Welcome to the second edition of our e-newsletter!

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In this issue...

• Dementia and Abuse in Aged Care
• WorkChoices and OSH

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A study released earlier this year has shown how dementia has the potential to create an Occupational Safety and Health crisis in aged care. The report by the Australian National University found that half of aged care assistants are confronted with sexually inappropriate behaviour by their elderly clients at least once a month. A second shocking finding of the research, carried out by community mental care nurse Dr Tony Jones was that about 60 per cent of these workers received no dementia training when they started their job and no ongoing training in dementia care.

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Dementia and Abuse in Aged Care

Dementia is affecting increasing numbers of Australians each year. As a result workers in health and aged care are dealing with the many issues involved with clients presenting with dementia symptoms. Carers are often reporting sexually inappropriate behaviour and aggression from residents. A study in Canberra has reported that large numbers of aged care workers aren’t being adequately trained to deal with dementia and are suffering abuse as a result. Almost 50 per cent of workers reported that they were being confronted by sexually inappropriate behaviour on a regular basis. But what is quality of the care being provided for dementia suffers and what can be done to improve it?

“It varies widely, some places are trying very hard while others aren’t so good,” says Sally Garratt one of the authors of the recent Alzheimer’s Australia paper on dementia care. The level of care, continues Dr. Garratt, varies with the quality of the physical environment of the facility, levels of staff education and training and the clinical aspects of care such as diagnosis and medication.

Recently there have been measures taken to improve what is known about dementia and the care of those suffering from dementia. The Federal Minister for Ageing Santo Santoro has acknowledged that, “Australia must continue to invest in research as well as early identification, treatment and support if it is to meet the growing challenge posed by dementia.” “It’s a bit of a hot potato topic at the moment,” agrees Dr. Garratt, “and there is more awareness about Dementia. But you can’t help be aware of it if half of the residents in your nursing homes have it!”

Training staff in ways to deal with the behaviour of dementia sufferers is an important way that the quality of dementia care can be improved. But according to Dr. Garratt, “staff need education that enables them to understand the person who has dementia rather than trying to control or ‘manage’ their behaviour. This approach is more likely to lead to quality outcomes.” Since becoming minister Senator Santoro has announced funding for “dementia-specific vocational training for 17,000 aged care workers”.

Tony Jones who carried out a study into aged care while at the Australian National University found that 70% or aged care workers in the ACT had no mental health or dementia training. “Considering Australia’s aging population and that 20% of people over 80 develop dementia, (it is inevitable that) dementia sufferers will be cared for by people who are largely untrained,” says Dr Jones.

“There’s effective training available that is focused on caring for a person and that is centred around what the person receiving the care needs,” says Safety First’s training manager Jenny Buchanan. This training “can be very effective, it doesn’t have to be long and complicated, but it does need to be continuous, ongoing and regularly updated to keep pace with research,” says Dr Jones.

It is often accepted in the aged care industry that there are high levels of staff turnover and absenteeism and Dr Jones believes this is linked to the frequent instances of physical abuse and sexually inappropriate behaviour carers may be encountering. “I’m certainly not making any moral judgements, these (residents) are people who have lost the ability to care for themselves, their brain has decayed,” continues Dr Jones. Dementia suffers may also have poor control over their body movements and may make contact with staff accidentally. However there are, “effective ways to deal with the challenging behaviour,” says Jones.

It is clear that the number of people suffering from dementia is going to increase over time and that it is an issue that is not going away soon. Dementia training has the potential to improve the quality care of people suffering with dementia, reduce the risk of injury to carers and as Dr Jones sums up “it says to aged care workers, ‘we value the work you do and we value you.’”

Safety First has developed a course “Person Centred Care” which will help carers and aged care workers to understand and care for clients with Dementia. For more information contact Jenny.Buchanan@safetyfirst.net.au.

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Work Choices and OSH

The Federal Government’s new industrial relations reform package – WorkChoices – caused a storm of controversy during its passage through parliament earlier this year. It changed some aspects of employment agreements including the unfair dismissal laws and Australian Workplace Agreements (AWAs).

The Federal Labor Party attacked the legislation and told parliament that workplace safety would be jeopardised. This was, Labor claimed, because it would be unclear whether employers would be permitted to agree to their workers obtaining leave to attend safety training. Federal Treasurer Peter Costello rebutted the claim saying that, “under state laws, employers continue to be required to meet their obligations, which includes appropriate training.”

Labor’s Industrial Relations spokesperson Steven Smith also asked whether union-organised training courses would be considered ‘prohibited content’ under the laws and would therefore not be allowed to be included in work agreements.

The Government ducked the question but the peak employer body, the Australian Chamber of Commerce and Industry (ACCI) met the challenge head on. They launched some research into whether it was common for agreements to include OSH training provided by unions. The ACCI’s Chief Executive Peter Hendy said that the research showed, “that prior to WorkChoices it was rare for a workplace agreement to specify OSH training by a particular provider, and even rarer for that provider to be a union.”

Labor’s Steven Smith says that increased workforce flexibility under WorkChoices is leading to higher numbers of casual workers. He told the National Safety Council that, “this employment structure has had a significant impact in terms of workers compensation, training and health and safety.” He accuses the Federal Government of promoting a work environment, “that is more uncertain for employees – both in terms of job security and in terms of pay and conditions.”

He also argued that WorkChoices undermines the ability of unions to conduct safety training. “While under the Act a trade union is able to provide occupations health and safety training, it is expressly prohibited for agreements to provide employees with the ability to take leave to attend… union training,” he told the Council.

ACCI’s Peter Hendy counters that, “before WorkChoices, OSH training in Australia generally was employer initiated or provided, and this remains the case.” Safety First Risk Assessors have seen first hand how top down safety initiatives often prove to be effective. But when speaking with Safety First earlier this year WorkSafe WA Commissioner Nina Lyhne maintained that “occupational safety and health is based on consultation, people working together and on people raising issues so they can be dealt with in the workplace. Unions are very much about that too so certainly they have a role.”

In the end however it seems that Labor Party and union claims that the WorkChoices legislation was preventing certain types of safety training may be missing the mark. But if the new employment legislation was preventing training then the consequences for OSH would have been serious. This is because safety training makes a big impact in the workplace, whether it’s written into employment agreements or not.

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