Welcome to 2019 which promises to be an important year for all of us working with older people. The current hearings of the Royal Commission into Aged Care Safety and Quality, the introduction of a single set of Aged Care Quality Standards, changes to accreditation, and the Federal Election provide us with a major opportunity to raise the many issues facing older people in Australia.
Here at NARI, we are very much focused on providing solutions. Our research is based on ‘bringing research to life’ in a bid to change policy, educate health professionals working with older people, and introduce new thinking to solving problems. Consequently, much of our research is ahead of the trend, as has become evident to me as I listen to hearings at the Royal Commission.
One example of this is our research into barriers to reducing the use of restraints in residential care facilities. This was undertaken by NARI in Melbourne in 2004. Researchers Betty Haralambous and Kirsten Moore looked at the potential risks of physical and emotional harm of restraining people living in aged care through the lens of perspectives of staff, residents and family.
The NARI research built on previous work which showed that restraining residents could be detrimental to their health and wellbeing; policy and practice had shifted towards reducing the use of restraints, but that physical, chemical and environmental restraints were used without evidence for their effectiveness.
NARI’s research revealed that often restraints were used to prevent physical harm; staff shortages emerged as another reason; families believed some staff did not have enough knowledge about alternative approaches; and that more education and support in evidence-based practice was needed for both families and staff.
Today, 15 years on, and it appears that these findings have not been heeded. And while the Federal Government has said it will introduce regulations to prevent the excessive use of restraints, the same issues exist: understaffing, lack of awareness about alternative approaches, and not enough education and training.
The Royal Commission has also heard calls to mandate dementia education among aged care staff.
Once again, I am mindful that our research is leading the way in training not only residential aged care staff but also home care workers supporting people with dementia. For instance, we are currently working on PITCH, a program that is developing and testing dementia specialist training program for home care workers.
Funded through a NHMRC grant, the project aims to directly benefit people with dementia and their carers by skilling home-care workers to provide care that promotes independence, improves quality of life and reduces family carers’ burden.
This type of research and development of specialist training is critical: 70% of Australians with dementia live in the community and, of these, 84% are estimated to have a severe or profound disability. The quality of home care they receive directly influences their life quality and ability to remain independent.
I am very mindful of the importance of the Aged Care Quality and Safety Royal Commission as an opportunity to air and explore the problems in our current aged care system. However, it is even more important to focus on solutions.
This means making use of the evidence base already available (such as the understanding of barriers to restraint use mentioned above) as well as building new evidence as gaps emerge. NARI’s work is focused on understanding and promoting the best models of care that promote quality of life for older Australians.