letter on NurseUncut.com.au. It was a letter from a woman whose elderly mother is in an aged care facility. It was a very touching and moving piece of writing – you could hear the love this woman, Belinda, had for her mother in every concerned word she wrote.
What was the main concern of the letter? That there were not enough nurses at the facility her mother was at. I, myself, have worked with helping people find the right aged care home for themselves or a loved one – and Belinda’s concern is a common theme that I hear about hear from families in similar situations.
Many people, like Belinda, have this expectation of what aged care should be like:
“I was always under the assumption that when you go into a nursing home you’re supposed to be cared for to the point you feel safe and loved. I guess I was wrong. Everyone knows when you go into a nursing home it’s the end of the line and they should be able to live out the rest of their days feeling happy and safe and secure.”
It’s not wrong of people to expect this, but they often find that their expectations are not met. Belinda is completely right in saying that the elderly should feel happy safe and secure when they move to a nursing home.
Having worked 20 years in the sector, I have seen that there are many reasons why people have such expectations, it could be because they’ve never previously visited or been involved in aged care. Or that they’ve been to hospital – where nurse to patient ratios are much higher (1:4 or 5 public or private) than seen in aged care facilities. Or they’re under the impression that if they pay a higher bond, that they will receive better care.
It’s not until they (or their loved one) is in an aged care that they realise that their expectations are not aligned with the reality of the situation.
The Right Staff
Belinda talks about how understaffed she sees the facility, particularly at meal times:
“Today there are 30 residents in the High Care ESU Unit and four nurses…four nurses is not enough for 30 high care residents. Six of the residents need to be fed because they can’t feed themselves. Then you have someone wanting to be toileted. Some people still need to be showered. One nurse is supposed to be on the floor at all times.”
I would agree with Belinda that there are not enough staff at hand, but I’d also want to add it’s not just the number, but the combination of staff available. One of the issues I have seen is that there isn’t the right mix of skills in the workforce. ANMF found that in terms of skills mix, a staff force should have a mix of 30% Registered Nurses, 20% Enrolled Nurses and 50% Personal Care Workers as a minimum to ensure safe residential care.
A common theme that I notice when I speak to families is that they often don’t realise the difference between a nurse and a carer. Back in day, they used to have different hierarchical uniforms – but this is no longer the case. Many people people seem the think that it is nurses that are doing tasks, when in reality those particular tasks are done by carers. Which can be confusing for families where this is a new experience for them.
In an ideal world, there would be a great selection of people to select staff from, but it seems that this right mix is hard to create when the quality of candidates apply for these jobs are often lacking. But this is only part of the reason we cannot create a quality workforce.
I find Belinda’s letter very compelling, but not unique as many people with loved ones in nursing homes have similar concerns. I certainly feel for her that she’s had this experience, but I understand that there are a number of providers out there that are working on a number of initiative that will address her concerns.