Fewer RNs leads to more aggression and loneliness     

A decline in the number of RNs in aged care facilities is having a significant negative impact on people living with dementia, an NSWNMA report has found.

Thirty per cent of respondents to an NSWNMA survey said shortfalls in staffing in their aged care facility had led to someone being injured because of an aggressive incident by another resident during the previous week.

Eighty-two per cent of respondents said insufficient staffing ratios increased the risk of abuse.

“Evidence suggests a deliberate and marked decline in the provision of RNs within the skills mix of residential aged care facilities (RACFs) has occurred,” the report says.

“Our survey findings suggest this has negatively impacted the care of people living with dementia in RACFs.”

Around 50 per cent of all admissions to residential aged care facilities are for people with a diagnosis of dementia.

The NSWNMA survey of 1600 nurses working in aged care found that RNs employed in rural not-for-profit RACFs were the most likely to have specific concerns about the management of behavioural and psychological symptoms of dementia (BPSD) in their facility.

“We often have violent residents and have had several major incidents of elder abuse (resident-to-resident) where due to injuries, death has occurred,” one RN in a rural not-for-profit RACF reported.

“Lack of supervision in dementia-specific wards results in falls, aggressive behaviours and dangerous situations with boiling water and kitchen utensils,” said another RN.

The report says there is not enough staff to combat the loneliness of many residents, which contributes to the prevalence and symptoms of dementia.

“We have many dementia residents who are lonely and don’t have many visitors. Sadly we don’t have time to spend with them,” an AiN working in a metro not-for-profit facility said.              

Understaffing also explained why “the most basic of care was not provided”.

“Failure to assist people to eat and drink, assist people to go to the toilet, or no time for stimulation leading to boredom were basic care needs reported as having been missed when staffing levels were inadequate.”

The report says many of the injuries from aggressive behaviour by other residents could have been avoided with better staff education on dementia care.

“Despite dementia-related conditions representing over 50 per cent of all admissions to RACFs, mandatory staff education on dementia is not a requirement for accreditation by the Australian Aged Care Quality and Safety Commission,” the report says.

“Instead, the industry sets the standards.”

Unacceptable levels of violence

  • 61% of respondents had experienced resident-to-resident violence in the previous week
  • 62% experienced resident-to-staff violence
  • 82% said insufficient staffing ratios increased the risk of abuse
  • 73% of respondents had insufficient time to sit and talk 
to someone who was lonely
  • 56% of respondents had transferred a resident to hospital because they could not manage their behaviour in the RACF.

Download the report: www.nswnma.asn.au/publications/reports