Abstract
Objective
To examine residential aged care (RAC) staff awareness of and engagement with dementia‐specific support services and education.
Methods
A cross‐sectional survey of staff (n = 179) from 36 Victorian RAC facilities.
Results
60% (n = 107) of respondents were aware of dementia‐specific support services, but only 27% (n = 48) accessed services in the previous 2 years. Approximately 77% (n = 137) were aware of dementia‐specific education, with 66% (n = 115) completing education in the previous 2 years. A significantly higher proportion of registered nurses had accessed dementia‐specific support services in the past 2 years compared with enrolled nurses and personal care assistants (P < 0.001).
Conclusion
A relatively large proportion of RAC staff were unaware of available dementia‐specific support services and education. While approximately two thirds accessed such education, only one in four accessed dementia‐specific support services. To optimise the quality of care for people with dementia, strategies to increase awareness of and access to these resources are warranted.
Keywords: dementia, education, health services for the aged, homes for the aged, long‐term care
Policy Impact
Results from this study demonstrate there is room for improvement in the awareness of and engagement with dementia‐specific support services and education amongst RAC staff. Further research exploring the enablers and barriers to awareness and engagement may uncover how greater uptake of these important resources and services may be achieved.
Practice Impact
Over half of older Australians living in residential aged care have a clinical diagnosis of dementia. This study contributes an understanding of staff awareness of and engagement in dementia‐specific education which may inform organisational strategies, policies, and guidelines to promote staff participation in education opportunities.
1. INTRODUCTION
In 2015, the authors of the World Alzheimer Report 1 estimated that 46.8 million people were living with dementia worldwide and forecasted an increase to approximately 74.7 million by 2030. The trend is similar in Australia. In 2018, there was an estimated 436,366 Australians living with dementia, 2 and dementia was reported to be the single greatest cause of disability in older Australians (aged 65+ years) and the third leading cause of disability burden overall. 3
Given these statistics, it is no surprise that dementia has been nominated as an Australian National Health Priority Area. Because 52% of people living in Australian Residential Aged Care Facilities (RACFs) have dementia, 4 staff require dementia‐specific support and education to assist them in optimising the well‐being of residents with dementia. However, the quality of clinical practice in dementia care in Australia is variable, with inconsistency in the availability of services to support workforce training, diagnosis, ongoing care, advance care planning and support for families. 5
A similar situation exists internationally. For example, in 2015 England released a nationally agreed sector framework for dementia educational content and learning outcomes. 6 Despite the existence of this national framework, it was later reported that among the dementia care workforce ‘there is no requirement for continuing professional development education or training to be accredited’. 7 ; p.967 Similarly, a competency in dementia education and training framework was released in Wales. 8 However, in Wales, like England, there appears to be limited provision for regulation or quality monitoring of dementia education. As a result, the content and quality of dementia education in these countries is variable and low levels of dementia knowledge among the aged care workforce are commonplace. 9
As Australia's ageing population grows, the need increases for a skilled and adaptable aged care workforce. It is estimated that by 2025, the health‐care and social assistance sectors will be among the top employing industries. 10 However, increasing numbers of workers will not address skill gaps; employment growth needs to be scaffolded by high‐quality and consistent training and qualifications. Innovation in education and professional development can help address skill currency, but employers must take a lead role in supporting staff to advance their knowledge and skills.
Investment in education is becoming increasingly important due to rapid advances in knowledge and best practice, as well as the continuing evolution of technology and digital equipment that is transforming skill requirements and how organisations operate. Work‐related education improves workplace performance and productivity 11 and is vital to ensuring best practice care for end users. Forecasts by the Australian Workforce and Productivity Agency 10 predict a growing need for skills to be deepened (ie acquisition of additional qualifications at higher levels than previously). 10 In the residential aged care (RAC) sector, research shows knowledge of dementia care was higher among staff who underwent dementia‐specific training 12 and targeted practice‐based dementia education resulted in greater dementia care competency. 13 Following dementia‐specific education, staff have also reported significantly higher levels of confidence in providing dementia care. 13 These findings have implications for practice in the aged care sector and highlight the value of comprehensive dementia‐specific training for RAC staff.
