From residential aged care worker to Dementia Care Support Worker: a qualitative study of senior aged care staff perceptions of the role

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Emma J Lea
Andrew Robinson
Kathleen Doherty


Dementia, Nursing Homes, Professional Role, Qualitative Research, Quality of Health Care


Objectives: The study investigated how senior residential aged care staff perceived the purpose, function, impact and challenges of implementing a new role in their organisation for an unregistered care worker with a Bachelor of Dementia Care: the Dementia Care Support Worker. The role was piloted over two years in an Australian organisation with three aged care facilities to examine its potential to address gaps in service provision for people with dementia.

Background: The residential aged care workforce is under pressure to care for residents with increasingly complex health conditions and where most care is provided by care workers. Presently no formal leadership role exists for care workers with specialised dementia knowledge in the aged care setting.

Study design and methods: A qualitative descriptive approach was taken to explore senior staff members’ perceptions of the role at two time points. Twenty-three semi-structured interviews held in July-August 2017 (n = 12), soon after role commencement, and in February-March 2019 (n = 11) were thematically analysed.

Results: Three themes reflected senior staff members’ expectations of the role: enhancing staff and management knowledge about dementia and dementia care practices; facilitating changes to improve care for residents living with dementia; and educating and supporting residents’ families. Eighteen months later, participants felt the role was helping meet the need for improved care of residents with dementia, and staff understanding of dementia. They suggested communication and support structures to improve role effectiveness.

Discussion: Staff were receptive to the establishment of the Dementia Care Support Worker role and felt it resulted in improvement in dementia care. Success was contingent on strong organisational support and resourcing.

Conclusion: Improving dementia knowledge of care staff is an essential first step in driving care quality improvements. The Dementia Care Support Worker role for care workers has the potential to address knowledge needs and support improved care practices.

Implications for research, policy, and practice: This research models how a new role might be configured for unregistered care workers with specialist dementia knowledge. Further research is needed to explore the establishment of such a role more widely in other organisations, to investigate whether it could provide a new career development pathway for care workers and improve the skills and capacity of the aged care workforce. Substantial policy changes would also be required to support role viability, such as around increased salary. Research which examines the impact of such roles on care outcomes would complement the findings.

What is already known about the topic?

  • While dementia is common in residential aged care, knowledge of dementia is typically low among the care staff.

  • Consequently, care staff are not equipped to meet the complex needs of residents with dementia and their families.

  • New roles for unregistered care workers with specialised dementia knowledge have been proposed, but not tested.

What this paper adds

  • This research models how a new role might be configured for care workers with specialist dementia knowledge.

  • Aged care facility leaders support a role for care workers with formal specialist dementia knowledge and skills, and perceive the role helps improve the quality of resident care and develop stakeholders’ dementia knowledge.

  • Appropriate communication and support structures are required for the effective establishment of the role.

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