It’s time to put the ‘person’ back into aged care

aged care HEALTH

> How we treat our elders

The recently announced Royal Commission into Aged Care has put the spotlight on systemic failures in the sector, highlighting numerous cases of appalling practices in aged care.

The inquiry has prompted more than 5000 submissions from families, carers, aged care workers and residents, health professionals and providers.

Michelle OppertAccording to a recent paper in Geriatric Nursing, co-authored by UniSA researchers Michelle Oppert, Dr Valerie O’Keeffe and Dr David Duong, the underlying cause for many of these failures relates to a lack of person-centred care (PCC) knowledge and practice in aged care facilities.

Oppert, a PhD candidate in the School of Psychology, Social Work and Social Policy and the School of Engineering, says Australia’s ageing society and the increasing number of dementia cases have created some major challenges for the sector.

“Almost four million people in Australia are over the age of 65 and by 2050, this number is expected to double. That’s a significant number of people who are going to need care, including around one million people living with dementia,” Oppert says.

Living with someone who has dementia can be challenging – especially dealing with those who exhibit aggressive behaviour – but this can be mitigated if the person with dementia is valued and respected as an individual, understood from their perspective, and included in a positive social environment, the authors say.

Known as person-centred care, this approach focuses on ensuring services are provided in a way that is respectful of, and responsive to, the preferences, needs and values of people receiving care and those who care for them.

“Person-centred care is still one of the best recognised ways to treat people with dementia, but it should also extend to any person who is receiving care or support,” says Oppert.

UniSA Research Fellow Dr Valerie O’Keeffe explains why person-centred care is critical for older people

“It is critical to the identity of older people and those experiencing dementia,” adds Dr Valerie O’Keeffe, a Research Fellow in UniSA’s Asia Pacific Centre for Work, Health and Safety.

“Focusing on people’s memories, finding out what makes them tick and how they interact with people is so important. Taking time to build a relationship with the person, despite their dementia, is the key.”

Time – or lack of it – appears to be the major barrier to aged care workers practising person-centred care.

“Because aged care workers are time pressured and need to be highly task-focused, the social interactions with residents are compromised, hindering person-centred care.”

Additional training and a better understanding of what PCC entails would go a long way towards improving care in aged care facilities, the authors say. Additionally, this would improve aged care worker satisfaction and help retain staff.

Oppert interviewed 12 aged care workers for her study, five of whom listed English as a second language.

“There was some confusion around the definition of person-centred care and it became clear that the phrase is more talked about than implemented, because aged care services still seem to be shackled by old patterns of practices,” Oppert says.

More than a quarter of Australia’s aged care workforce are born overseas and are employed in approximately 87 per cent of aged care facilities.

Some of these workers from culturally and linguistically diverse (CALD) backgrounds did not have enough understanding and training in person-centred care, which is part of the issue, the authors say, although to some extent their own family values and respect for elders potentially make up for this.

“CALD workers may possess greater understanding of the principles of PCC due to the principles they live by in their own culture, where elders are treated with more deference than in western society,” says Dr O’Keeffe.

The paper recommends more investment in training and promoting teamwork to facilitate person-centred care in aged care facilities. These changes will enable care workers to focus on embracing individuality and a sense of belonging among residents.

Oppert presented the research at the South Australian Association for Gerontology Conference where she was awarded the Gary Andrews Student Prize for best presentation.

How we treat our elders

Did you know there are very few legal protections and safeguards in place to protect older people?

Understand the growing problem of elder abuse and what can be done to address it in the latest edition of Enterprise magazine.