In addition to education, dementia support services are available for RAC staff, both nationally (eg Dementia Support Australia, National Dementia Helpline) and state‐based (eg Dementia Australia—Victoria and Aged Persons Mental Health services). These services provide advice and support for staff regarding management and care of people with dementia, with information available online, via telephone or face‐to‐face. It has been shown that the degree of perceived support among RAC staff when caring for older adults with behavioural and psychological symptoms of dementia has been positively correlated with staff psychological well‐being. 14 Additionally, RAC staff who access dementia support services and education can expect an increase in confidence levels, 13 psychological well‐being 14 and proficiency in dementia care. 13 However, it is unclear whether staff working in RACFs are aware of the range and scope of dementia‐specific services and education opportunities available to them and, if so, the extent to which they engage with such resources. To address this gap, the Victorian public sector RAC workforce was surveyed. Results from the survey provide a benchmark reference for future measurement of change in level of awareness of and engagement with dementia support services and dementia education.
The aim of this study was to explore RAC staff awareness of, and engagement with, dementia‐specific support services and education. The research questions were as follows:
To what extent are health professionals and care workers in RACFs aware of dementia‐specific support services and education opportunities?
To what extent do health professionals and care workers in RACFs engage with dementia‐specific support services and education?
The results of the survey have direct relevance to and implications for a wide audience, including RACF managers, staff, residents with dementia and their families.
2. METHODS
2.1. Design
This study involved a purpose‐designed, cross‐sectional survey.
2.2. Participants
Leaders from 177 public sector RACFs across rural, regional and metropolitan Victoria, Australia, were contacted to seek approval to invite their staff to participate in the research. Thirty‐six (20%) of the 177 RACF leaders consented to their staff being invited to participate and 179 survey responses were received from participating RACF staff, including health professionals (eg registered nurses, enrolled nurses) and care workers (eg personal care assistants, lifestyle staff).
2.3. Survey
A survey was purpose‐designed to contain a combination of items informed by research in this area 15 , 16 , 17 , 18 and the expertise of the research team. Open and closed questions elicited information about respondents' (a) awareness of dementia‐specific support services; (b) engagement with dementia‐specific support services; (c) experiences in engaging with dementia‐specific support services; (d) awareness of dementia‐specific education opportunities; (e) participation in dementia‐specific education; (f) experiences of participating in dementia‐specific education; and (g) demographics.
The survey was developed in both a paper‐based format and online format, with the latter created using Research Electronic Data Capture (REDCap) software. Both versions were pretested with approximately 10 nurses and personal care assistants (PCAs) who work in RAC. Feedback from the pretesting phase informed minor revisions to the final survey, which was completed anonymously, taking approximately 10‐15 minutes to complete. Participation was anonymous and voluntary. Consent was implied when respondents participated in completion of the survey.
2.4. Data collection and analysis
An email was sent to a senior staff member (eg Director of Nursing, Facility Manager) at all Victorian RACFs (177), informing them of the research and inviting them to participate. A follow‐up email included a link to the online version of the survey. Upon request, paper‐based surveys were hand‐delivered to 14 RACFs and completed surveys were either collected in‐person or returned via post. Data were collected between March and June 2019.
Data from paper‐based surveys were manually entered into REDCap, and data were exported into IBM SPSS statistics version 25. Data were analysed using descriptive statistics, with inferential statistics (eg chi‐square, independent‐samples t test, one‐way ANOVA) used for analyses of key variables. Where Levene's statistic indicated a violation of homogeneity of variance assumption (<0.05), the Welch test was used as an alternative to the standard ANOVA, with the Games‐Howell test used for post hoc comparisons; Tukey's HSD was used for post hoc tests for standard ANOVA. For categorical variables where the minimum expected cell count was less than five, the Fisher exact test was used as an alternative to the Pearson chi‐square test, with p values reported (ie no statistic is calculated for the Fisher exact test). Free‐text responses were classified into common categories and analysed quantitatively.
