Aged care employees bare a weight of responsibility that very few members of the workforce would have to deal with.
Being asked to care for another person is one thing, but being asked to care for an extremely vulnerable person who is nearing the end of their life, is something completely different.
The elderly can be extremely vulnerable and often require assistance on a variety of levels in order to be able to function. Being entrusted to care for these people should be a privilege and responsibility that is treated with the utmost respect.
Unfortunately though, there is a very small percentage of human beings currently working in aged care facilities, who have absolutely no business being anywhere near a frail and elderly person.
Yesterday we reported on the case of a male nurse employed at an aged care facility in NSW, who has been charged with sexually assaulting an 89 year-old woman with dementia.
The horror of the incident itself is compounded by the fact that this alleged assault was witnessed by a fellow co-worker who failed to report the incident until almost 2 months after it occured.
And while failing to report serious incidents can be the result of a number of circumstances including fear, surely the wellbeing of vulnerable and elderly residents needs to be non-negotiable, as the essence of caring for someone is putting their welfare above anything else.
What Are Current Standards for Employees?
All facilities would obviously encourage their employees to report incidents of misconduct, but some workers within the industry are held to a higher standard than others.
Nurses are required to attain registration through the Australian Health Practitioner Regulation Agency, in order to be able to work in any type of facility.
This registration requires a police background check, and has a number of regulations relating to code of conduct and professional standards.
Breaching this code by failing to report a serious incident, can result in this registration being stripped, ultimately ceasing this person’s ability to work as a nurse.
Carer’s on the other hand have no other form of scrutiny or governance outside of the rules of the facility in which they work.
This inconsistency has some calling for carers to also require some form of registration, including Australian Nursing and Midwifery Federation (Victorian Branch) Assistant Secretary, Paul Gilbert.
“The ANMF supports the extension of this regulatory regime to all those involved in nursing, and has long advocated for the registration of personal care workers with the Nursing and Midwifery Board of Australia. This would formalise their obligations and responsibilities as well as their rights and set a minimum education standard,” said Paul.
Given the discussion surrounding staff ratios recently, it’s astounding that theses facts did not garner a whole lot of attention.
Because even though facilities boast a mix of staff in order to facilitate needs, the vast majority of facilities have a much higher ratio of carers than nurses.
This means that the employees that residents deal with the most, actually have the least qualifications and least amount of scrutiny.
The Standard That You Walk Past, is the Standard That You Accept
Those who prey on vulnerable people cross a line of moral code that reaches far beyond the rules and regulations of criminal law.
And those that fail to speak up and allow these behaviours to continue are complicit in the actions of those they fail to report.
Turning a blind-eye to serious co-worker misconduct is virtually condoning their actions.
The sheer value of the task that aged care employees have been entrusted with, should dictate that those who fail to uphold its sanctity should be punished criminally regardless of whether they committed the act, or knowingly allowed it to go unpunished.
The elderly people of Australia are clearly undervalued across the entire spectrum of society, including the justice system.
‘Extenuating circumstances’ is a phrase commonly heard within the judicial system to describe reasoning that can negate the amount of guilt that a person is responsible for. This reasoning takes both their life and personal situation into account when assessing the crime.
Surely then, the same premise could be used to take the situations of the victim of crimes into account, and upgrade the severity of punishment for crimes involving the elderly and vulnerable. Part of this could be criminalising a failure to report.
Improving the safety and wellbeing of Australia’s elderly will require change on a number of fronts, but the first and most crucial should be having laws that protect them that acknowledge crimes committed against the elderly and vulnerable are more severe than normal crime.
It was once said that ‘a society should be judged by the way in which they treat their most vulnerable,’ if this is the case, let’s hope whoever is judging us, is just as lenient as the judges currently sentencing people who prey upon our oldest and most vulnerable.
I have evidence that an Aged Care Worker told me one thing and then documented something else. Under reporting is an issue but even worse than under reporting is documenting something that is contrary to the facts as observed and discussed. In my view PCAs who are found to be mistreating and/or neglecting residents should be charged with assault. Once someone dies from neglect and/or mistreatment it is almost impossible to do anything about it. Aged Care is using the cheapest most insecure labour they can find in order to mazimise profit. This is what happens when vulnerable people are left with people who are grossly overworked and/or just don’t care.
When you have a family to support and will lose your job it gets very difficult. Exposing failures of abuse has consequences for the owner and its business. You are very likely to be blaming the wrong people in this article.. Remember the nurse who reported senior staff who covered up the way a residents had died. She was fired the next day. Others have suffered the same way. In what we at Aged Care Crisis are pressing for that nurse would also be reporting to a community visitor working with the provider and staff and with the power to investigate immediately. There will be an involved community to back them up. Covering up or penalising staff for integrity will breech relationships with the community and trust. This will have have serious economic costs – a very different position. We need a community presence and a community engaging with the providers on an equal footing. We need you all to get behind us in supporting this sort of solution and persuade the Royal Commission that this is the way to go.
Yet this very same regulatory system allows nurses in a private hospital to secretly administer antipsychotic sedatives to dementia patients without their knowledge or consent or that of their substitute decision makers. How does this improve the safety and well being of elderly patients? The code of conduct and professional standards does NOTHING to protect vulnerable dementia patients in hospitals if nurses resort to chemical restraint to control them as the very first option. How has years of nursing training helped them care for dementia patients – clearly it hasn’t. What is astounding is that these facts do not garner a whole lot more attention! The majority of kind, caring aged care workers are forced to suffer the indignities of unfair perception and are treated as criminals because they have less training. If they have less scrutiny, change the system so that more is required of them – but don’t put nurses up on a pedestal simply because they hold a degree and have done more training – unless you are 100% sure they won’t be knocked off.
“The fish rots from the head”. Too often I see organisations that blame downwards, saying if we get rid of the “bad” staff then everything will be good.
We are seeing a broad mix of staff in aged care from many cultures with varying perceptions and shades of what is normal and acceptable. Even though there is much discussion on how difficult it is to attract staff to aged care, there is increasing voice for more staffing and reporting staff ratios. Where will these staff come from?
I was recently at a facility that had very good staff numbers due to low occupancy. Still, residents waited a very long time for assistance and support. There was little evidence of a “dining experience” despite staff presence. There was no conversation and no engagement. I returned one resident to their room who requested he would like to go to bed. He required a hoist & 2 staff to transfer him. I asked the staff in the next room if they could take care of him after the transfer they were doing. I was told, no that is the job of the afternoon shift. I asked what time would that be – after 2pm. I asked what the time was – 12.30! They said, put him in front of TV and he will get sorted later.
Our diverse care staff need support and guidance and training and mentoring on a daily basis to shape them into the valuable staff we would like them to be. Many do not know the norms and expectations that are required of them that are acceptable to family, regulators and the broader community. If we dont want abuse in all its forms, then we need to teach better ways.
We cannot shape and grow the staff to succeed just by telling them what NOT to do. This extends upwards to management. Too often I see a revolving door of management who get jettisoned into a job to sort things out. They are expected to snap their fingers and make everything good. Quick fixes end up with unexpected consequences. They fail and get moved on.
Aged care will not get simpler. We will not solve tomorrow’s problems with the same level of thinking that created them. This is going to take a collective effort beyond the aged care sector to nurture and grow all, right up to Board level, into the future we would like to see.