Dec 18, 2017

Violence Against Nurses in Aged Care: Lack of Reporting

One would never imagine that working in aged care puts a person at risk of violent assaults and verbal attacks.

But for some aged care workers, this is a reality that comes with the job – something that no one should ever have to face.

In Australia, up to 95% of healthcare workers have experienced verbal or physical assault while on the job.

And within three months, more than 1000 nurses across Australia experienced violence during their shifts.

In some cares, nurses are bitten, struck and spit on regularly by elderly residents, usually ones with dementia who may be agitated or confused.

Sick days that were taken on account of “accidents at work” have also risen steadily since 2005.

An international research found that 80 per cent of aged care workers in Finland experience violence from their patients

The research chief, Timo Sinervo explained that the situation is dire, “it would be easier to respond to the situation if there were a reason for the violence, but there is none that we have found”.

An estimated 193,000 people in Finland have diseases or disorders that affect memory.

This European study suggested that the violence is often linked to the residents’ dementia symptoms – as well as saying that adding more staff would not improve the situation.

It was found that people in home care would also resort to violence in some situations, and were more likely to do so than people in residential aged care.

As one nurse pointed out, some residents are placed into aged care because their families being unable to cope with their aggressive behaviours.

Many of the attacks and abuse were not reported to authorities or even the managers at the facility. In fact, police are practically never involved when it comes to elder violence.

Some nurses even said that they didn’t tell their own families and loved ones about the ordeals they faced, “it is an occupational issue and we are duty-bound to secrecy.” said one nurse anonymously.

The Union of Health and Social Care Professionals says that only the most heinous attacks are reported.

Kaija Ojanperä, from Union of Health and Social Care Professionals, explained that many nurses choose to not report violence or abuse they experience because they are used to the behaviour or they do not believe their case would lead to any concrete measures.

In most aged care facilities, there are considerable less staff working night shifts than during day shits.

One of the anonymous interviewees said that “nighttime is the worst”, because any potential incidents are to be faced alone.

If a nurse were to be attacked or knocked unconscious, it may be hours before any help arrives.

Though facilities may be aware of the potential dangers, the lack of staffing ratios and budget means more staff will not be added at night.

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  1. In view of this article it would be an interesting exercise to do a survey with training providers on how many graduates they have put through over a given period and how many are still employed in the aged care sector or gone onto different employment. Violence across all shifts is a common occurrence towards staff, more difficult to manage at nights due to lower number of staff. Biting, scratching, verbal abuse are a pretty common occurrence, grabbing and twisting wrists and thumbs is pretty common as well, one strategy for a particular resident may not work for another resident who requires a different approach and even then those strategies don’t always work. As for reporting and documenting incidents that have occurred overnight,I figure if nothing has changed after the years I have worked at this facility then probably a waste of time , just end up managing it the best way we can. As I said would be interesting to see the drop out rate of graduates as opposed to retention rates in the aged care industry .

  2. While I do not advocate medicating all aged care facility resident, All incidents must be reported. that way the resident can be assessed to see if there is something new going on.
    when training staff it is good to put them into a situation where they are suddenly and silently rolled over or grabbed, what is their first reaction?
    It is so difficult to understand what is happening in the mind of any person let alone someone living with dementia so quietly softly and visible is a good way to approach a person. as I often say get rid of the clocks in facilities, allow people to live on their own time, it can be done on a rolling roster,

    1. Agree, forget a the clock, and the whole away a person approaches a resident is so critical. Learn that individuals history and tap into what’s important to them and for them.

  3. I think that in many cases the problem is the carer. I have a tremendous respect and gratitude for carers, but some of them don’t have that special talent they need. My husband had advanced Alzheimer’s, the female carers undressed and showered without any problem, they called him darling, sweetie, dear, etc. And they smiled, sang and were happy doing the job. He loved them and was always happy and very affectionate and polite.
    Then he had a male carer who said “come on son, I’ll shower you” and started to undress him. His reacción was a punch on the face, which is the normal reacción of any man when another man starts undressing him. So they said that he was aggressive and gave him large daily doses of zyprexa, which made him like a zombie and easy to manage. It also had to be effect of stopping him from walking, talking or even reacting. And that happens a lot in nursing homes. They overmedicate to make the patient easy to handle, and turning them into a vegetable living a hell of a life. And once the patient turns into a sad being, suffering every minute of their lives, the only way out is to stop feeding, because this sort of euthanasia is legal, while a compassionate one, with morphine, is not.

    1. YES agree. The way a carer approaches a resident is so important. Also knowing when to back off and give the resident space. There day their way.

  4. Back in the 90’s this was an issue. Then homes introduced diversional therapists. They obtained social and cultural histories of people and what triggered actions. Often it was things like bathing every day when their pattern in life for last 30 years was every few days. It could be taking 5 minutes to explain who this stranger was touching them intimately, it could be changing patterns such as bathing in evening rather than racing to do all before breakfast, it could be playing certain music to calm people or talk about long held interest. Attacks on staff and loud vocalisation plummeted. Legal opinion was given that physical or chemical restraint without authority of Adult Guardian was assualt. Then staffing numbers plummeted, many 457 visa carers were introduced with no training in dementia and problems arose again. Staff ratios are necessary but so ix traing. The Commonwealth funds Dementia Behaviour Advisory Services in every State. Use their expert knowledge to help manage residents.

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