Dementia Australia’s submission on restrictive practices to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, noted the “inappropriate overuse” of restraints on people living with dementia in residential aged care.
Restraints are “regularly used” on aged care residents, despite “significant evidence” to show the practice is ineffective and can cause adverse side effects, the submission says.
Changes in behaviour are common for people living with dementia, and are generally a way for the person to communicate their needs or wants in response to their situation and/or the environment they are in.
Using physical restraint on an aged care resident who is living with dementia can increase the risk of falls or injury as the person struggles to free themselves. It can also lead to the development of pressure ulcers, and chemical restraint is another serious risk.
Psychologically, it can cause feelings of humiliation or being ‘trapped’, depression, increased stress and agitation.
To this end, from 1 September 2021, residential aged care providers have been required to develop behaviour support plans for each resident who requires, or may require, the use of restrictive practices as part of their care.
Behaviour support plans are intended to reduce reliance on restrictive practices, and provide an opportunity to refocus practices towards higher quality dementia care.
One of the first steps to providing quality dementia care is to understand the capability of the workforce.
Dementia Australia’s Dementia Practice Health Check is an online tool that helps aged care providers assess the dementia care capabilities of their workforce, identify areas for improvement and clarify opportunities for staff development.
The tool first requires the manager to complete a five-minute survey, and then team members can complete a 45-minute scenario-based survey. The tool produces a detailed health check report and recommendations.
Results can be compiled into a detailed baseline report that allows for monitoring over time and can be used to demonstrate improvement.
The tool has also been developed in line with the Aged Care Quality Standards and consumer expectations.
So far, Dementia Australia has learned that more than one-third of aged care staff don’t seek input from people living with dementia when they develop support plans.
More than half did not understand the importance of residents being able to move about freely outside, and nearly half were unaware of way-finding strategies.
More than a quarter of staff who have used the assessment tool did not feel they have the knowledge and skills to deliver quality dementia care.
The tool has been developed by Dementia Australia’s Centre for Dementia Learning, a leading national provider of professional dementia education. The Centre for Dementia Learning’s information is informed by the lived experience of people impacted by dementia, the latest research and the best in contemporary practices.
For more information on changed behaviours and dementia, view Dementia Australia’s Help Sheets.