Supporting and Retaining Dementia Care Workers
Nursing homes, day centers and supported housing, rely on a good reputation by providing high standards of care by their care workers. The work is often very demanding and staff retention is a major issue in this sector. Although no national statistics are kept on staff turnover rates research since the early 1980s indicates it is an ongoing and serious problem.
In the USA turnover rates for nurse aides in residential aged care are well documented with some reaching over 100% annually. For supervising nurses that rate was 50% annually. The skills built up by experienced workers are invaluable to care homes and is not always easy to replace. It is expensive, time consuming and could easily impact on a care home’s reputation. Workplace stress, known to have a negative effect on staff retention, is often caused by insufficient skills and knowledge.
Il-Ho Kim and colleagues, in their research published this year in the International Archives of Occupational and Environmental Health, found that unmet care needs appear to be a consistent predictor of depression in both cross-sectional and longitudinal studies of care staff. Unfair treatment, client’s family abuse, client health and emotional suppression were also significant in contributing to their depression.
Data compiled by the US Government Occupational Safety and Health Office in 2002 found work in aged care has one of the highest rates of worker injury of all worksites in the USA. Moreover, in my experience, and backed by research, aggression and assaults by residents and family make a significant contribution to staff wastage if not handled well with education, good medical support and treatment and robust care home policies.
A systematic review of stress in staff caring for people with dementia living in 24-hour care settings, found that family caregivers of people with dementia are at risk of psychological distress. The findings, from the University College London, also suggest this may also be the case with paid caregivers who care for people with dementia due to its emotional and physical demands.
From much of the research available the essential strategies linking recruitment with retention are:
- Increased staffing levels
- Pay parity across different health settings
- A learning environment
- Careful selection of nurses
- Ongoing supervision and education training for skills
- Leadership and teamwork for new and existing nurses,
- Family friendly policies.
Also of importance is the involvement of families of relatives in care homes. As one study points out, “family-friendly, learning environments that value and nurtures its nursing staff, in the same way as nurses are expected to value and care for their patients and residents, is critical in ensuring their retention in dementia and aged care.”
Il-Ho Kim et al. Emotional demands and the risks of depression among homecare workers in the USA
International Archives of Occupational and Environmental Health
2012, DOI: 10.1007/s00420-012-0789-x
Institute of Medicine. 2001. Quality of Care in Nursing Homes. Washington DC: National Academy Press
International Psychogeriatrics / Volume 23 / Issue 01 / February 2011, pp 4-9
DOI: http://dx.doi.org/10.1017/S1041610210000542 (About DOI), Published online: 18 May 2010
Lynn Chenoweth, L et al. 2009.A systematic review of what factors attract and retain nurses in aged and dementia care. Journal of Clinical Nursing. Volume 19, Issue 1-2, pages 156–167, January 2010