It’s your parent’s right to receive confidential and compassionate care if they become mentally unwell. Social isolation and depression are common in residential aged care so it is important staff know how to care for your parent’s physical and mental health. Here are 10 questions to ask about mental health needs in residential aged care. Note these questions have been written from your parent’s perspective, but you can ask them too on their behalf.
1. How will staff recognise if I become mentally unwell?
Staff should assess your physical and mental health needs and write a care plan with you. This should include the warning signs that let you and your family know you are becoming unwell. It’s important that your needs are reviewed regularly, including mental health and medication reviews by your GP and/or therapist.
2. Are staff able to support my mental health needs?
Staff training can vary and turnover can be high so check if any staff are trained to support a range of mental health conditions/ symptoms. New staff should be made aware about your day to day mental health needs and how to respond if you start to get mentally unwell. Few places employ registered nurses with specific mental health qualifications, so if you need specialist nursing care check how you will receive this.
3. How many care staff are employed day and night?
It is important to have enough staff to keep both you, and others safe. Falls may happen with some mental health conditions and having enough staff to keep you safe is a legal requirement. Check the ratio of staff to residents and look to see if there are staff around at all times.
4. What support do you provide for mental health needs?
The range of mental health services provided can be variable so check what therapeutic services are offered and agree how you will access these when needed. You are entitled to access GP services and externally sourced mental health practitioners.
5. What activities do you provide?
Boredom can heighten low mood so check if a diversional therapist is employed, how often they attend and if activities offered match those you enjoy. Regular activity, social connection and having pets around can also reduce anxiety. Structured Life Review and Cognitive Behaviour Therapy are also highly effective techniques for improving mood.
6. Will I be able to move freely around the place?
The areas you are shown on your first visit are not always where you will be looked after when you move in. There may be specific rooms where people with mental health needs are accommodated. Sometimes this is required for safety, but freedom of movement must never be restricted for other reasons, such as not having enough staff.
7. Are there psychologists or social workers on-site?
Very few places employ psychologists or social workers so you may need to pay for privately funded psychologists to visit. Depending on your eligibility, you may be able to claim some financial support*. If you have to visit clinics off-site, check if you are charged for transport and staff to accompany you. If you are receiving mental health support at home, make sure this will continue when you move in.
8. Do I have access to a psychiatrist?
You can keep seeing your own psychiatrist although you may need to travel to see them so check if you have to pay for transport and staff to go with you. There should be links with local mental health services so also check how referrals are made. Aged care psychiatric teams may be available and can provide an assessment of your needs within the facility. If you or your doctors feel that you need more intensive care, you may be hospitalised.
9. Will my family and friends be involved in my care, and supported?
Family and friends should be consulted about your care history and preferences and be involved in your care, with your consent. Check how staff will keep your loved ones informed about your care, when they can visit and how they can arrange overnight stays with you. Friends and family supporting you may also feel anxious or depressed. Some facilities also offer services to family and friends, such as support groups so check what help is provided.
10. How can I keep links with my local community?
It’s important to keep in touch with services that you have at home, particularly if your stay is temporary. This helps staff personalise your care and support you appropriately. Make sure staff know who to contact and they record this in your care plan.
You may find these 10 questions to ask about your mental health needs useful when:
• Searching for a high-quality residential aged care facility.
• Reviewing the quality of your current residential aged care facility.
• Deciding between two residential aged care facilities that appear similar.
It’s important that there are enough registered nurses within the staff skill mix to meet everyone’s needs. You should ask questions about how your individual care needs will be met.
Many staff wear similar uniforms. Just because someone looks like a nurse does not mean they are. Here are the differences:
A Registered Nurse (RN) has undertaken a minimum three-year Bachelor of Nursing course. They can undertake nursing procedures, manage pain medication and help prevent unnecessary hospital admissions.
An Enrolled Nurse (EN) works under the direction of an RN. Both are registered by a regulatory body. Registration ensures professional standards are maintained and protects the public.
Assistants in Nursing (AIN)/Care Workers/Care Service Employees (CSE) are unregistered. They provide most of the care in residential facilities and communities but their level of training is variable.
Some useful links:
10 questions to ask about your mental health needs. – http://www.10questions.org.au/
Carer’s Circle article on Walking on eggshells around mum’s mental health –
https://carerscircle.com.au/2021/07/23/walking-on-eggshells-around-mums-mental-health/
Carer’s Circle article on Stubborn older parents and how to deal with them –
https://carerscircle.com.au/2020/07/20/stubborn-older-parents-and-how-to-deal-with-them/
Quality Aged Care Action Group (QACAG) – An independent grassroots community action group that lobbies for high quality aged care in all settings including residential and home care. QACAG is an organisational member of the NSW Aged Care Roundtable. It contributes to the development and consumer testing of the ’10 Questions to Ask’ series of consumer-facing resources for people seeking aged care – https://qacag.org.au/
Photo credit: Black and white portrait of a white elderly woman eyes closed by RawPixel
