Nurses union in compulsory reporting of aged care abuse proposal

Abuse in aged care homes is going undetected and unreported owing to outdated laws, a submission to an inquiry says.

A fifth of nurses working in care homes witnessed elder abuse between residents up to twice a week, according to a survey of the NSW Nurses and Midwives Association.

Abuse in aged care homes is going undetected and unreported owing to outdated laws, as the problem intensifies with more residents being admitted to care with dementia-type illness, a submission to a Parliamentary inquiry has reported.

Residential aged care providers would be compelled to report all incidents of abuse in care homes between residents under changes to state and federal law proposed by the NSW nurses union in the paper prepared for the state’s inquiry into elder abuse.

A fifth of nurses working in care homes witnessed elder abuse between residents up to twice a week, according to a survey of the NSW Nurses and Midwives Association’s 10,000 members working in residential aged care facilities, reported in the submission.

The Association also recommends making providers _ or even managers _ legally responsible for resident-to-resident abuse and for the adoption of better screening tools on admission to identify a risk of aggression.

“There is a need to extend the current Federal legislation so that those failing to protect are penalised,” says the paper obtained by The Australian.

“Some collective responsibility must lie with aged care providers and the aged care regulator ... this raises the question of whether responsibility should be transferred to the managers or organisation charged with keeping a person safe and well cared for, and whether the law needs to reflect this.”

The Association calls for changes to federal law — which does not compel providers to report to police violence committed between residents with “cognitive or mental impairment” or “where there are repeated allegations of the same assault” — arguing more elderly people are entering residential aged care homes with dementia-type illnesses.

“It would be inappropriate to criminalise people with cognitive impairment for committing acts of physical or verbal violence as they are essentially ‘blameless’ … however there must be an effective system in place to keep both aged care residents and staff protected from physical or verbal attack,” the paper states.

“Requiring providers to report, through legislation, all incidents of elder abuse would enhance the body of knowledge that we have about the prevalence of abuse in RACFs regardless of perpetrator or blame.

“Such data would not only provide people with additional safeguards, but would enable external agencies the ability to more effectively monitor the quality of care and assess whether systems to manage challenging behaviour are effective”.

Fatal and near-fatal assaults in care homes in Brisbane and Adelaide in the past two years were committed by one resident on another.

“Managing aggression is one of the most challenging areas for staff and many RACFs (residential aged care facilities) lack guidance in this area,” the papers states.

Elder abuse is also “commonly underreported due to a focus on reporting staff-to-resident abuse and the assumption that reporting conflicts with the caring role or belief it is part of the job”.

The paper also calls for better screening tools as part of the admission process, “since the first few weeks post admission are a known trigger for aggressive behaviours associated with loss of control and resistance to care”.

“There is little evidence of such tools current being use to inform staffing and skill mix within RACFs.”