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Staff self care management in aged care facilities

Author: Deborah Rawlings, Lecturer at Flinders University
07 April 2014

How do staff in aged care facilities manage self care following the death of residents? This question was analysed by Deborah Rawlings and Kim Devery with their post graduate students at Flinders University. Deborah and Kim are presenting at the Palliative Care Nurses Australia (PCNA) Conference on April 6-7.

Working as academics and teachers in Palliative and Supportive Services at Flinders University, Kim Devery and I were particularly impressed by the depth and thoughtfulness of the student discussion in one of our online postgraduate topics: PALL8436 Palliative Care in Aged Care Settings. 


In this topic, students are invited to critically reflect on bereavement and the organisational recognition of grief and loss and the presence of any rituals, as well as self care and the care of colleagues. 


We were so interested in these discussions, which with ethics approval and students’ full consent, we began researching grief and loss and the subsequent support offered by healthcare professionals and organisations.


Bereavement, grief and loss are a part of life for all of us. In aged care settings residents may experience grief and loss due to the death of relatives or the death of fellow residents.


Additionally, staff may grieve over the death of residents and this effect can be a significant contributor to burnout and overwhelming stress, as well as impacting on their emotional and professional growth. The death of residents can have an impact on all staff in the facility in different ways, such as cleaners, kitchen, occupational therapy, or in the community like the GP, registered nurse or carer.  The impact of these frequent losses may be helped or hindered by the culture of organisations and the emotional and professional wellness of staff.  


Students reported in lively, interactive discussions that contributed not only to their overall learning experience but also to our understanding of what is happening in practice. We found that not only hospices but also aged care facilities often marked death with rituals incorporated into practice. These could be organisational (e.g. memorial service, flowers next to a photo) or individual (e.g. writing a note to the family). The care of fellow residents was another important issue and despite the complexity of communication, patients with dementia do need to be told when someone dies. 


Students also reported how they support colleagues and employ self care strategies, both of which we know help to maintain professional and emotional wellbeing. However, this support is not always formalised and sometimes is not in place. Saying this, there is no right or wrong way, and we encourage students to critically reflect on their own situation, with many subsequently taking away ideas to implement in their practice. 


What seems to be important in response to loss and bereavement is that management and administration are responsive as well as individual clinicians. This combination of organisations and individuals wishing to create a culture where expressions of loss are respected, leads to empathic and compassionate living and working places.


See below to read other articles from the 5th Biennial Palliative Care Nurses Australia Conference:

Building connections through Social Media: Palliative Care Nurses Australia Conference

Guiding care for vulnerable populations


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