Is 6 minutes long enough for staff to get each resident ready in the morning?

One claim we have heard lately is that staff working in aged care have only five or six minutes in the morning on average to prepare residents before breakfast.

In that time they must shower, dry, dress, and toilet residents, and help them make their way to the dining room.

Can this possibly be true? We spoke to experts in the field to try and find out where these reported numbers have come from.

Where do these reports come from?

Dr Rodney Jilek, principal adviser, Aged Care Consulting and Advisory Services, told HelloCare that even though staff might not be given formal time limits for getting residents ready each day, if you look at what has to be done between set times and do the maths, it works out that around 5-6 minutes per resident is quite possible. He said there is “obvious pressure” on staff to get residents ready quickly in the mornings.

“It is not uncommon for care staff to be responsible for preparing eight to 10 residents on a morning shift. Some residences have more staff, but some have less”, he said.

Given that residents start waking at 6.30am and the “vast majority” of aged care facilities have breakfast at 8, that leaves nine minutes per resident, he said.

Factoring in that staff might have to sign on, receive handover, read memos, read care plans, find equipment, find someone to help them if needed, help the resident go to the toilet, wash the resident, dry the resident, apply creams or lotions, select clothing, dress the resident and get each resident to the dining room, 5-6 minutes per resident “is not out of the question,” said Dr Jilek.

“And that doesn’t take into account administration of medications, management of falls, incontinence, impaired mobility, altercations between residents and the fact that anything can happen at any time in aged care,” he said.

Many aged care staff are run off their feet, making it difficult for them to deliver proper care to residents, Lori-Anne Sharp, Assistant Federal Secretary of the Australian Nurses and Midwifery Federation (ANMF), told HelloCare.

“We are hearing from our members that due to chronic understaffing they just haven’t got the time to deliver the care that our elderly vulnerable deserve,” she said.

“This comes at a time when we know that elderly are entering nursing homes older, frailer and with multiple chronic medical conditions,” she said.

Judith Kiejda, Assistant General Secretary, NSWNMA, said it has been reported to her that some aged care workers are having to get staff ready in 5-6 minutes, and in some instances even shorter times.

“Low staff to resident ratios mean staff simply do not have the time required to care for residents’ basic needs,” she said.

“It’s impossible for someone to get someone out of bed, get them showered and get them to the breakfast table in six minutes. It’s ridiculous,” she said.

Ian Yates AM, Chief Executive of Council on the Ageing, said it hasn’t been reported to him that staff are having to get residents ready within 5-6 minutes, but he said he would be concerned if it was the case.

He pointed out that some residents may wish to get themselves ready every day, and don’t require much help at all.

The problems that occur if staff are rushed

Ms Sharp said that understaffing is leading to more incidences of poor care. Her comments echo the claims made on Four Corners this week by a magistrate who dismissed assault charges against two aged care staff because he said they were rushed off their feet.

“There’s evidence that understaffing has led to increasing episodes of missed care for our elderly,” said Ms Sharp.

“Basic individual care, like bathing, feeding and toileting is being compromised as a result of chronic understaffing,” she said.

Dr Jilek, who has worked in aged care for decades, said there’s no doubt that rushing causes adverse reactions from residents, particularly those living with dementia. Rushing increases the likelihood of skin tears, falls, medication errors, and staff burnout, he said.

Ms Kiejda said understaffing can lead to “neglect”, and can lead to increased risk of injury for both residents and staff.

“When staff do not have enough time to properly care for residents, there is limited scope to provide adequate hygiene, administer medications safely, prevent falls and mobilise residents as often as needed,” she said.

What’s the solution?

Extended breakfast hours could allow more time for those residents who take longer to get ready, said Dr Jilek.

“By extending breakfast over several hours, from 7 until 9 for instance, you effectively remove the deadline mentality that currently exists, provide staff with additional time and simultaneously increase resident choice and decision making,” he said.

