How Residential Care Staff Conceptualize the Identities of Residents With Dementia and Its Relevance for Decision Making

The ways in which residential aged care staff conceptualize the identities of residents with dementia has significance for how they support them to make decisions and make decisions on their behalf. This article aims to further understand how staff in residential aged care facilities comprehend who residents “are.” Methods: This qualitative study draws on individual and group interview data with aged care staff from two Australian states concerning decision making for individuals with dementia. It identifies themes relevant to how staff refer to identity in relation to such residents. Results: Staff possess disparate ideas about what things comprise residents’ identities and, accordingly, which sources of knowledge are most relevant to learning about residents. Discussion: This article argues for the application of a multidimensional and temporally inclusive understanding of identity by those who provide care to people with dementia.

Download Full-text

Challenges faced by residential aged care staff in decision-making for residents with dementia

Dementia ◽

10.1177/1471301220929154 ◽

2020 ◽

pp. 147130122092915

Author(s):

Nadine Cameron ◽

Deirdre Fetherstonhaugh ◽

Michael Bauer

Keyword(s):

Decision Making ◽

Aged Care ◽

Self Determination ◽

Care Staff ◽

Residential Aged Care ◽

Organisational Support ◽

Care Facilities ◽

Aged Care Facilities ◽

Residential Aged Care Facilities ◽

National Framework

Care staff in residential aged care facilities (nursing homes) in Australia are obligated, under the Australian National Framework for Action on Dementia 2015–2019, to support residents to exercise choice and make decisions. Research indicates, however, that care staff are often given little guidance regarding which residents’ decisions should be supported or how to make decisions on their behalf. This lack of guidance can result in a denial of residents’ rights and inconsistent treatment by staff, placing residents’ wellbeing at risk. Through providing an analysis of the responses of staff at RACFs in Victoria and Queensland to two case scenarios, this study seeks to provide some understanding of the difficulties staff face in supporting residents’ self-determination and their own need for greater organisational support.

Download Full-text

How do care staff in residential aged care facilities conceptualise their non-verbal interactions with residents with dementia and what relevance has this for how residents’ preferences and capacity for decision-making are understood?

Dementia ◽

10.1177/1471301218798422 ◽

2018 ◽

Vol 19 (5) ◽

pp. 1364-1380 ◽

Cited By ~ 1

Author(s):

Nadine Cameron ◽

Deirdre Fetherstonhaugh ◽

Michael Bauer ◽

Laura Tarzia

Keyword(s):

Decision Making ◽

Aged Care ◽

Verbal Communication ◽

Care Staff ◽

Residential Aged Care ◽

Verbal Interactions ◽

Staff Members ◽

Care Facilities ◽

Aged Care Facilities ◽

Residential Aged Care Facilities

This paper considers the significance of how staff in residential aged care facilities interpret the non-verbal communication and behaviour of residents vis-a-vis their assessments of residents’ preferences and ability to participate in decision-making. It highlights the risks associated with staff members’ failure to interpret residents’ non-verbal communication and behaviour with reference to residents’ backgrounds and prior experiences. It also considers how non-verbal communication implemented by staff may impact residents’ emotional state and, as a consequence, decision-making abilities. Drawing on interview data with aged care staff from Queensland and Victoria, it demonstrates that care staff in residential facilities appear to rely heavily on non-verbal signals in assessing the decision-making capacity and preferences of residents with dementia. It also indicates that many staff fail to consider residents’ non-verbal communication and behaviour with due consideration of residents’ individual histories.

Download Full-text

Enhancing palliative care in rural Australia: the residential aged care setting

Australian Journal of Primary Health ◽

10.1071/py10054 ◽

2011 ◽

Vol 17 (1) ◽

pp. 95 ◽

Cited By ~ 18

Author(s):

Geoffrey Mitchell ◽

Caroline Nicholson ◽

Keith McDonald ◽

Anne Bucetti

Keyword(s):

Palliative Care ◽

End Of Life Care ◽

Aged Care ◽

Care Staff ◽

Residential Aged Care ◽

Care Facilities ◽

Aged Care Facilities ◽

Residential Aged Care Facilities ◽

Advance Care

The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.

Download Full-text

Person-centered care and engagement via technology of residents with dementia in aged care facilities

International Psychogeriatrics ◽

10.1017/s1041610217001375 ◽

2017 ◽

Vol 29 (12) ◽

pp. 2099-2103 ◽

Cited By ~ 6

Author(s):

Anita M. Y. Goh ◽

Samantha M. Loi ◽

Alissa Westphal ◽

Nicola T. Lautenschlager

Keyword(s):

Aged Care ◽

Care Staff ◽

Residential Aged Care ◽

Cross Sectional ◽

Convenience Sample ◽

Person Centered Care ◽

People With Dementia ◽

Care Facilities ◽

Centered Care ◽

Aged Care Facilities

ABSTRACTTouchscreen technology (TT) is a resource that can improve the quality of life of residents with dementia, and care staff, in residential aged care facilities (RACF) through a person-centered care approach. To enable the use of TTs to engage and benefit people with dementia in RACFs, education is needed to explore how these devices may be used, what facilitates use, and how to address barriers. We sought to provide education and explore RACF staff views and barriers on using TT to engage their residents with dementia. An educational session on using TT with residents with dementia was given to staff from three long-term RACFs in Melbourne, Australia. A cross-sectional convenience sample of 17 staff members (personal care attendants, registered nurses, enrolled nurses, allied health clinicians, and domestic staff) who attended were administered questionnaires pre- and post-sessions. As a result of the education seminar, they were significantly more confident in their ability to use TT devices with residents. TT, and education to staff about its use with residents with dementia, is a useful strategy to enhance RACF staff knowledge and confidence, thereby enhancing the use of technology in RACFs in order to improve care standards in people with dementia.

Download Full-text