2.5. Ethical considerations
Ethics approval for this project was granted by the Deakin University Faculty of Health Human Ethics Advisory Group (HEAG)—Ethics ID: HEAG‐H 187_2018. Ethics was also granted by Monash Health [HREC/51461/MonH‐2019‐165845(v1)], Barwon Health [19/23], Ballarat Health [authorised via email by the Manager, Research Ethics and Governance] and Bass Coast Health [2019‐08 SSA Bass Coast Health].
3. RESULTS
A total of 179 surveys were returned, with 58% (n = 103) completed on paper and 43% (n = 76) online.
3.1. Characteristics of respondents
Respondents identified their geographic location as metropolitan (n = 37, 20%), regional (n = 80, 45%) or rural (n = 50, 28%); 12 (7%) participants did not indicate their location. The median age of respondents was 49 years (IQR = 18, range: 22‐67 years). Over one quarter of respondents (n = 48, 27%) were born overseas, representing 20 countries; however, 84% of respondents spoke English at home. Respondents had worked in their current position for a median of 5 years (IQR = 7.9, range: 1 week to 35 years) and in the RAC sector for a median of 10 years (IQR = 12.3, range: 1 week–41 years). Table 1 outlines other demographic characteristics of respondents.
TABLE 1.
Demographic characteristics of respondents (n = 179)
| Variable | n | % |
|---|---|---|
| Gender | ||
| Female | 138 | 77 |
| Male | 28 | 16 |
| Other | 2 | 1 |
| No response | 11 | 6 |
| Country of birth: a | ||
| Australia | 118 | 66 |
| Africa | 5 | 3 |
| Americas | 2 | 1 |
| Asia, including Southern Asia (eg India and Sri Lanka) | 23 | 13 |
| Europe, including United Kingdom | 9 | 5 |
| Other Oceania (ie not Australia) | 3 | 2 |
| Other country, not specified | 6 | 3 |
| No response | 13 | 7 |
| Language spoken at home: | ||
| English | 151 | 84 |
| Other | 17 | 10 |
| No response | 11 | 6 |
| Current role: | ||
| Personal care worker/personal care assistant | 33 | 18 |
| Enrolled nurse (including six without a medication qualification) | 69 | 39 |
| Registered nurse (including one graduate) | 15 | 8 |
| Nurse unit manager/associate nurse unit manager | 26 | 15 |
| Director of nursing/associate director of nursing | 3 | 2 |
| Other advanced registered nurse role (eg education) | 3 | 2 |
| Lifestyle/diversion therapy | 11 | 6 |
| Other b | 10 | 6 |
| No response | 9 | 5 |
| Highest education completed: | ||
| Secondary school | 4 | 2 |
| Certificate III | 16 | 9 |
| Certificate IV | 35 | 20 |
| Hospital trained certificate (division 1, 2 or 3) | 17 | 10 |
| Graduate/postgraduate certificate | 2 | 1 |
| Diploma | 34 | 19 |
| Bachelor's degree (including one with honours) | 39 | 22 |
| Graduate diploma (including one advanced diploma) | 12 | 7 |
| Masters | 10 | 6 |
| PhD | 1 | 1 |
| No response | 9 | 5 |
| Where education was completed: | ||
| Australia | 149 | 83 |
| Overseas and recognised in Australia | 18 | 10 |
| Overseas but not recognised in Australia | 3 | 2 |
| No response | 9 | 5 |
| Employment arrangements: | ||
| Permanent | 143 | 80 |
| Fixed‐term contract | 11 | 6 |
| Casual | 11 | 6 |
| Student | 1 | 1 |
| No response (or invalid response of ‘part‐time’) | 13 | 7 |
| Work hours: | ||
| Less than 15 hour | 10 | 6 |
| 15‐24 hour | 47 | 26 |
| 25‐34 hour | 54 | 30 |
| 35‐39 hour | 32 | 18 |
| 40+ hour | 25 | 14 |
| Can't say | 1 | 1 |
| No response | 10 | 6 |
| Worked in a dementia‐specific facility in the past 2 year: | ||
| Yes | 81 | 45 |
| No | 88 | 49 |
| No response | 10 | 6 |
| Workplace location: | ||
| Metropolitan Victoria | 37 | 21 |
| Regional Victoria | 80 | 45 |
| Rural Victoria | 50 | 28 |
| No response | 12 | 7 |
Countries are grouped into geographic regions based on the United Nations standard country codes (M49)—https://unstats.un.org/unsd/methodology/m49/.
