Jan 31, 2022

Aged care assessment tool identifies gaps in dementia knowledge and practice

Dementia carer

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.

To find out more about Dementia Australia’s Dementia Practice Health Check, visit their website.

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  1. My wife works in aged care and I do volunteer work at an aged care facility and I observed and heard that to get work in the aged care sector all you need is a Cert 3 in aged care, with little, if any, ongoing education. My research also suggests that upwards of 80% of residents have some level of dementia, from very mild to very severe.
    Consequently, at the urging of the Professor who heads up the Wicking Dementia Research Team, I’ve established a business called Talking Dementia…I’m not teaching it, or training it, that’s the role of the Uni and Dementia Australia who are giving me a great deal of encouragement and support from the team here in Tasmania. I’m getting people talking about dementia, talking about their frustrations and challenges while working with people living with dementia. I’m also enrolled in the Diploma of Dementia Care starting in a few weeks.
    I’ve found that, as we raise awareness of dementia, as we did with a Dementia Expo here in Devonport last year, it lowers the stigma attached to dementia. I spent 10 days leading up to it, promoting the Expo to every aged care facility and doctors surgery in a 40 km radius. We hoped to get 20 exhibitors, we got 35. In the 4-hour window that we held the expo, we hoped to get 250 people through the doors, we got over 370. Consequently, we will be holding many more throughout Tassie this year.
    The other area Professor Vickers wants me to address, particularly as I have a long history of working with the medical and nursing professions, is General Practitioners.
    BTW, I’m 73 and very excited about the year ahead and beyond.

  2. I think it is very important that staff have quality training in caring for residents with dementia. For example, difficult situations could be avoided by proper training of female staff on how to interact with male residents who no longer realise when their speech or behaviour is inappropriate. I believe Aged Care staff, who are often from various cultural backgrounds and often with limited English language skills, need more than a Cert 3 training course to be able to handle all dementia situations with understanding and compassion.

    1. Education is of course important but when you are dealing with residents with advanced dementia experience is the key. A severely affected resident with dementia can very quickly change personality and temperament that is simply not able to be covered by education. It’s hands on experience, knowing that meds are running out ( sundowning) and that it’s time to either entertain or leave a particular resident alone for a bit.
      Facilities have on going education, it’s part of the accreditation requirements, and this is directed at specific requirements in that home.
      You can’t read experience!

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