Both Ms Kiejda and Ms Smith said mandating staff ratios was the key to improving the standard of care in aged care facilities.

Mr Yates said he expects the Royal Commission will look very closely at the amount of care each resident receives in aged care. Watch this space.

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  1. How long does it take YOU to get ready in the morning?? my guess 30-60 mins so why are we expecting our older people who have mobility and cognitive issues to get ready in much less time.

    A rolling roster is a good start. staff come on at usual times,say start at 6-30am if a resident is awake or up, they are then asked would they like to shower and get dress. if yes. good go ahead when you have finished you give them breakfast,if no ok suggest they wash their face and hands and come and have some breakfast or a cup of tea. when the next shift starts they ask who still needs breakfast or showering, does it matter if its 10am or later? the only constant is the lunch is served at a set time. even is the same as morning they eat when they want and what they want, and are asked if they would like to get their pj’s on.what time they go to bed is up to them, IT IS THEIR HOME, why are staff dictating what time they do anything, if they want to be up all night so what, thats what night staff are there for. if they want to spent half the day in bed is it really going to be the end of the world. Have staff ratios and RN ratios they all work set shifts but the residents do what they want when they want. simple.

    1. Elizabeth . . I agree with you 100% . . These idiot paper pushers are clueless as to how much work is involved when caring for our elderly . . How would they like to be rushed around in their own home and have a 30 second shower. . This is a subject very close to my heart . . The staff bullying by senior staff is another thing that needs to be addressed . . When nursing staff are considered as disposable employees and made to feel inferior, they don’t exactly feel enthusiastic about the quality of their work, especially when they are being rushed and berated by senior staff members. The pay is lousy and staff are never guaranteed permanent hours to earn a liveable wage. The staff are expected to be on call 24/7 when the nursing home call and guilt trip staff into working shifts. Some of the really good nursing staff are run into the ground to the point of burn out and are harrassed on their days off to work. The fact that these nurses have a life doesn’t come into the equation. It’s very difficult for nursing home staff to plan any leisure time and the commencement of burn out begins, once the nurses are a nervous wreck they are discarded and replaced, and so the cycle of abuse is continued. So then the residents are made to suffer, having to get used to another new staff member who more than likely is inexperienced, and so the bullying and fear tactics are bestowed upon the new nursing staff by senior staff once again, and so goes the cycle of complacent care and abuse. The residents feel the negative energy from the staff, and tje residents who don’t have their faculties and cannot communicate effectively start to display antisocial and or violent behaviours toward the staff and other residents, becoming a danger to themselves and those around them. The carry on effects of staff bullying, unrealistic time frames, poor staff to resident care ratios, lousy pay conditions and unstable shift work is a huge recipe for disaster . . Not to mention the lousy meals provided to the residents and lack of staff to feed and toilet the residents . . The list goes on. I was having conversation with a friend of mine who went to uni and scored a job with a government department. . His job involved deciding the rate of pay nursing home staff were to receive, and how much money was going to be funded for aged care facilities, and the staff to resident care ratio . .My friend admitted that he had never stepped into a nursing home in his life and was clueless as to what actually went on, and yet his job entailed the distribution of funds and the hourly rates including the reduction of penalty rates. He was even spun out that he got the job, but only due to getting a university degree, and it had nothing to do with nursing or the care industry, it was a degree in finance. Nursing homes are run for profit, not care. There are some beautiful, empathetic and dedicated nursing staff who love their career caring for our elderly, then there are nursing staff who should not be in the industry and only view the work as a job and do as little as possible, these people need to be weeded out. I’m medically retired now from nursing due to heart/ lung disease , but I still advocate for the elderly and go into bat for our nursing staff doing a bloody tough job with very little appreciation or reward. . It breaks my heart to see the injustice and the lack of respect shown to our elders and the people who genuinely care for them.

