There is simply not enough staff to carry out all the daily duties in residential aged care facilities. Not having the necessary number of workers to care for the elderly means essential care is missed.
I will start by describing a morning in a RACF that I don’t believe has ever been documented in any detail. Just as an example:
The first thing (all) people want to do when they wake up in the morning is go to the toilet. But there is not enough time for two carers who have arrived on duty at 0700 hours to take 20, 30, 40 residents to the toilet all at the same time.
Many are woken at the crack of dawn (although I do not know why they are woken at all) to be showered. I believe they should be allowed to sleep and wake up naturally. Some can walk, go to the toilet, and wash their hands themselves, but there are many who wear incontinence pads and they need their pads to be changed before breakfast. Many are faecally incontinent and changing pads requires care staff to devote a lot of time to clean them up properly (or even to shower them before breakfast).
Many residents have hearing aids. Care staff have to make sure the aids are clean and batteries are working/changed/tested before they are inserted correctly into residents ears, before breakfast. This can be difficult when residents have dementia because they may become resistive and lash out at care staff (often hurting them).
Then there are dependent, immobile, residents who need total assistance from at least two or three care staff using a mechanical lifter after they have had their hearing aids and dentures put in and pad changed. Lifting these residents out of bed and into a wheelchair to push them into the dining room takes time and I repeat, when residents have dementia they may become resistive and lash out at care staff (often hurting them and themselves).
Breakfast may be served at 0730 hours but the kitchen closes at 0830 hours. Many of the 20, 30, 55 residents need their food cut up for them and some need to be fed (if they have lost the use of an arm following a stroke, for example).
The routine of toileting, pad changing and hand washing is repeated before every meal. Then, at night, hearing aids and dentures must be removed and cleaned. Toileting, pad changing and hand washing is repeated.
I am an aged care, wound care, Registered Nurse (RN). I have been in about 300 RACFs and many private homes since 1997 to see residents with wounds and advise on clinical care and infection control.
I have watched them working. I have fed residents when I see that two staff simply cannot get around all the residents who need to be fed (and we wonder why some are malnourished).
I am so frustrated because I feel ‘ratios’ need to be discussed in the context of what care staff must do each shift. They cannot get everything done. Dentures alone can take 20 minutes to remove, clean, re-insert in one resident’s mouth when they have dementia.
Well done to all aged care staff – I truly admire you. I know the workloads you have every shift.
Catherine Sharp is the Founder and CEO of The Wound Centre®. The Wound Centre® provides wound care/infection control/pressure injury prevention/management and education through the free Wound Centre® Visit website: www.thewoundcentre.com.
Thank you. I also spoke at the Royal commission in Perth. I described a day in the life of a care worker. The government announced billions of dollars would be immediately spent on aged care and yet in my daily work life I see not a single change in residential care and I work in what I would describe as a good facility.
Staffing is a major issue. It seems that those who have the power to address this, just don’t get it.
I would love to see the PM, aged care minister, the commissioners etc do a real buddy role in each position of a RACF( RN/AIN/DiversionalTherapist/RecreationalActivity Officer/Physiotherapy/Catering/Laundry and see what it is truly like….
We have two care staff to look after just 8 residents and its a struggle. We cook do all the caring and medications as well and linen changes and washing and all the residents notes as well as sometimes directing the RNs with information as they are not really on the floor to observe the residents so rely on the staff for information. The cooking although we have 8 residents we sometimes have to cook 4 different meals. It has got to the point where we some times go without breaks and food. Only to have management ask what is the problem.
HI Catherine Thank you for writing the truth and what you have seen .
That is so true, I have just had to leave RACF due to the stress and ending up having a TIA.
Then have a RN ( I do Love RN) when I rang from the hospital say “really now I need to change the roster” . The pressure on staff both Carers , EEN and RNs are so stressful. And having to wait so long for extra staff is annoying. I hope to return to RACF one day but decided to do some Home Care and then go into management.