Home' Australian Ageing Agenda : AAA Jan-Feb 2015 Contents Consider this hypothetical
Anne usually worked 12
hours per week on a casual
basis for Tulip Aged Care
Facility. Anne also did casual shifts at
two other residential aged care facilities.
She averaged 35 hours in total per week
across her three employers.
Over the last 16 years, Anne had
gained a lot of experience caring for and
supporting residents, including managing
their behaviours of concern.
Victor, one of the residents Anne
cares for from time-to-time, had been
increasingly confused, which had led to
occasional outbursts of frustration and
verbal aggression. Anne felt that Victor
had started to stand inappropriately close
to her at times too.
Anne spoke about this to a colleague.
She did not tell her manager or submit an
incident report as she thought this was
typical for a person with dementia. Anne
had seen more serious behaviours from
other residents in the past.
One morning while helping Victor to
get ready for breakfast, Victor started
to verbally abuse Anne. He grabbed her
aggressively by the arm and would not
let her go. Fearful of being hurt, Anne
tried hard to get away. Victor loosened his
grip. Anne tripped and fell to the ground,
painfully injuring her shoulder. Other staff
heard the commotion and came to assist.
Anne later required surgery for her
The review of the incident found no
one had submitted an incident report
regarding Victor's escalating behaviours
Based on the National Report: Home
Care, Community Care and Outreach
Staff Safety Survey 2013 we conducted
in 2014, staff are facing an average of 1.2
incidents per month but only 16
per cent of casual and part-time
staff reported incidents to their
organisations. What does this say
about the remaining 84 per cent?
Under-reporting of incidents
by all staff presents obvious
issues for the organisation, for
individual managers, and for the
staff and clients involved in the
Minor acts of aggression are
often precursors to more serious
acts of aggression. It is interesting to
ponder why high frequency incidents are
the ones that seem to be the least likely to
One survey respondent said: "This
(aggressive) behaviour is expected and
normal for the client to display." While
another said: "I didn't realise getting
locked in was considered abuse and
There are many contributing factors
inhibiting the reporting of incidents.
There are just as many reasons why staff
should invest time in reporting incidents.
Incident reporting for effect rather
than merely compliance will identify
escalating and de-escalating trends and
the prevalence of minor - for example,
no one is physically injured - and often
high frequency incidents. This will enable
supervisors and managers to understand
what, or who, is and is not working well
in order to allocate adequate resources to
mitigate the foreseeable risk of physical,
emotional and psychological harm.
The survey shows that 23 per cent of
incidents of aggression and/or violence
involving casual or part-time workers
resulted in the casual or part-time worker
suffering a psychological injury, even if no
physical harm had been suffered.
If I was to take a fall today and injure
my shoulder like Anne did, it
is clear what incident caused
the injury, and for whom I was
working for at the time of the
incident. Therefore, it is also
clear who will be paying the
workers compensation claim.
It will not always be so clear
which particular incident(s)
contributed significantly to a
worker's psychological injury
and for which employers the
worker was working for at
those times. In this case study, Tulip
Aged Care Facility will be paying workers
compensation for Anne's psychological
injury even if the injury was contributed to
by other incidents at Anne's other places
Over the two days prior to the incident,
Victor had been upset about his son
travelling overseas without taking Victor
with him. This had not yet been added
to Victor's care notes. Unaware it might
be a potential trigger for Victor, Anne
had asked Victor about his family on the
morning of the incident.
Time pressure can mean staff
have difficulty finding time to share
their knowledge effectively with their
colleagues about residents. This can be
more evident with casual and part time
staff who may be less familiar with the
residents they are supporting. Without
up-to-date information, staff miss the
opportunity to use the best strategies
for the wellbeing of the resident and the
safety of all.
Following surgery, Anne's physical
wounds began to heal and Tulip Aged Care
Facility offered Anne light duties to help
her to successfully return to work.
Even with the light duties, Anne was
anxious about coming back to work. Prior
to the incident, Anne thought she knew
With a quarter of the aged care workforce employed on a casual
basis, organisations need to assess the occupational health and
safety implications, as they may find themselves liable even
if injuries were contributed to by incidents at other places of
employment, writes Travis Holland.
38 | JANUARY -- FEBRUARY 2015 | AAA
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