    2. Hello E.D.
      in our residential facility, like most others, we just shake our heads at the naivety of the hysteria built up by the media of late. its quite sad that the poor practices of a tiny percentage of any industry is enough to blacken the whole.
      What happens in the mornings is really quite different to the reports, firstly, residents do have the option to bathe early or late or in fact not bathe if they so want, staff well know who likes to be up early and who doesnt. Showering goes on all through the day but if you like an evening shower then thats what happens.
      Residents needs and desires are very well documented and most families are very vigilant ensuring that things happen at the residents. Its also well worth noting that its a much more pleasant experience bathing a happy soul rather than disgruntled one. Residents have individualised care, and its absurd to believe the reports of 5 minute preparations etc….exactly what do you think the nurses are doing between breakfast and lunch? Just sitting around? Of course not, they are bathing, making beds and making the residents comfortable, probably with bingo,trivia, art,church or just reading the paper or watching tele.
      So, its really easy to get indignant and use aggressive punctuation marks but the reality is that residents do have their own routines and good homes like ours work to make their lives as good as possible

      1. I just wanted to say … good on you! for taking the time to show a different view of residents living in an aged care home. It’s a pity a few bad apples can spoil the whole bunch.

    3. The facility where I was trained gave us 15 mins. to get residents ready for breakfast. They worked strictly to a schedule. The residents had turns one morning shower the next morning wash. One kind carer left her residents sleep in but she got into trouble as she ended up running late. My mother in her facility where initially they were more relaxed, was not always showered before breakfast as she was high care and so they would look to do that after or whenever. Mom often had breakfast in her room alone. Sometimes Mom only got out of her room in time for lunch. The staff are rushed and it impacts on the residents. Helping an experienced carer shower and dress a resident he got upset because in her rush, he was still wet when she was dressing him. It showed me that the schedule was more important than the person.

  2. Yes it so true you do not have long to get them up and showed, iv work in age care here and in the UK one place in the UK you were not allowed to shower till after breakfast, you got the then up toileted dress them in there dress grown sat in a chair breakfast taken to there room, then after them eaten you could start your showers, while they had breakfast we had hand over, was a lot calmer. But try to change the cares to do this is hard

  3. People are already being put to bed early and woken earlier than normal to save time. You would get better care and probably better food and more legal rights in prison. We need mandated staff ratios and the employment of more Nurses right now.

    1. Yes Gian, I was so heartened to see your post in the Hellcare.com.au/5-6 minutes long enough staff get resident ready morning article. Staff were briefly talking about this comparison in my last job in aged care. I had never thought about it like that before and my eyes were fully opened about how bad things have been allowed to get in aged care. I deeply care and respect our older generation, and it greatly saddens me. It was so bad where I was working I had to leave for my sanity.

  4. I have a suggestion ,,,why not let the idiots that have reached these decisions see if it’s possible for ANY ONE OF THEM to get ready in less than 10 minutes,,,,don’t forget to throw in the fact they are 90 years old, can’t move without at least 2 people assisting them, and then just for shits and giggles a touch or a lot of DEMENTIA!!! I swear, if anyone threw a tablecloth on meat 7 in the morni g, whereby I may not have fallen asleep until 5am, I’d smack them into the middle of next week…..what about the fact that some of these people are NOT morning people and never have been???I spent over 20 years as a nurse in long term care….just couldn’t see these wonderful people being treated as though they were on an ASSEMBLY LINE,,,,I’d get into what the poor souls were forced to eat,,,but would run out of space!

  5. Extending breakfast hours to accomodate residents who get up later sounds like a good idea, but when care staff, yes that is the same group of amazing hard working people who are responsible for getting the residents up and ready for the day, are also often responsible for giving breakfast trays out and making cups of tea and then clearing and resetting the tables, it really doesn’t help. There is no solution other than more and better trained staff.

  6. You. Have got to be out of your minds. 6 Minutes to do resident care. I would like to see you do that. I have been in long term care as a CNA for over 30 years. You obviously don’t care about these elderly people.

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