Includes other staff such as environmental, administrative and allied health staff.
The highest proportion of respondents were enrolled nurses (ENs) qualified to administer medication (n = 63, 35%), followed by personal care workers/assistants (PCWs/PCAs) (n = 33, 18%). This varies from the 2016 Australian RAC workforce profile comprising mostly of PCAs (70%) followed by ENs (10%) and RNs (15%). 15 The highest level of education completed by respondents ranged from secondary school to masters and PhD‐level postgraduate education, reflecting the range of work roles represented in the sample. Over 80% of respondents (n = 149) completed their highest level of education in Australia. Most respondents (n = 143, 80%) were employed on a permanent basis, but there was substantial variation in the hours they worked per week, with 32% (n = 57) of respondents working less than 25 hours per week.
3.2. Dementia support services
Only sixty per cent of respondents (n = 107) were aware of dementia support services available to them. Of these respondents, only 48 (27% of the total sample), typically registered nurses (RNs) and lifestyle staff, had accessed such a service in the past 2 years. Dementia Australia was the most frequently cited service, including Dementia Victoria and the National Dementia Helpline, which operates under the auspices of Dementia Australia. Dementia Support Australia (DSA) was also commonly listed, with some respondents identifying specific DSA services provided, such as the Dementia Behaviour Management Advisory Service.
Of the respondents who were aware of the dementia support services available to them, 45% had accessed these in the past 2 years. The number of services accessed ranged from one to five with a mean of 1.6 (SD = 0.9). Collectively, 78 individual services were accessed (Table 2), predominantly via telephone and online, with 16 respondents using more than one method to contact services (eg telephone call and in‐person). Approximately 38% of respondents contacted support services outside work hours, with 35% contacting support services six times or more.
TABLE 2.
Dementia support services (n = 78) accessed in the past 2 years
| Dementia support services | n | % |
|---|---|---|
| Support service accessed | ||
| Dementia Support Australia, including DBMAS a and SBRT b | 23 | 30 |
| Dementia Australia/Dementia Victoria | 12 | 15 |
| Aged Community (or Aged Persons) Mental Health Service | 10 | 13 |
| Online learning/resources, including E3 education | 7 | 9 |
| Alzheimer's Australia c | 4 | 5 |
| University of Tasmania/Wicking Dementia Centre | 3 | 4 |
| Workplace information and support | 3 | 4 |
| Dementia Training Australia | 2 | 3 |
| Other dementia support service d | 5 | 6 |
| No specific dementia support service identified | 9 | 12 |
| How did you access the support service? e | ||
| Telephone | 37 | 47 |
| Online | 37 | 47 |
| In‐person | 21 | 27 |
| No response | 2 | 3 |
| When did you access the support service? | ||
| During work hours | 48 | 62 |
| Outside of work hours | 15 | 19 |
| Both during and outside of work hours | 15 | 19 |
| How many times did you access the support service? | ||
| 1 time | 12 | 15 |
| 2 times | 17 | 22 |
| 3 times | 14 | 18 |
| 4 times | 3 | 4 |
| 5 times | 2 | 3 |
| 6 times or more | 27 | 35 |
| No response | 3 | 4 |
Dementia Behaviour Management Advisory Service.
