Despite calls from the Federal government’s Aged Care Quality and Safety Commission, increasing personalised care for people with dementia in aged care homes located in rural Australia faces significant challenges – with issues including limited resources, less opportunities for staff training and a transient workforce.
Australia has more than 425,000 people with dementia, a population growing by about 250 people each day, and two in every five people with dementia live in rural and remote areas. This places a substantial burden on regional aged care homes.
A research team from Flinders University Rural Health SA, led by Dr Vivian Isaac, has developed Harmony in the Bush, an ambitious national dementia research project to develop and evaluate a personalised model of dementia care in rural Australia.
A recent sub-study by this team specifically evaluated the dimensions of personalised aged care relating to dementia. They found that staff training for a person-centred approach and building strong relationships between staff and residents are essential to improving the quality of personalised care.
Flinders University’s Dr Mohammad Hamiduzzaman led analysis of the study that interviewed more than 100 staff, including clinical managers, registered nurses, enrolled nurses and care workers from five rural aged care homes in Queensland and South Australia.
“Personalised care is integral to the quality of residential dementia care, but the dimensions of personalised aged care relating to dementia often remain under-managed,” says Dr Hamiduzzaman.
“To achieve quality care, the dimensions that are of importance for the aged care homes include resident and family centeredness, assessment and care planning, staff education and training, staff-resident interaction, work-life balance, leadership and organisational culture and physical environment and safety.”
Dr Hamiduzzaman says the survey identified a lack of consideration about family members’ views by management and staff, together with poorly integrated holistic care plans, limited resources and an absence of ongoing education for staff, which resulted in an ineffective implementation of personalised dementia care.
The paper – Towards personalised care: Factors associated with the quality of life of residents with dementia in Australian rural aged care homes, by Mohammad Hamiduzzaman, Abraham Kuot, Jennene Greenhill, Edward Strivens and Vivian Isaac – has been published by PLOS One (https://doi.org/10.1371/journal.pone.0233450).
“The current service delivery focuses too much on perceived generalised clinical care needs, rather than specific person-centred care,” says Dr Abraham Kuot, Project Manager of the Harmony in the Bush dementia study.
“Better design of personalised care plans needs to include the voice of residents and their family members so that they can exercise some control over care service.”
Dr Vivian Isaac, Principal Investigator of the Harmony in the Bush study, says that placing an emphasis on staff retention, strong recruitment and adequate resources is important to improve the quality of personalised dementia care in rural aged care homes.
“The aged care policy makers and organisation leaders should consider work-life balance of staff as a key issue and should respond with mentorship and formal support structures,” says Dr Isaac.
Understanding the dimensions and associated factors may assist in interpreting the multidimensional aspects of personalised approach in dementia care.
Dr Isaac says ongoing staff training on a person-centred approach to dementia care, attention to individual preferences and needs of persons with dementia and their family carers, and building stronger relationships between staff and residents are necessary to achieve sustainable personalised care in rural aged care settings.
“It is evident that rural aged care homes require additional commitment from the policy makers relating to resource stabilisation and improvement,” he says.