Impact of the COVID-19 pandemic on the Australian residential aged care facility (RACF) workforce

Objective: We conducted a survey to understand the challenges faced by the staff of residential aged care facilities (RACF), during the COVID-19 pandemic. Background: In the current pandemic, the RACF workforce has been required to work under stressful conditions, with immense mental and physical pressures, resulting in anxiety and stress felt towards their jobs. Study design and methods: We electronically surveyed both clinical and non-clinical staff at public and private RACFs in Australia in June and August 2020. The survey asked a mix of open-ended and closed questions about preparedness for the pandemic, information flow, experience with personal protective equipment (PPE), management of suspected COVID cases, restrictions on visitors, and impact on RACF staff personal and home life. Quantitative data were analysed in SPSS; qualitative data using content analysis. Results: We received 371 responses: 198 from clinical staff and 168 from non-clinical staff. Respondents were between 20–71 years old, and 87% were female most commonly from Victoria (28%) or New South Wales (28%). The majority (80%) felt that Australian RACFs were well-prepared for the pandemic and 87% agreed that relevant healthcare authorities were contactable for information needed. A total of 37% reported challenges in estimating and ordering appropriate quantities of protective equipment. Ninety percent of facilities reported screening residents for possible symptoms and 77% introduced precautions or quarantine measures to protect residents. Most participants (98%) reported their RACF implemented restrictions on visitor access and 43% reported unfair or abusive treatment by family or friends of the residents. Commonly reported personal impacts included: workload increase, stress, emotional toll, family issues and fatigue. Support from colleagues as well as training, de-brief sessions and frequent meetings were identified as helpful facilitators during this time. Conclusion: We identified a wide range of practices and coping strategies among Australian RACFs. Whilst a majority of respondents reported coping well, a large proportion reported struggling both mentally and physically. Factors reported as helpful by the respondents may assist RACFs in planning for future pandemics. Implications for research, policy and practice: Understanding the challenges faced by all levels of staff within RACFs may aid decision-makers on a range of different levels – researchers, aged care providers, local/regional/state health departments and national leaders within government to help inform the development of interventions that may help the sector to recover, as well as prepare for potential future outbreaks. Of particular importance, are interventions or initiatives that focus on supporting the physical and mental health of staff i.e. those that prevent or minimise worker fatigue, emotional burnout and stress.