Severe Behavioural Response Team.
Alzheimer's Australia became Dementia Australia in 2017—respondents may have accessed the service prior to this change.
Includes other specific support services mentioned by only one individual, including geriatrician, disability, NEXUS and aged care standard.
16 respondents accessed a support service using multiple methods (eg telephone and in‐person), so the number of cases reported exceeds the sample of 78 services.
3.3. Dementia education
Seventy‐seven per cent of respondents (n = 137) reported knowledge of available dementia education. The most frequently cited education was the massive open online course (MOOC) delivered by the Wicking Dementia Research and Education Centre at the University of Tasmania (n = 44, 32%) (see Table 3). Dementia Australia and Dementia Training Australia were the next most frequently cited organisations, and almost 14% of respondents (n = 19) reported dementia education was provided within their organisation.
TABLE 3.
Dementia education courses (n = 228) completed in past 2 years
| Education and training variables | n | % |
|---|---|---|
| Course provider and/or course name | ||
| Wicking Dementia Centre/UTAS a —MOOC b | 35 | 15 |
| Online course (eg REHSEN/E3)—understanding dementia | 16 | 7 |
| Dementia Training Australia—dementia essentials (3 d) | 8 | 4 |
| Dementia Training Australia—other or unspecified course | 20 | 9 |
| Dementia Australia | 13 | 6 |
| Workplace education (eg in‐service, workshop) | 12 | 5 |
| Online/e‐learning (education provider unspecified) | 8 | 4 |
| Formal qualification (eg degree, diploma) | 8 | 4 |
| REHSEN/E3—other c or unspecified course | 5 | 2 |
| Altura Learning, previously Aged Care Channel | 4 | 2 |
| Montessori | 4 | 2 |
| Education provider unspecified—understanding dementia d | 3 | 1 |
| Dementia dynamics (USA) | 2 | 1 |
| Melbourne University (no other information provided) | 2 | 1 |
| Tri‐focal Model of Care modules, Deakin University | 2 | 1 |
| Other (eg courses mentioned by a single respondent) | 28 | 12 |
| No response (eg education completed but not named) | 58 | 25 |
| Mode of completion | ||
| In‐person | 82 | 36 |
| Online | 123 | 54 |
| Both in‐person and online | 15 | 7 |
| No response | 8 | 4 |
| How many hours did it take? | ||
| <1 h | 26 | 11 |
| 1‐2 h | 38 | 17 |
| 3‐5 h | 38 | 17 |
| 6‐10 h | 44 | 19 |
| 11‐20 h | 30 | 13 |
| 20+ h | 42 | 18 |
| No response | 10 | 4 |
| Was there an assessment? | ||
| Yes | 136 | 60 |
| No | 77 | 34 |
| No response | 15 | 7 |
| To what extent have you used your new knowledge and skills in your work? | ||
| Not at all | 1 | 1 |
| Very little | 6 | 3 |
| Somewhat | 44 | 19 |
| Quite a bit | 80 | 35 |
| A great deal | 84 | 37 |
| No new skills learnt | 1 | 1 |
| No response | 12 | 5 |
Wicking Dementia Research and Education Centre/University of Tasmania.
Includes free‐text responses that mentioned UTAS, Wicking and MOOC, with or without specifying the individual course components ‘understanding dementia’ and ‘preventing dementia’; excludes those completing a formal qualification at UTAS.
Excludes the ‘understanding dementia’ course.
Includes free‐text responses that mentioned the course name ‘understanding dementia’ but did not specify if it was provided by UTAS/Wicking Dementia Centre or REHSEN/E3.
Of the 137 respondents, 115 (84%) had completed dementia education within the past 2 years. Most of these respondents had completed between 1 and 7 courses, with the mean number of courses completed per respondent being 2 (SD = 1.5). Collectively, all respondents had completed 228 individual courses in the past 2 years (Table 3).
