clinical focus
Program helps carers recognise problems
addressing depression and behaviours related
to dementia, then guides them down the
difficult path of crafting their own solutions.
Marita McCabe interviewed by Dallas Bastian
S
taff must be trained and strategies implemented to
recognise and address depression and behavioural and
psychological symptoms of dementia (BPSD) in aged care,
but to do this effectively, organisational change is necessary.
This is a key point professor Marita McCabe, director of
the Institute for Health & Ageing, raises while discussing the
effectiveness of IHA’s Staff as Change Agents program, which aims
to support frontline workers in identifying and acting on issues
they have confronted in relation to depression and BPSD.
Recent research reveals that the program led to an improvement
in the detection and management of depression. Also, staff involved
reported lower carer strain and experienced significant and sustained
improvements in knowledge and confidence in working with
residents who have depression and dementia.
In order to improve the way depression and BPSD are
approached in aged care, McCabe says, organisations need to give
staff permission and time to change their approach.
“We need to empower junior staff to talk with more senior
staff regarding their concerns about residents, the change in
the behaviour of residents,” she says. “We need to improve the
communication within residential care.”
She adds that while education and training are important,
organisational change is also necessary to ensure detection of
these conditions doesn’t fall through the cracks in the future.
Here, Aged Care Insite sits down with McCabe to discuss the
key elements of the Staff as Change Agents program and what is
needed to ensure its success.
ACI: Why are programs that focus on BPSD and depression or
mental illness more generally needed in this space?
Painful but
necessary
24 agedcareinsite.com.au
MM: Within residential care, there is a high level of depression.
Probably about half of the people in residential care have at least
got depressive symptoms, and quite a number of them also have
actual diagnosed depression.
A large amount of this goes unrecognised. We felt it was important
to help staff better recognise depression and to have strategies in
place to address it and refer residents on for treatment.
Behavioural and psychological problems associated with
dementia, often referred to as BPSD or challenging behaviours, are
also common in residential care. The prevalence of BPSD is high
in the community and is often the reason older people are moved
into residential