This might involve remote, possibly artificial intelligence-assisted, virtual care, rather than physical nurse presence, to assist nursing homes to meet new legislative requirements to have a registered nurse present 24/7.
There are clear opportunities for technological innovations to improve the care, health, and wellbeing of older people. However, substitution of face-to-face nursing and human interaction with remote care is not the answer.
What are ‘virtual nurses’?
The benefits of technology in health care are unquestionable and many innovations have improved care for older people. Artificial intelligence shows promise in helping prevent and detect falls, and socially assistive robots such as PARO (a baby harp seal), have been shown to reduce stress, anxiety and antipsychotic use in people with dementia.
Technology should not, however, be introduced at the expense of care quality or supporting and sustaining a suitably sized and skilled aged care workforce. We still need to adequately staff nursing homes to provide safe, dignified care.
We need adequate staffing
The Royal Commission into Aged Care Quality and Safety heard a vast quantity of evidence regarding insufficient staffing, particularly of nurses who have the education and skills to deliver high quality clinical and personal care.
Insufficient staffing results in workers not having time to interact with residents meaningfully and compassionately and also contributes to avoidable hospitalisations, worse quality care and outcomes, and poor working conditions for staff.
As social beings, human interaction is fundamental to health, wellbeing, and best practice care. This is particularly true for older people in nursing homes who are less able to engage with others and is especially vital for those living with mobility challenges and dementia.
Partly due to nurse low staffing levels, loneliness, isolation and mental ill health are widespread in aged care and have become more common due to pandemic related restrictions on visitors and staff.
Seeking to replace human contact with virtual interfaces seems both inconsistent with the Royal Commission’s findings and possibly cruel.
Knowing those they care for helps care staff to understand how someone would like to be cared for and what is important to them. It helps staff to care – and to care in a way that reinforces that person’s sense of self and maintains their dignity. This type of person-centred care takes time.
Rather than circumventing reforms to ensure more nurses provide face-to-face care in nursing homes, we need to address the range of challenges contributing to widespread and tenacious workforce shortages.
There are clear challenges for growing and retaining a sufficiently sized and skilled aged care workforce. However, government reforms, such as better pay, mandated care time, and greater accountability and transparency regarding the use of funds all work together to make aged care a feasible and attractive sector to work in.
This is one where staff are supported to provide the high quality and safe aged care all Australians deserve and where older people receive best practice, human care.
- ^ reportedly proposed (www.theguardian.com)
- ^ many older people suffer (www.hrw.org)
- ^ attract and keep (www.ncbi.nlm.nih.gov)
- ^ Our ailing aged care system shows you can't skimp on nursing care (theconversation.com)
- ^ Robot nurses (www.nature.com)
- ^ telehealth (www.sciencedirect.com)
- ^ certain tasks (www.nursingworld.org)
- ^ calling out for (www.theguardian.com)
- ^ prevent and detect falls (www.nature.com)
- ^ PARO (bmcgeriatr.biomedcentral.com)
- ^ expense of care quality (www.sciencedirect.com)
- ^ safe, dignified care (www.sciencedirect.com)
- ^ Before replacing a carer with a robot, we need to assess the pros and cons (theconversation.com)
- ^ Royal Commission into Aged Care Quality and Safety (agedcare.royalcommission.gov.au)
- ^ legislated (www.aph.gov.au)
- ^ 'Fixing the aged care crisis' won't be easy, with just 5% of nursing homes above next year's mandatory staffing targets (theconversation.com)
- ^ unacceptably low levels of staffing (ro.uow.edu.au)
- ^ around 20% (www.health.gov.au)
- ^ not having time to interact (www.anmfsa.org.au)
- ^ fundamental to health (www.ncbi.nlm.nih.gov)
- ^ older people in nursing homes (onlinelibrary.wiley.com)
- ^ mobility challenges (onlinelibrary.wiley.com)
- ^ dementia (pubmed.ncbi.nlm.nih.gov)
- ^ loneliness, isolation (link.springer.com)
- ^ mental ill health (www.racgp.org.au)
- ^ pandemic related restrictions (www.apa.org)
- ^ Working conditions in aged care homes are awful, largely because the work is done by women (theconversation.com)
- ^ human interaction and contact (www.ncbi.nlm.nih.gov)
- ^ meaningful relationships (onlinelibrary.wiley.com)
- ^ Royal Commission (agedcare.royalcommission.gov.au)
- ^ workforce shortages (onlinelibrary.wiley.com)