The power of staff ‘presence’ in dementia care

A recent survey underscores the importance of staff presence in dementia care within aged care facilities and the challenges they encounter.

In a recent survey conducted in three residential aged care homes (RACHs) in New South Wales, researchers from HammondCare—John Swinton, Srivalli Nagarajan Vilapakkam, Mustafa Atee, Tom Morris, and Chris Poulos—explored the importance of staff presence in caring for residents living with dementia.

Defined as meaningful engagement, person-centred care, attentiveness and living in the moment, “presence” emerged as a vital factor in shaping care practices and resident outcomes.

The study highlighted the challenges faced by care workers in their pursuit of meaningful engagement with residents living with dementia. Staff shortages, competing demands in the workplace, and time constraints were identified as significant obstacles hindering their ability to be more present with residents.

The research emphasised that dedicating focused time to residents facilitated a deeper understanding of individuals who might be considered challenging to care for. This, in turn, led to more comprehensive care practices and improved resident outcomes.

Two pivotal findings emerged from the study, published in The Gerontologist. Firstly, establishing meaningful engagement requires building trust through consistent and reliable relationships over time, a challenging feat in the face of a transient workforce and staffing changes, especially amidst restrictions on foreign workers during the COVID-19 pandemic.

Secondly, creating an environment conducive to staff presence demands appropriate organisational structures, sufficient resources, and adequate staffing levels. These components are necessary to ensure that care workers can effectively focus on individual residents.

Survey participants consistently noted that being present with those they care for constituted the most enjoyable and rewarding aspect of their demanding role. They observed a significant improvement in resident engagement and a reduction in dementia-associated behaviour when additional staff members were available.

Despite the positive impact of staff efforts to connect with residents, the complexities of dementia often hinder such connections. Residents’ disorientation and a sense of loss from their previous lives frequently led to withdrawal from social connections.

To address these challenges and enhance staff presence, the researchers suggested various approaches. Increasing government funding to improve staff-to-resident ratios was seen as a fundamental step. However, they also emphasised the need for a multifaceted strategy involving education, training, and regular coaching for care staff. Integrating reminders about practising presence into routine workplace activities, such as shift handovers, was also recommended.

The researchers concluded that resolving the challenge of enabling care worker presence in residential aged care homes should not fall solely on aged care providers. Collaborative efforts involving regulatory bodies, governments, community groups, and aged care homes are essential to secure adequate funding and resources. This collective approach aims to empower care workers and ensure the delivery of person-centred care in these settings.

Ritchelle Drilon

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Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.

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