A market-based service: why Australia’s aged care homes fail residents with dementia

Registered nurse Alison* has spent almost $40,000 throughout her 20-year career in aged care learning how to work compassionately with elderly people and, in particular, those with dementia.

Despite more than two-thirds of those in residential aged care living with moderate to severe cognitive impairment, including dementia, and the condition being Australia’s biggest killer of women, training in dementia care is not compulsory for aged care staff.

Staff who do want extra training often do it in their own time and at their own expense, though there is also government-sponsored training available.

“Compulsory training to handle dementia patients is basically nonexistent,” Alison says.

“I’ve spent $40,000 between getting a graduate diploma in gerontology and completing my master’s in ageing and health because I love aged care and because I want to be good at what I do, and those courses more comprehensively cover dementia. When I try to inform managers of my training and offer to upskill staff, they are often threatened by the fact I know more than them, rather than encouraging.”

The tragic case of 95-year-old Clare Nowland raises important questions about why a police officer allegedly resorted to Tasering a 95-year-old woman with dementia, who was using a walking frame and wielding a steak knife at the time. Left with serious head injuries after being Tasered on 17 May, Nowland died on Wednesday, and an investigation into the police response is under way.

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But those in aged care and geriatrics say the incident also raises critical questions about how aged care staff can deal with people with dementia and when police intervention is needed.

Lack of dementia training is a glaring oversight, the aged care royal commissioners highlighted in their final report handed down in 2021. They wrote: “We are deeply concerned that

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