A Look at Worker Wellbeing in Australian Aged Care

This article is part of a series by Healthy Business, where we leverage our health and wellbeing expertise to explore research and offer our own insights in order to help some of Australia’s most important industries. See the rest of the series here.

The duty employers have to address with psychosocial hazards at work can be complicated in aged care facilities. That’s because the same factor that makes the work meaningful – caring for people in their final years – also makes it emotionally and physically difficult.

Here, we look at research that provides an overview of the most significant wellbeing risks facing workers, with a focus on Australian data.

The overall picture

Ensuring employee wellbeing during the pandemic was an issue for all companies. Aged care organisations are different from many of those because research suggests the issues persist.

Published in the Medical Journal of Australia, ‘Mental health and wellbeing of health and aged care workers in Australia’ analysed three surveys from mid-2021 tomid-2022.

As you would expect given the intense difficulties presented by COVID, self-reporting of depression and anxiety in the aged care workforce saw a large increase between mid-2021 and late-2021.The former went from 16.4% to 22.6% while the latter almost doubled in that timeframe, from 8.8% to 16% of the workforce.

By mid-2022, as the vaccine rollout got into full swing and lockdowns decreased in severity, acute mental health issues did decrease (to 19.2% for depression and 11% for anxiety). However, that’s not the whole story.

As employers no doubt have some visibility over, as time passed, more and more workers thought at least once about leaving the profession entirely – 32.2% in mid-2021, 42.5% in late-2021, and 54.0% inmid-2022. In other words, even when the worst was over, more people thought about resigning.

The research also found that from the first to last survey, burnout increased while wellbeing, resilience and life satisfaction all decreased. Given this, it makes sense that the turnover intention is so high.

When you then layer this more recent information with what we understood of the sector before 2020, it becomes apparent that the retention risks could in some organisations be quite pronounced.

The ‘Survey of Residential Aged Care Workers Feb-Jun 2019’– conducted by Australian Community Research (ACR) and included in the Aged Care Royal Commission resources – found that “86% of Care staff and Nursing Assistants and 79% of staff overall said that they had been abused by residents or visitors”.

Despite that, when asked to list the “most stressful” aspect of their job only 9.9% said “patient behaviour”. Much higher was “management, colleagues” (15.1%) and “not enough time, not enough staff”(64%). These factors suggest structural issues that might not be easily overcome.

The roots of distress

While every organisation necessarily has individual factors that cause wellbeing issues, there are industry-wide factors. Some of the most common, and a few of the surprising, are listed below.

1. Musculoskeletal disorders

A meta-study on the topic found that “physical, organisational and psychosocial factors have been found to contribute to musculoskeletal disorders in aged care work”. The paper notes that while a lot of health care work involves physically moving people from one place to another, aged care often requires assisting people who are a particular challenge to move.

The researchers lament that the data isn’t strong enough to clarify exactly what the most potent causes are, or which interventions are most effective. However, they found that a combination of intervention types – such as bringing in the right equipment and conducting training – “showed promise”.

Healthy Business offers manual handling consultation – a specialist will come in and observe staff and from that research our team will deliver a customised presentation to help reduce health risks.

2. Emotional labour

A lot of healthcare requires emotional labour – that is controlling your feelings so that you present a certain attitude toward clients and their families. Because aged care often requires engaging with high needs clients, it stands to reason the levels of emotional labour will also be higher.

This could be an issue, as one study that looked at the relationships between nurse’s resilience, emotional labour and turnover intention found a strong link between higher levels of emotional labour and burnout. During the pandemic, a separate study found that 65.1% of aged care workers reported “emotional exhaustion reflecting moderate–severe burnout”.

3. Internalising stigma

While the pandemic may have led many to reevaluate the importance of aged care and aged care workers, the profession remains somewhat culturally and socially devalued. According to research published in the Journal of Applied Gerontology, when this stigma is internalised, “aged-care workers experience greater psychological distress, job dissatisfaction, and turnover intentions.”

4. Acculturation stress

Because a relatively high proportion of aged care staff are migrant workers, researchers looked into whether the challenge of adapting to the local culture had an impact on wellbeing. They found that self-reported English proficiency was a significant contributor to acculturation stress, which suggests language training for those who need it might have outsized positive effects.

How to become healthier… and wealthier

Factors two through four suggest multivalent pressures on aged care workers’ mental health. If a nurse or even someone in the kitchen staff is internalising stigma, trying to adapt to a different culture, and having to put on a brave face through abuse from patients, it would make sense that they would feel burnout and think about quitting.

As with all organisations, the wellbeing of staff can have a direct impact on aged care organisation’s bottom line. Not only is there evidence that have healthier workers have higher levels of productivity, there is a direct link between poor health outcomes and an increase in absenteeism. (To see how much this might be affecting your company’s finances, you can use this free calculator.)

A culture that champions wellbeing is important, but such a broad change can take time. Thankfully, collective wins can be achieved through individual and team-based programs.

For example, one study found that registered aged care nurses saw enhanced resilience when they had “collegial support that provides opportunities to debrief and validate experiences”.

Healthy Business offers a ‘Building Resilience’ Workshop that allows up to 25 staff to attend at once. In other words, at the same time as teaching people strategies that assist in building everyday resilience it fosters camaraderie. They also provide a range of mental health presentations designed to equip employees with practical skills and support techniques when it comes to managing their mental health.

Because staff have different backgrounds  and residents' personalities and ailments can vary greatly, personalised coaching could also be a wise approach. Rather than relying on a one-size-fits-all philosophy, Healthy Business’ HealthCi is a scalable solution that helps individuals identify poor health and wellbeing and then offers support, education, empowerment and sustainable improvements.

Do you want to improve wellbeing in your company?

Healthy Business has had tremendous success in helping organisations rethink and revitalise the mental and physical wellbeing of workers.

Our consultative, tailored method will help you avoid tick-box solutions that might not be suited to the particular challenges of your organisation. Get in touch today.