Psychological trauma and fear for personal safety as a result of behaviours that challenge in dementia: The experiences of healthcare workers

Abstract

Few studies have systematically documented the psychological effects of exposure to aggression on healthcare workers. In 2007 an exploratory study invited 96 nurses and 228 care assistants from nine care homes to complete a questionnaire that incorporated the Impact Events Score — Extended (IES-E). Of the 112 returned (response rate 34.56%), 77 (68.8%) staff had been involved in an incident where they feared for their personal safety and 80 (71.4%) witnessed an incident where they feared for the safety of a colleague. Over the previous year 34% felt ‘very unsafe’ and almost 18% felt ‘terrified’. Violence against care home staff are not isolated incidents and irrespective of length of time working in dementia care staff lack the skills to identify triggers factors or appreciate the role they play in activating aggression. Their reluctance to engage with aggressive residents compromises care. An increasing ageing population combined with prevalence rates for dementia will place greater demands on care homes. Nationally agreed accredited qualifications for care assistants based on knowledge, and skills and attitudes specific to dementia care, may raise the standard of care. Infrastructures to support assaulted staff may reduce feelings of isolation, assist with recruitment and retention problems and provide social support.