May 22, 2024

Invisible Scars: Preventing Aged Care Workers From Taking On Residents’ Trauma

Invisible Scars: Preventing Aged Care Workers From Taking On Residents' Trauma
Aged care staff are particularly vulnerable to vicarious trauma due to the nature of their work.[CoPilot].

In many professions, the physical signs of work are visible. Carpenters might have rough hands, construction workers may be covered in sawdust, and chefs often bear burns and cuts from the kitchen.

However, in the aged care sector, the marks left by work are not so easily seen. Cameron Burgess, National Director at the Mackillop Institute, introduced me to the term “emotional labour” to describe the unique burden borne by aged care staff. These workers carry the emotional weight of their job, which can lead to vicarious trauma.

“Vicarious trauma is exposure to other people’s trauma,” Burgess explained. “This could be hearing stories or witnessing events that have the same harmful effect on an aged care staff member as if they had experienced that trauma directly.”

Aged care staff are particularly vulnerable to vicarious trauma due to the nature of their work. 

“The end destination point for anyone in aged care is death. So that, in and of itself, is a traumatic event for anybody,” Burgess said.

He further noted that aged care environments often bring unresolved personal traumas to the surface for residents, who have ample time to reflect and share their stories with staff. This exposure can deeply affect not only care workers but also cleaners, chefs, and other staff members.

The entry into aged care is often a traumatic experience for residents and their families, signifying significant losses. This can lead to dysregulated behaviour, adding to the stress faced by staff. 

“Repeated exposure to these dynamics, in addition to medical episodes, contributes to vicarious trauma,” Burgess said.

Recognising the signs of vicarious trauma is crucial. Burgess outlined three categories of warning signs: physical, behavioural, and psychological.

Physical signs include insomnia, exhaustion, frequent sickness, and stress-related illnesses with no clear medical explanation. “We use a fancy academic word called ‘somatisation’ to describe these stress-induced ailments,” Burgess mentioned.

Behavioural signs include labelling or grouping residents as hopeless, reduced empathy, avoidance of people, irritability, and overreaction to situations. “You might find yourself overreacting to comments or situations, or keeping it together at work only to be harsh with your kids at home,” Burgess noted.

Psychological signs include emotional exhaustion, a shift in worldview, and questioning the meaningfulness of one’s work. “You might start to think people aren’t inherently good anymore or feel that your work isn’t making a difference,” Burgess explained. In extreme cases, this can lead to a workaholic approach as a way to cope.

To combat vicarious trauma, the Mackillop Institute emphasises prevention through training and social support.

“It’s not a fait accompli; you don’t have to experience vicarious trauma,” Burgess asserted. Their training covers identifying warning signs, understanding risk factors, and creating a supportive work environment.

One of the most effective preventative measures is fostering social support within teams. “Creating dynamics where staff can support each other through difficult times is crucial,” Burgess said. The training also includes developing personal safety plans, encouraging staff to identify three strategies to ground themselves and gain perspective during tough times.

Ultimately, supporting aged care staff is about valuing their well-being. “If we can create a skilled and supported workforce in aged care, the benefits will flow to the residents,” Burgess concluded. “We want facilities where staff genuinely care, not just those who are burnt out from the emotional and systemic pressures of the job.”

The emotional labour carried by aged care workers may be invisible, but acknowledging and addressing vicarious trauma is essential. Through awareness, training, and strong support systems, we can help safeguard these dedicated professionals and improve the quality of care they provide.

Frontline Experience

Inspired by hearing Cameron Burgess speak about the impact of vicarious trauma at an aged care conference, Residential Aged Care Manager, Milly Kuranage decided that both she and her beloved staff at Brotherhood of St Laurence Aged Care could benefit greatly by undertaking training at the Mackillop Institute.

“The work we do is quite difficult most of the time, and what I felt was that there was not enough support and not enough talk about how another person’s trauma could affect caregivers and nurses,” said Kuranage.

“I was very hopeful when I heard the speech from Cameron, and I thought, wow, there is support out there. Hence the reason for me to reach out to him.”

Kuranage also observed the prevalence of vicarious trauma in her staff before they underwent training.

“I see it all the time. And obviously, I go through it as well, being the manager. It’s very common and very much underreported.”

According to Kuranage, both she and her staff found the training uplifting and empowering as staff felt a renewed confidence to speak up and implement their newfound skills to decompress.

“It’s also having support and acknowledgement that the trauma they feel is a real thing,” said Kuranage.

She emphasised the need for more mental health support in aged care. “There’s no doubt about it. There is absolutely no doubt about it, there needs to be more discussions, there need to be more support. I feel like people know that it happens but they feel as though it’s just part of the job, but it doesn’t have to be.”

Regarding the necessity of training, Kuranage added, “Obviously with the standards coming into aged care, the commission is also acknowledging the fact our care delivery needs to come from a trauma-informed place. And it needs to go vice versa. Yes, we are caring for people with a lifetime of good, bad and ugly experiences, but at the end of the day, as aged care, we need to look after ourselves as well.”

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  1. What is any different to an aged care worker to medical staff in emergency departments, ambulance people attending catastrophic accidents, funeral workers, etc. All these people confront death daily. This just seems like another excuse for “mental health days”. If the job is confronting find another job

    1. Hi James! As an aged care worker fr 12 years I agree with you . If an aged care worker works in a properly managed (as I now do) then a lot of the issues raised in the whilst challenging are managed with good support from the management. I have often seen a “martyr” mentality amongst past employees who take on way more outside of their scope and then complain about the level of work. Working outside your scope is damaging and should be managed by the RN. Everybody who works has challenging times.

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