Approximately 15% of the respondents (n = 35) who completed dementia‐specific education, had completed the MOOC delivered by the Wicking Dementia Research and Education Centre at the University of Tasmania (see Table 3). Approximately 54% (n = 123) of the 228 individual courses completed in the past 2 years were delivered online, 32% (n = 72) of respondents completed education involving 10 + hours of study, but only 60% (n = 136) completed education involving assessment of learning outcomes. Seventy‐two per cent (n = 82) of these respondents reported using new knowledge or skills in their work ‘a great deal’ or ‘quite a bit’. Small proportions of respondents indicated they paid for some (n = 13, 11%) or all (n = 4, 4%) of the dementia‐specific education they completed in the past 2 years; for the remaining 85% who did not pay for any education, it is unclear whether this is because the course was free, provided in‐house by their employer or the cost of external education was met by their employer.
3.4. Characteristics of staff who most often engage with services and education
There were no significant differences between responses of RNs and nurse unit managers/associate nurse unit managers so their responses were combined for comparison with ENs and PCAs (other roles had insufficient responses for inclusion in these analyses). Of the 85 respondents who were aware of dementia‐specific support services, RNs (n = 24, 80%) were more likely to have used dementia‐specific support services in the past 2 years than both ENs (n = 10, 26%) and PCAs (n = 5, 31%), P < 0.001 (Fisher's exact test). In contrast, the proportions of respondents who had completed dementia education and training in the past 2 years were similar across the three groups, ranging from 73% of RNs to 85% of PCAs. No other analyses that compared responses based on demographic characteristics identified any significant findings. Length of time working in aged care and current role, country of birth, type of RACF (eg dementia‐specific vs general aged care) and geographic location (eg metropolitan, regional or rural) did not significantly impact engagement with services and education.
4. DISCUSSION
While just over half of all people living in Australian RACFs have a diagnosis of dementia, 4 our study to explore staff awareness of and engagement with dementia‐specific support services and education found only 27% of staff had accessed dementia‐specific services, and only two thirds (66%) had accessed dementia‐specific education in the previous 2 years. These findings prompt concerns about currency of staff knowledge and skills needed to promote well‐being of older people living with dementia in RAC. This finding should be considered in the context of previous reports regarding variable quality of care and inconsistent availability of services to support workforce training. 5 , 6 , 7 , 8 , 9 It should also be considered in the context of low staffing levels across the sector, 19 as it may be difficult for individuals to engage with dementia support services and undertake education because many RACFs are under‐resourced and cannot provide replacement staff to backfill positions when individuals are on study leave. 20 , 21
In addition to capturing the extent of use of dementia‐specific services and education by RACF staff, this study also identified how staff engage with these services when they do use them, which provides some insights into how future use may be increased.
A promising finding was that most respondents from Victorian RACFs were aware of available dementia‐specific education opportunities. Despite this positive finding, nearly one quarter of respondents were unaware of any dementia‐specific education available to them. This is consistent with the previous research 16 , 17 and highlights the need to promote dementia‐specific education among RAC staff. Contrary to research suggesting participation in work‐related training tends to increase in accordance with individuals' level of education, 22 the current study found a similar level of awareness and engagement with dementia‐specific education across PCA, EN and RN participants. This is particularly important given the key role of PCAs, who typically have a lower level of initial educational preparation in the day‐to‐day care of RACF residents.
