Voice of Aged Care

Show notes: Episode #44

Escalating Concers

For those who work in aged care or care for elders in their home, it can be difficult to know when and where to escalate concerns about client wellbeing. This applies to concerns about the wellbeing of the person’s family and your colleagues too. While I do talk about this at the end of my training programs, I think it is a really important topic that needs to be discussed in its own right. So in this episode, we’ll explore when and where to escalate concerns about the wellbeing of your clients, their families and your colleagues.

With the high prevalence of mental health conditions in Australia, noticing signs that things are not right can make such a difference to mental health outcomes. In 2023 in Australia, about 9 people take their own lives every day. Early intervention and support, even as simple as a confidential chat, can make a real and positive difference. But where can those who may be struggling turn to for support?

When it comes to clients, you may first notice they are a bit flat, are not themselves, are disengaged or maybe a little teary and emotional. While we all have bad days, if this continues for longer than a few days, it may be a sign that something is not right. Maybe they have experienced changes to their physical health, or are going through grief and loss? Always follow workplace procedures for escalation if you are worried. Often this means escalating your concerns to a GP who can have a confidential chat with the person and their family to evaluate what is happening and screen them for any medical issues that may be having an impact Where in the past GPs may have prescribed medications exclusively, they are now more likely to offer non-pharmacological strategies to boost wellbeing alongside or as an alternative, such as counselling or joining a group where appropriate. A GP is in a unique position as they can evaluate what is going on, monitor the person’s health and wellbeing and review the outcomes, refining strategies if needed. Keep in mind that it is often not the GP who first notices any changes, and this is why it is so important to escalate your concerns. From there, the GP can assess the person to determine what is the best course of action

Depending on your client, they may prefer to call and access support services themselves. If this is the case, provide them with contact details for organisations that can help including Lifeline, Beyond Blue and Swinburne Wellbeing Clinic for Older Adults.

Many families can have difficulty processing changes in late life too. From the role reversal of care to their past family history, it can feel like a lot to deal with all at once. Sometimes things change overnight, at other times it can be subtle shifts over time. Families are often processing grief about what is happening now and what will happen in the future. Accepting things are different is hard, especially when they feel they need to be strong on the surface. So, if you notice families are needing additional support, what can you do? After speaking to families, it can be helpful to provide them with brochures that talk about transitioning to aged care, or dealing with grief. Organisations such as the Australia Centre for Grief and Bereavement have some excellent resources that discuss the emotions family or friends may be experiencing, including guilt, sadness, shame, fear, frustration, anxiety, as well as information on how they can take care of themselves. The brochures also includes phone numbers of support groups where they can have a confidential chat. Be sure to mention it’s okay to talk to staff about their loved one’s care. Opening the lines of communication and providing them with the information they need could be the first step in helping them to seek support sooner, as opposed to pushing through. When we are working with families, they are more likely to feel supported, which in turn allows them to engage more positively with the client, which is a better outcome for all.

Another situation where it may be necessary to escalate concerns is if you notice a colleague who is struggling. Perhaps they seem a bit off, a bit short or are just not themselves? They could be experiencing personal stress or burnout, or maybe the organisation is going through a challenging event, such as accreditation. Where can we escalate these concerns?

Speaking to your colleague directly is a good first step, or if this is not possible or doesn’t help, escalate concerns to management. Many workplaces have handouts on employee assistance programs (EAP) and offer access to counselling, which can be really beneficial to those who need short-term intervention. For those needing more long-term support, EAP can guide them towards additional services if and when required. When your colleagues know that staff and management are there to support them when they are going through difficult days and difficult times, it can encourage then to see their GP or health providers for external support if needed.

Remember, it is also really important to take care of yourself. The more we practise self-care, the better equipped we are to look out for each other.

And when it comes to escalating concerns, it is always better to be safe than sorry, and it’s always better to help someone sooner rather than later.

In this episode you will learn:

How to escalate concerns about a client’s wellbeing
The importance of noticing changes and acting
How having difficult conversations with families can leave them and you feeling vulnerable
What you can do to help families who are struggling with changes
Why we need to look out for each other and how to escalate concerns about colleague wellbeing.

Resources:

Australian Centre for Grief and Bereavement – PH: 1800 642 066

Beyond Blue – PH: 1300 224 636

Swinburne Wellbeing Clinic For Older Adults – PH: 03 9214 3371

Lifeline – PH: 13 11 14

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Dr. Julie Bajic Smith