It’s a question that echoes through staff rooms and tugs at the hearts of worried families: “Are aged care staff even allowed to cut a resident’s nails?”
Some facilities give a cautious nod, provided staff are trained, while others slam the door shut, banning scissors or clippers in the hands of personal care workers. So, what’s the real deal? Is this a legal barrier, a clinical safeguard, or just a myth that’s grown legs?
What is the law?
There’s no explicit legislation in the Aged Care Act 1997 or the Aged Care Quality Standards (as outlined by the Australian Aged Care Quality and Safety Commission) that slaps a ban on aged care staff trimming residents’ nails.
The Quality of Care Principles 2014, which govern clinical care, stress safe and high-quality care but don’t single out nail care. Instead, decisions hinge on:
In short: nail trimming isn’t against the law, but it may be fenced off by a facility’s policies or clinical risk assessments, especially for high-risk residents.
Why the nail-trimming nerves?
Aged care providers often tread carefully around nail trimming due to real clinical and safety concerns, particularly for older adults with complex health needs. The risks are no small matter:
Because of these risks, many providers restrict nail care – especially toenails – to registered nurses, podiatrists, or specially trained staff.
The Royal Australian College of General Practitioners (RACGP) Standards for General Practices (5th edition) underscore the need for sterile equipment and trained professionals for procedures involving skin, a principle many aged care homes apply to nail care.
Crafting the gold standard
Best practice in aged care nail trimming strikes a balance between resident comfort, safety, and clinical rigour. Here’s what it looks like:
Staff must always follow their organisation’s clinical governance protocols and check with supervisors when in doubt.
Easing family frustrations
Families often feel a pang of frustration when told they can’t trim their loved one’s nails, especially if it’s a cherished ritual they’ve done for years.
Yet, aged care staff are juggling a complex web of risk management, scope of practice, and compliance with the Aged Care Quality Standards, particularly Standard 3 (Personal Care and Clinical Care), which prioritises safe and effective care.
To smooth the tension, best practice includes:
Digging deeper: insights from the field
A 2023 report by the Aged Care Quality and Safety Commission highlighted that clinical governance in aged care has grown increasingly cautious following the 2021 Royal Commission into Aged Care Quality and Safety. This has prompted tighter policies around tasks like nail care, which, though small, can have big health implications.
A 2022 study in the Australasian Journal on Ageing found that improper foot care, including nail trimming, contributed to 15% of preventable infections among aged care residents with diabetes.
Posts in online forums also reveal lively debates among aged care workers. Some call for better training to empower PCAs to handle basic nail care safely, while others argue podiatry referrals are more cost-effective and reduce liability.
These discussions highlight the patchwork of practices across Australia’s aged care sector.