Workplace violence in aged care: part of the job?

More than 12 thousand workers compensation claims were made in the aged care industry in the three years to 2014.

A person stopping a raised hand from striking them

Workplace violence can cause physical and mental injuries for aged care workers and makes up around 9.2 per cent of claims.

With an ageing population, ensuring staff are able to cope with the aggressive behaviour associated with some types of dementia is an important issue for aged care providers and work health and safety regulators.

What’s in store for Australia?

Alzheimer’s Australia says that by 2050 almost 900,000 people are expected to be living with dementia, and it will be striking down younger and younger people.

In addition, mental illness is the third leading cause of disability in Australia and, although 90 per cent of people with mental disorders have no history of violence, when we age with mental illnesses our cognitive functions can also deteriorate and lead to behavioural changes.

For those who work (or live) with people with challenging behaviours, violence can be a very real part of their day.

‘Challenging behaviours’ are associated with a decline in cognitive capacity, generally due to dementia and/or psychiatric conditions such as schizophrenia, bipolar affective disorder, anxiety disorders and agitated depressive states; issues that circulate around aggression and resulting physical incidents in the aged care industry.

Steve Charles, Assistant State Inspector SafeWork NSW, says incidents involving violence toward staff are common in aged care, especially in dementia units.

A history of mental illness can further complicate behaviour management.

“A typical incident involving violence would be where a carer approaches a resident to provide care and the resident becomes aggressive,” Mr Charles said.

Carers need to engage with residents in intimate ways such as when feeding, bathing and dressing so for any patient you can imagine it’s a vulnerable situation to be in.

Mr Charles advised that a safe work strategy might involve working in pairs, so there is a level of additional support for both the resident and team member where an incident has the potential to occur.

Caring for the resident while also ensuring a safe environment for team members is essential, and this needs to be fully acknowledged within management plans and risk assessments.

Safety systems to stop workplace violence

Tony Robinson, Director of Specialist Services at SafeWork NSW says workplace violence occurs more in some jobs than others, such as aged care where workers deal directly with residents, but says it shouldn’t be seen as a normal or natural part of anyone’s day.

“The most important WHS strategies to address violence at work include making sure employers understand their duties, workers understand how to identify hazards and risks related to work-related violence, and that they can choose appropriate control measures and respond to incidents,” said Mr Robinson.

Support from management is also vital to maintaining best practice systems and keeping staff well trained.

“As the majority of aged care nursing home facilities are owned and managed by large private companies, establishing good safety systems and influencing change happens at the corporate level: with the people who design, deploy, manage and monitor such systems.

“For example, given that managing challenging behaviours is inherent in aged care work, an effective way to get an overall picture of the types of behaviours and risk involved is with good record keeping.”

Prevention is key

Mr Charles said good record keeping is a must in order to identify behavioural triggers so carers can log and avoid situations that lead to violence.

“In addition, to prevent and manage workplace violence there are a range of other important considerations: you need to consider appropriate levels of lighting, facility design, opportunities to exercise, a reduction in noise and staff resourcing.”

“On top of that, education and training, a commitment from management, and individual resident plans also play a role.

“There are many factors that need to work together to create a safe environment.”

The demand for aged care services is  increasing and with it, the potential for workplace injuries and illnesses.

Keeping aged care workplaces safe is a must, so that violence does not just become ‘part of the job’.

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