Jun 11, 2021

Why are aged care staff so stressed – and what can be done about it?

Aged care staff are particularly prone to feeling stressed at work because of the huge demands that are placed on them, the lack of autonomy they have in their roles, and poor support networks.

“In aged care, you’ve got the whole shebang, physical demands, emotional demands, cognitive demands,” said Andrea Shaw, director of organisational health and safety consultancy, Shaw Idea. 

She said stress should be treated just like any other occupational health and safety issue: you identify the hazards, assess the risks, and then control the risk at its source.

The fact that stress is common among aged care workers is unlikely to come as a surprise to many of our readers, who often write on our pages about the pressures they feel at work, and their desire to care for residents, but the time and resource constraints that make it difficult for them to do so.

“A whole lot of pressure”

There’s “a whole lot of pressure” on aged care staff, Ms Shaw told HelloCare.

Aged care workers often aren’t given a lot of autonomy. They have a set number of tasks they have to perform in a shift, and this is often a shortage of staff available to do the work required.

Lack of support 

Aged care staff also often find themselves without a lot support in their workplace.

“You might not get support from your employer, from your supervisor, or from your peers,” Ms Shaw said. 

“You could be working in isolation. If you’re doing home-based care, you’re working completely alone. In facilities you can be working in a fair degree of isolation at night.”

Casual workers are particularly alone, she said.

“If you’re not in the same workplace every day, you don’t develop a support network in your workplace.”

The physical cost

While stress can lead to psychological illnesses, such as depression and anxiety, there is also evidence to suggest it can cause physical ailments, too.

“The evidence is extremely strong that work that involves a high degree of stress is also more likely to result in musculoskeletal disorders,” Ms Shaw told HelloCare. 

“In an aged care workplace, where we know there are the physical risks of manual handling injuries, it makes it much more likely people will have musculoskeletal disorders.”

Stress can also contribute to heart disease.

“The evidence is very strong that stress is closely associated with cardiovascular disease, so in a workplace that has a lot of job stress, you’ll also see a higher incidence of cardiovascular disease,” Ms Shaw said.

“In my view they [the physical effects] are more significant than the psychological issues,” she said.

Employ more staff: “It’s a no brainer”

Ms Shaw said the best way for aged care organisations to decrease stress levels for their staff is to employ more people.

“That’s a no brainer,” she said. 

“It’s needed … not just because of the health of employees, but clearly it’s better for the people who are in these facilities. 

“We need to have a better resourced sector. It’s criminal the way it’s been underfunded for so long,” Ms Shaw said.

Staff made scapegoats

Staff are being blamed for actions that arise because of stress and lack of oversight in the workplace, Ms Shaw told HelloCare.

“My concern is that, at the moment, we’re seeing a fair bit of victim blaming. 

“No one would excuse the reprehensible behaviour the aged care royal commission is showing, but when you’re in a workplace that is under such pressure, it’s not surprising that those kinds of behaviours are coming to the fore,” she said.

“In a system under such stress, it’s not surprising that people without a strong moral compass behave in reprehensible ways. And when there’s not really control in the workplace, it comes to the fore.”

Counselling useless if problems’ sources not addressed

Staff who are experiencing stress, depression, anxiety or other mental illnesses, should receive the support they need, but the source of the problems also need to be addressed so staff know their concerns have been taken seriously.

“There’s no doubt if someone is experiencing mental ill health, they deserve to have proper professionals to help look after them,” Ms Shaw said. 

“But the problem with that is, if… you don’t change the problem that caused the ill health in the first place, it’s worse than doing nothing at all.”

“The evidence is clear on that count. If you don’t do something about what’s caused the problem in the first place, the ill health reoccurs and in fact can be worse as a result of feeling even less cared for and less valued in the organisation,” she said.

What can you do?

Ms Shaw said aged care staff who are feeling stressed should work with the Australian Nursing and Midwifery Federation (ANMF) and other health and safety support structures in their workplace.

“Make it clear it’s a health and safety issue, and it’s the same as any other health and safety issue: you identify the hazards, you assess the risks, then you control the risk at its source,” Ms Shaw recommended.

Psychological stress should be treated the same as any other workplace injury.

