Program to upskill aged care workers could reduce hospital admissions
LONDON: A programme to upskill aged care workers could reduce the number of emergency hospital admissions.
A crucial part of Shelton Murphy’s job in aged care is advocating for his residents.
“You are with them all the time, so you get to know the idiosyncrasies they have,” the personal care worker said.
“And if there’s a slight difference or change in their demeanour, or the way the walk, or the way they’re speaking, you pick it up straight away.”
The relationship between nurses and personal care workers like Mr Murphy is one that two Queensland educators are looking to strengthen to reduce hospital admissions and emergency presentations.
Sam Matthews, a nurse on Bundaberg’s Geriatric Emergency Department Intervention Team, has seen firsthand the impact of a hospital trip on elderly patients.
“There’s a lot of adverse side effects of coming to the emergency department if you’re elderly or frail,” Ms Matthews said.
“There’s a lot of auditory and visual stimulus — it’s a confusing, noisy place and people get disoriented and try to get away or have falls and things like that.”
For Sam Matthews and her Central Queensland University (CQU) nursing lecturer mother Joy Matthews, recognising the potential for early intervention is key.
“If we can treat somebody who’s old and frail in the early stages of a disease process, they’ve got a much better outcome,” Joy Matthews said.
“We can potentially prevent it becoming a medical emergency.”
According to the Australian Institute of Health and Welfare (AIHW), in 2017-2018, 46 per cent of potentially preventable hospitalisations were for people aged 65 and over.
A workshop was developed after 2020 data across the Wide Bay region, about 400 kilometres north of Brisbane, showed 40 per cent of hospital admissions from aged care facilities were avoidable.
Joy Matthews said in some cases it was falls brought on by simple things like urinary tract infections or constipation.
“Had we picked [those issues] up on day one or two, we could have put treatment and care in place much earlier and avoided the hospital,” she said.
Personal care workers “doing the work on the ground” were skilled at spotting changes in residents, Joy Matthews said.
“But there’s a gap between them spotting it and then being able to articulate it to their team leaders and escalate it.”
After 18 months of industry engagement, the mother and daughter developed the Early Recognition of and Response to Deterioration in the Older Adult project to address that gap with training, to help personal care workers escalate health concerns.
The upskilling project aims to educate about the signs of deterioration in the elderly, with industry-specific language, tools to monitor deterioration, non-pharmacological pain management and identifying the common causes of hospitalisation.
Sam Matthews said residential aged care facilities have their own policies and procedures to identify and escalate concerns, so the project aimed to bring some uniformity across the sector.
“The course utilises an industry-approved tool that aims to streamline the process of escalating concerns and objectively reporting changes,” she said.
“The hope is this will create a standardised approach within the aged care sector and improve communication with external agencies such as the Queensland Ambulance Service or primary healthcare professionals.”
The upskilling program comes at a time when aged care is in the spotlight, with the federal Aged Care Act to be passed by July 1.
The Act was a key takeaway from the 2021 Aged Care Royal Commission that included 148 recommendations to improve aged care.
“Effectively, their report said the aged care system was broken and needed significant reform,” Geoff Rowe, the chief executive of Aged and Disability Advocacy Australia said.
Mr Rowe said one of the recommendations was about listening to the older person and making sure their voice is heard and understood.
“A program that looks at empowering support staff so they can understand what is happening to an older person and can articulate that to nursing staff or doctors can only be a good thing.”
Mr Rowe said it could also have relevance beyond residential care.
“Many older people access aged care services in their own home, so a support worker may be one of only a handful of people that has regular contact with the older person, a pretty unique position to be able to watch what’s going on and articulate what’s happening for them,” he said.
The one-day micro-credentialing program has received $58,000 in state government funding for four free workshops.
Sam Matthews hopes to see the program continue Queensland wide.
“These are the exact same issues that everybody’s facing, it’s an Australia-wide issue,” she said.
“So I would like to see it carry on just growing legs and moving around the country.”
For personal care worker Mr Murphy, who’s completed the training, learning the skills to identify issues and speak up is invaluable.
“You pick up [changes] straight away … to be able to say, ‘Look, Mary has got a problem, there’s a significant change in her demeanour, she’s been off her food for a couple of days, it seems to be a pattern’.
“And if you can get that across to the nurse, they can go from there.”
