Aged care staff are crucial to the well-being of people living with dementia. Staff continue to be there to support those who need them most, making a difference each and every shift, in ways that can often go unnoticed or underappreciated.
To provide the best possible dementia care, staff need to be supported, not only through adequate pay and conditions but equally through comprehensive education and training to best equip them to provide safe, person-centred care. De-escalation training for a behavioural emergency in aged care is critical.
We know that dementia can change people’s behaviour. Sometimes, people living with dementia may feel anxious, fearful, distressed and confused. They may also be in pain or disorientated – visually or spatially. Often, they are unable to communicate how they feel or what they are experiencing in the usual ways.
As a result, people living with dementia may become agitated and display noticeably changed behaviours. They might get upset, pace, scream, shout or make threats, and become physically violent towards themselves or others.
Once agitation and violence occur, behavioural emergencies and occupational violence in aged care are time-critical situations that need to be appropriately responded to. In these situations, each decision can be critical.
In these emergencies, aged care providers with effectively trained and supported staff to help guide the response of staff are much more equipped to de-escalate the situation and prevent or reduce the risk of further incidents. This leads to better outcomes for both the person living with dementia as well as improved working environments for staff.
Proactive approach to changed behaviours
Data from the Serious Incident Response Scheme (SIRS) shows that since reporting began in 2021 to 30 June 2022, more than 39,000 incidents were reported in care homes. This scheme helps to strengthen aged care systems, build providers’ skills so they can better respond to serious incidents and ensure people receiving aged care have the support they need.
Proactive approaches like SIRS are needed to educate staff, monitor and manage the cognitive and behavioural needs of people living with dementia, allowing for safe provision of care and empathetic de-escalation.
Quality and regulatory processes that support the minimisation of restraint in people with dementia, as well as the provision of mandatory dementia education, are imperative to ensure the delivery of quality dementia care in which the use of restraint is a very last resort. We know that managing such behaviours with restrictive practices such as physical or pharmacological restraint is often ineffectual or can make the situation worse.
All individuals living with dementia experience unique and varying behavioural and psychosocial symptoms of dementia. Behaviour assessments and care plans must be modified as needed when current strategies to address changed behaviours are found to be ineffective.
Staff are encouraged to intervene before an incident takes place, using interventions that reduce the everyday risk of aggression, as well as those that are implemented when aggression is perceived to be imminent. However, for this to be implemented in a meaningful way, staff must be equipped with the knowledge, skills, and resources to intervene in ways that are respectful and effective.
Dementia Australia’s de-escalation training resource
Dementia Australia has recently launched D-Esc, a new innovative virtual reality (VR) training workshop for assisting staff to de-escalate a behavioural emergency in a care setting.
D-Esc provides an immersive simulation, designed for frontline and healthcare professionals to use an interactive approach to de-escalation training. Participants will build empathy and understanding towards people with dementia, with the aim of reducing the use of restrictive practices in care.
Dementia Australia will provide the training in an in-person three-hour workshop, with up to 15 participants, at your location.
At the completion of the D-Esc workshop participants will be able to recognise emotional and physical signs of behaviour escalation; understand how increased stress impacts a person with dementia; apply person-centred de-escalation skills; better contribute to debriefing; and reduce overall risk of harm.
The initial delivery of the program to 6,500 people is funded by Dementia Training Australia until June 2025. To confirm the eligibility of your staff please visit dementia.org.au/d-esc or contact [email protected].
If this story has prompted any questions or concerns, please call the National Dementia Helpline 1800 100 500, with support available 24 hours a day, seven days a week.
Dr David Sykes
Director Centre for Dementia Learning