“There’s a whole lot of mysticism about job stress and I think it’s a way of disguising the fact that it’s the same as anything else. If someone got mesothelioma, you wouldn’t tell them it’s their own genetic fault because they’ve got a genetic predisposition to cancer … you find out where the asbestos is, and you get rid of it,” Ms Shaw said.

The health and safety “apparatus” in aged care workplaces can support staff who might worry about being “victimised” about speaking up.

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  1. Dear Caroline,
    Thank you for your story. Stress in my workplace is very real. Most registered staff, including myself, have had to drop shifts for our own mental health. We cry on the job. The pressure to complete so many tasks from our managers is unrealistic. I have had an increase in antidepressants and sick leave is sky high with my colleagues. Nurses are having panic attacks, one sent by ambulance from work.
    We need to be screaming this work environment from the roof tops. Surely someone has to listen.

    1. Thanks for your comment Kym. Sorry it’s taken me so long to reply. I just saw it. I’m very sorry to hear you are experiencing this. I hope you have been able to get the help you need. It sounds as though you are working under very difficult circumstances. Caroline

  2. what is needed is more staff…. I am a carer who looks after one person with Alzheimer & that drains me let alone one nurse looking after about 10 of them & having to do the extra work that they have to do… Definitely need more staff in the nursing homes… Private facilities worry about bringing in the money for the shareholders & the CEO .. They need to add MORE staff as it is very stressful looking after a dementia person….if all the nurses leave their positions because of stress who is going to look after the poor patients…

  3. We were usually told this is a 24/7 if you dont complete your tasks the next shift will, good way to foster working partnerships dump your work on already short staffed shift.Aftrnoon shift smaller staff numbers

    1. Hi, I did my placement in the facility in which I have been working for about a year now…We are not allowed to say we are “understaffed” when we clearly are…. all the buzzers going off at once… 3 AINs to 20 residents who are all high care (hoists etc)… I have changed my shift from Morning to afternoon as it is less wear and tear on my body and slightly less stressful and less bullying of SINs and residents.. I have exacerbated an existing knee problem (degenerative) and also find I am crying on the job from pain and stress….. I have experienced several bullying episodes from peers…. who I had stood up to but I have seen new people leave because of it.
      I usually find when I start my shift that it has clearly been understaffed because of the state of the residents, dirty pads etc… however I don’t blame the staff as I know how bad it is… it just upsets me for the residents..I changed careers as a 57 year old fit woman to help others… and it’s detrimental to my physical, mental & emotional health…. I have no one to talk to about my feelings as I can’t at work.

  4. You start the day with 3 to 4 residents to showers in within an hour and half. Some are high care and needed lifters, some lifter machines are very old and difficult to maneuver. Nearly everyone needs assistance to get ready to attend breakfast, depending where the dining is located some facilities have well designed open plan building where dining and activity lounge is easy to access. Some facilities are poorly designed, everything is spread around. The amount of walking you have to do to transfer the residents or even to collect their meals is exhausting and time consuming. Carers also do medication aside from working on the floor. Some residents have behavior issues and can be verbally and physically agressive. You have computer works to do plus paper works, plus other tasks. You dont really go home on time.

  5. Hi, I’ve been working in an aged care facility for almost 9 years. I am mostly in the high dementia care where most other AIN’s don’t want to be. We get bitten,spat on,hit,and just abused by our ‘ lovely” elderly. It’s not a place you walk out of feeling elated,it’s very sad actually. The place I work in is a very large facility. We have had extremely low staff ever since the pandemic, yet we are in far north qld . On our day off we get multiple texts to fill shifts and it’s never ending. Making us all so stressed and high anxiety. It feels like we have no life. We don’t get a good enough wage to be able to have a life because we spend it all on dr visits and medication and psychologists. I am really not living my life and feel apart from my children and husband. I don’t even want to visit my mum and dad anymore because it’s such a demanding job we do with the elderly. I hope I never lose my compassion, but I am feeling ..alone..

  6. Hi, I’m one of the unrecognised EENs with BH and constantly reminded of their negative reciprocity values. We along with the RNs are sick of the pressure forced upon us staff.

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