Approximately 60% of dementia‐specific education completed by respondents in the past 2 years was delivered online, and a small proportion also included an element of in‐person delivery. This is markedly higher than the latest data for work‐related learning in Australia, where approximately 19% of work‐related learning across diverse industries was completed online. 22 As the aged care sector has an older workforce compared with other industries (median age of 46 years), 15 this finding assists in dispelling stereotypes that older workers are less tech‐savvy, unlikely to engage in online learning and have more difficulty learning new things and complex tasks. 23 , 24 , 25 The increasing availability of online education may also account for the relative equity in participation rates among staff working in metropolitan, regional and rural facilities, with no statistical differences identified between these sites in the current study. The duration of individual education activities varied, but 18% of respondents completed courses requiring 20+ hours of study, suggesting comprehensive content and high levels of commitment to professional development, specifically in dementia. Conversely, 40% of respondents completed education that had no assessment, which is a key strategy for evaluating achievement of learning outcomes. 26
Although most respondents were aware of dementia‐specific support services, just over a quarter accessed such services in the past 2 years. There were clear differences in service access based on work role, with RNs significantly more likely than both ENs and PCAs to access dementia support services. This finding is consistent with the hierarchical nature of the RAC workforce, with RNs responsible for supervision of staff, undertaking higher level resident assessment and care planning and, consequently, taking overall responsibility for managing residents' symptoms of dementia. 27 Nonetheless, the findings indicate there is scope to raise awareness of available services to support staff working at all levels of RAC, and encourage utilisation of these services whenever necessary. As discussed in the Introduction, implications for RAC staff who access dementia support services and education include benefitting from increased dementia knowledge, 12 confidence levels, 13 psychological well‐being 14 and dementia care competency, 13 which in turn can lead to better outcomes for RAC residents with dementia. 7
4.1. Limitations and recommendations for future research
This study was conducted with participants from public sector RACFs in Victoria, who may have different demographic and/or workforce profile characteristics to those from the not‐for‐profit and private sectors. In addition, the RAC workforce in Victoria is large (in 2016, the direct care workforce was estimated to be 42 309) 15 compared to the relatively small sample size recruited for this study, thereby limiting the generalisability of results. This is also the case for some occupational roles, including low response rates from allied health professionals. The overall population size was unknown; hence, a response rate could not be calculated and there were missing responses for many individual survey items. These are clearly outlined in Tables 1, 2, 3, and we acknowledge this has potential to impact the accuracy of the findings. Further, the self‐report method used to collect data has potential for response bias, with individuals who are interested in dementia care being more likely to complete the survey. Hence, the findings may be more favourable than reality in the broader aged care workforce. In addition, while the purpose‐designed survey was pretested, it was not psychometrically validated and was only available in English, which may have presented difficulties for participants with poor written English language and/or comprehension skills. This is important given reports indicating cultural diversity of the workforce within the RAC sector. 15
Recommendations for future research include exploring barriers to and enablers of dementia services use and education uptake by RAC staff. For example, preferred modes of access might be explored for dementia services such as telephone and online platforms; similarly, for dementia education such as onsite, online and offsite learning where geographic distance may impact attendance. In addition, costs of education and infrastructure issues may play a part in participation, for example availability of computers and Internet access. Organisational‐level influences may have a role in education uptake through management support and provision of paid leave to access services and participate in education opportunities. Research into potential barriers to and enablers of access to dementia support services and uptake of education opportunities would provide useful knowledge about potentially modifiable factors to optimise the use of services and workforce education.
5. CONCLUSIONS
Over half of older Australians living in RAC have a clinical diagnosis of dementia and require care from staff with specific knowledge of dementia care practices to promote well‐being. The results from this study highlight a need amongst RAC staff for greater awareness of and engagement with dementia‐specific support services and education. There is an undeniable need for dementia‐specific education across all staff levels in the RAC sector. While several high‐quality dementia‐specific education resources and support services are freely available to RAC staff, increasing awareness and promoting uptake of opportunities can be facilitated by employers. Further research to explore enablers and barriers associated with access to and engagement with dementia‐specific support services and education could inform strategies to promote the use of these resources.
CONFLICTS OF INTEREST
No conflicts of interest declared.
Williams R, Ockerby C, Rawson H, Redley B, Hutchinson A. Residential aged care staff awareness of and engagement with dementia‐specific support services and education. Australas J Ageing. 2021;40:e223–e233. 10.1111/ajag.12904
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