What makes dementia care home staff happy at work?

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Around 70 percent of care home residents in the UK have dementia (Alzheimer’s Society, 2014). With no family constantly nearby, it’s important that care staff are happy and engaging with the residents, and make them feel comfortable and cared for in their new surroundings.

People with dementia are often admitted into a care home when their own families can no longer cope with the intensity of the associated caring responsibilities, such as memory problems or behavioural issues (Afram et al., 2014).

Care homes are often featured badly in the press (Pickstock, 2015) and are under particular scrutiny by the Care Quality Commission in England, whose recent report on dementia care across care homes and hospitals showed that in 90 percent of care homes and hospitals visited, poor or variable care was found (CQC, 2014). So we need to ensure even more so that care staff feel capable and happy in doing what can be a stressful and demanding, as well as rewarding job, so that the residents with dementia are also well looked after and happy (Carr, 2014).

That’s why fellow Social Care Elf blogger, Professor Jill Manthorpe looked at the elements that make care home staff working with dementia content and happy with their jobs. I discuss her analysis in this blog.

we need to ensure even more so that care staff feel capable and happy in doing what can be a stressful and demanding, as well as rewarding job, so that the residents with dementia are also well looked after and happy

Care staff need to feel capable and happy so that the residents with dementia are also well looked after and happy.

Method

The author reviewed several articles focusing on care workers in nursing homes, care homes, long-term care facilities and aged care.

Only English language studies were included in the review, and studies were identified through keyword searches of bibliographic databases, including Social Care Online and PubMED. A scoping review methodology was used to conduct the study, which identifies existing literature as well as gaps in research.

Results

Before the author presents the results, she refers to a relevant synthesis on job satisfaction in long-term care settings (Castle et al., 2006), which identifies personal, social, and managerial aspects of the care staff job to be important. The findings from this paper about aspects of job satisfaction for care workers of people with dementia in residential settings are used by the author to divide up the literature for her own review into the three thematic categories.

On the personal level, it appears that building relationships, both with fellow care staff and with residents, seems vital to care staff being happy in their working environment. There also needs to be room for personal growth for care staff. On the downside, if they feel neglected, their job performance may suffer because they feel demoralised.

On the social level, group living for people with dementia appeared to be better for care staff than standard care homes. This might be because care staff spend more time with individual residents and get to know these better (this refers back to the importance of building relationships). It’s a shame that the model of group living for older adults and people with dementia is not common in England, as it is in the Netherlands (Verbeek et al., 2012).

On the managerial level, staff prefer regular meetings with their teams and engage in staff-only activities, to build peer support and relationships on both personal and social levels. Because many people with dementia are admitted into a care home owing to behavioural issues, it seems understandable that staff want to receive sufficient training to manage any behavioural difficulties.

if they feel neglected, their job performance may suffer because they feel demoralised

If staff feel neglected, their job performance may suffer because they feel demoralised.

Conclusion

The author concludes that

There is substantial literature on the problems experienced by dementia care home staff and the need for a matrix of responses to these to improve satisfaction and work enjoyment. Being happy in work appears to lead to positive outcomes for residents by leading to better quality care and decreased turnover.

Summing up

There are some limitations, or uncertainties, to the conducted review. On the one hand, it is unclear how many articles resulted from the searches. Usually, there is a description of the included studies, which is lacking in this review. I also wondered if the the author looked at the studies which Castle et al. (2006) had identified in their review.

I’m sure we all feel similar to care home staff in that we all want to build relationships in our job, be supported by our peers, and receive support and guidance where we need it. This review is a useful evaluation of what care home staff in dementia consider really important, and just shows how simple things, such as providing feedback to staff, or creating activities to build relationships can have an impact on the job satisfaction.

On a grander scale, the environment in which staff are working (group living versus standard care homes) seems important too. Perhaps it’s another argument for rethinking England’s overall care home model, as well as care staff reward and recognition, to add to those already being put forward (Kennedy, 2014; Cavendish 2013).

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Simple things like providing feedback to staff, or creating ways to build relationships can have an impact on job satisfaction.

 

Link

Manthorpe, J. (2014) Enjoying the front-line of dementia care: an integrative analysis of what care home staff report makes them happy at work. Working With Older People 18 (4) pp. 167-175. [Abstract]

References

Afram, B., Stephan, A., Verbeek, H., Bleijlevens, M., Suhonen, R., Sutcliffe, C., Raamat, K., Cabrera, E., Soto, M., Hallberg, I., Meyer, G., & Hamers, J. (2014). Reasons for institutionalization of people with dementia: Informal caregiver reports from 8 European countries. Journal of the American Medical Directors Association, 15, 108-116. [Abstract]

Alzheimer’s Society (2014) Dementia UK: Update (Second Edition) London: Alzheimer’s Society. [Full Text]

Carr, S. (2014) Pay, conditions and care quality in residential, nursing and domiciliary care services York: JRF. [Full Text]

Castle, N.G., Degeholtz, H. and Rosen, J. (2006) Determinant of staff job satisfaction of caregivers in two nursing homes in Pennsylvania, BMC Health Services Research, 6, p.60. [Abstract]

Cavendish, C. (2013) The Cavendish Review: An independent review into healthcare assistants and support workers in the NHS and social care settings London: DH. [Full Text]

CQC (2014) Cracks in the pathway: People’s experiences of dementia care as they move between care homes and hospitals London: CQC. [Full Text]

Kennedy, J. (2014) John Kennedy’s Care Home Inquiry York: JRF. [Full Text]

Pickstock H (2015) Care home where abuse was caught on hidden camera bans hidden cameras The Bristol Post March 24th 2015. [Full Text] Warning: includes a distressing image.

Verbeek, H., Zwakhalen, S.M.G., Rossum, E., van kempen, G.I.J.M., & Hamers, J.P.H. (2012) Small-scale, homelike facilities in dementia care: a process evaluation into the experiences of family caregivers and nursing staff. International Journal of Nursing Studies, 49 (1), 21-29. [Full Text]
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Clarissa Giebel

Clarissa is currently a Research Fellow at the University of Liverpool. Her research focuses on enabling people with dementia staying at home for as long as possible, whilst addressing potential health inequalities in accessing the right care. She is currently leading the first Covid-19 dementia study in the UK, exploring the effects of social service closures on the lives of people with dementia and unpaid carers. In her role as postdoctoral research associate at the NIHR ARC NWC, Clarissa is the Principal Investigator on a number of dementia and health inequalities projects. This includes a European Alzheimer's Society funded project into health inequalities in dementia care access in England and the Netherlands, also collecting Young Onset dementia specific data in Australia. Further funded international collaborations in dementia care include Colombia and Chile. She is also involved in the North West Coast Household Health Survey, looking at health inequalities in health service usage across the population. In addition, Clarissa is leading a care home collaboration, where she works jointly with colleagues from the Netherlands on implementing changes to a local Liverpool-based care home and developing a UK Dementia Village. Additional collaborations and projects include working with the Brain Charity evaluating social support groups for people with dementia, and with the Liverpool House of Memories to look into evaluating their intervention for family carers of people living with dementia and care professionals, and trying to roll the intervention out to other neighbourhoods.

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