Jun 14, 2023

Do care staff have the right to refuse care of a resident?

For some aged care workers, dealing with clients can be a challenge. [Source: Australian Nursing and Midwifery Journal]

It has been proven that  care workers, particularly those working in home care, have to put up with verbal and sometimes physical abuse from clients and their loved ones which can be harmful to their health, leading to job dissatisfaction and burnout.

Depending on clients’ background and cognitive state, workers can experience racism, religious slurs, physical assault and sexual harassment from clients at work. 

In accordance with the Aged Care Quality Standards outlined by the Aged Care Quality and Safety Commission, aged care providers and workers are required to provide safe, quality and consumer-centred care at all times but what if the care worker doesn’t feel comfortable doing so?

While providers are required to assess, understand and take account of the needs and preferences of the people they are caring for, they also have the responsibility to provide their staff with a safe workplace.

Why are clients treating me this way?

There can be many reasons why clients behave in a way that is challenging or upsetting for staff. This could be for many different reasons such as symptoms related to dementia, a lack of pain management, medication side effects or concerns about care delivery. 

Additionally, the sector’s chronic staff shortages – which were compounded by the COVID-19 pandemic – have meant several clients have experienced service delays, creating agitation and tension for clients who then sometimes take out their frustrations on staff.

Megan Mainwaring, a case manager at myHomecare has worked in aged care for the past eight years and said the mental toll of navigating abuse in the sector is becoming “unbearable” for herself and her workers.

“It’s not getting any better even though the pandemic is calming down, in-home care seems more stressful,” Ms Mainwaring told Nine News.

The Aged Care Quality and Safety Commission states that a mixture of staff training and clear and proactive engagement with consumers and/or their representatives can help identify problems and put solutions in place. 

Your employer’s responsibility

Like all workplaces, providers must ensure that they are compliant with applicable workplace legislation and regulations in their operating State or Territory, such as work health and safety provisions.  

But there are other things employers can do to ensure their staff feel protected when they come to work while also providing suitable care for clients.

Firstly, formal agreements, policies and procedures should revolve around the standards and expectations providers have for both staff and clients to ensure harmony and safety. Such agreements should be created around existing frameworks such as the Charter of Aged Care Rights and the Charter of Sexual Rights in Residential Aged Care which standardise clients’ rights and responsibilities. 

“While every situation is different and must be considered and treated based on its own merits… Aged care providers, through mechanisms like agreements, can make clear to consumers their expectations about safe, respectful interactions between consumers and the staff providing care or services to them,” explained Aged Care Quality and Safety Commissioner, Janet Anderson.

According to Ms Anderson, in a scenario where matters cannot be resolved, a provider may look to the agreement they have with the client and any circumstances under which they can cease to provide care. 

This would have to be in line with their legislative responsibilities and the provider remains legally obliged to provide quality care and services that meet that consumer’s needs until care delivery ceases.

If you have any concerns about your workplace, you can visit the Safe Work Australia website.   

Have you felt uncomfortable or threatened by a client? How did your employer deal with it? Let us know in the comments below. 

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  1. Its all very well to have policies and procedures in place and educate your staff and consumers alike, and have a compliant work place, but many care workers still suffer racial abuse on a daily basis which has been ingrained into certain cultures since birth. The consumers may know this is wrong, but continue with ingrained unacceptable habits.

  2. Yes, smacked very hard with open palm in the face by a female resident whilst assisting another resident with dinner, then on the same evening 2 hours later while assisting a male resident in bed with a carer, he too punched me in the face with closed fist. All while I was assisting in care. No provocation at all. I was stunned (saw stars and red marks) shocked as well as injured and pain.
    Elder Abuse we don’t tolerate, but what of staff abuse from resident. We are subjected to consent verbal abuse daily from residents and not a thing can be done about it.

  3. Absolutely yes. I have been an aged care provider for almost 40 years and the protection of residents and staff has detioratated especially over the last few years. The resident rights and responsibilities legislation was replaced with just residents rights. Ageing in place has failed dramatically!
    The “system” including the ACAT has degenerated to the point where providers can’t trust the document.
    If a particularally agressive resident is admitted due to lack of honest information then staff must refuse care…for their own safety and the safety of residents around.

  4. I have found that organisations find it easier to blame the resident’s condition, rather than dealing with the resident’s conduct.

    From experience, residents’ are able to do whatever they like to staff; including false allegations. Organisations, will protect the consumer but not their employees.

    Since the aged care sector becoming customer focused, it is now, “The customer is always right”. A paying customer is never permitted to assault staff physically, sexually or verbally. This is not accepted in hospitals or even at a Centrelink office.

    I will now refuse care to those who are aggressive towards myself. I will try various techniques to overcome any issues, such as re-approaching and asking another colleague to assist etc. But if the consumer is threatening in any form, I will choose the right to protect myself first.


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