11: The workforce treating and caring for people with dementia
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Services provided across the health, aged care, disability and community sectors are a major source of support for people with dementia and their carers. This can include health care services (for example, those provided in the community by general practitioners (GPs), specialists and allied health professionals, and health care in hospital settings), pharmaceuticals, aged care assessments, aged care packages, National Disability Insurance Scheme (NDIS) supports, and other community and residential aged care services. Post-diagnostic support services are also important to help manage dementia.
There is an expansive workforce providing treatment, care and support to improve outcomes for people living with dementia. Regular monitoring of this workforce would open avenues to:
- identify workforce gaps and plan for future needs
- target dementia-specific training in current areas of high need
- identify optimal educational contexts for introducing dementia-specific training to ensure maximum coverage of the workforce (such as communities of practice, micro credentials, and sharing of resources regarding effective dementia responses and supports).
However, there is a current lack of national comprehensive data on the formal workforce treating and caring for people with dementia (AIHW 2023).
Addressing the data gap and improving data
The national aged care workforce is monitored and reported on through a 4-yearly census and survey conducted and reported on by the department. The Royal Commission into Aged Care Quality and Safety (the Royal Commission) recommended more regular monitoring of the aged care workforce (Royal Commission 2021). The Aged Care Provider Workforce Survey has replaced the Aged Care Workforce Census, with a survey in 2023. An Aged Care Worker Survey is planned for early 2024 (DoHAC 2023).
The Royal Commission also recommended implementing mandatory dementia care training for workers engaged in residential aged care and in care in the community after finding that staff often lack skills and resources to appropriately care for people with dementia, particularly people experiencing behaviours and psychological symptoms of dementia (Royal Commission 2021). The Australian Government funds the Dementia Training Program to improve workforce skills for those working with people with dementia in the primary, acute, residential and community-based care sectors. This includes personal care workers, as well as GPs, nurses, pharmacists, psychologists, specialists, and allied and other health professionals (DoHAC 2022).
There is evidence that insufficient training among health and aged care workers contributes to the substandard care of people living with dementia (Royal Commission 2021). Better data on dementia education and training among health and aged care providers could be used to monitor care provision and identify where further training is needed. Better data are also needed on knowledge of dementia risks and risk reduction strategies among primary health care professionals.
Building a better understanding of the composition of the workforce treating, supporting and caring for people with dementia beyond aged care, and their training, would improve ongoing dementia-specific workforce monitoring. It would also help monitor workforce knowledge to provide high quality, person-centred care for patients and clients with dementia.
Proposed data improvement activities
There are 2 main activities proposed to improve data on the workforce treating and caring for people living with dementia at a national level. These include activities to:
- collect data on the knowledge of dementia, risk factors, risk reduction strategies, and capability among the workforce caring for and supporting people with dementia
- report data from dementia education and training across Australia.
Each activity provides information on the intended outcome, priority rating, level of investment required, timeframe for completion of the activity and who is responsible for undertaking the activity.
To support a skilled, dementia-aware workforce caring and supporting people with dementia, it is important to know the workforce’s current knowledge of dementia. This activity involves collecting data on the knowledge of dementia, including risk factors, risk reduction strategies, use of non-pharma behaviour support, capability and adherence to evidence-based clinical practice among the workforce caring and supporting people with dementia This would indicate where efforts should be targeted. Data could be collected every 3–4 years to assess the impact of any interventions.
As there are no existing data to comprehensively capture the expansive workforce providing treatment, care and support for people with dementia, a new study will likely be needed to capture knowledge and capabilities of dementia, its risk factors and risk reduction strategies.
Outcome: Data on workforce knowledge of dementia, including risk factors, prevention strategies, capability, and adherence to evidence-based clinical practice, established to inform workforce training and minimum standards
Priority: High
| Alignment | Foundational | Dependency | Priority Group Data | Priority score (Maximum 10) |
|---|---|---|---|---|
| 4 | 2 | 1 | 0 | 7 |
- Alignment: multiple highly important data gaps (National Dementia Action Plan (NDAP) objectives 2 and 6)
- Foundational data: baseline data to inform educational programs and monitor the impact of actions stemming from the NDAP
- Dependencies: requires healthcare providers or professional groups partnering to support data collection
- Priority group reporting: unlikely
Level of investment: Medium
Timeframe: Medium term (2–6 years) for initial data collection
Responsible stakeholder: AIHW National Centre for Monitoring Dementia (NCMD).
Building a better understanding of the training undertaken by the unpaid carers and paid workforce caring for people with dementia would provide a step toward monitoring how well-equipped the dementia workforce is with the knowledge to provide high quality, person-centred care for patients and clients with dementia. Regular monitoring of dementia education and training would open avenues to target dementia-specific training to where it is needed and identify optimal educational contexts for introducing dementia-specific training to ensure maximum coverage of the workforce.
This project would aim to explore the sources of workforce training information available (such as, Wicking Centre, Dementia Training Australia, Dementia Australia and possibly universities and Registered Training Organisations that include TAFE and entities approved to deliver specific courses) to determine whether sufficient dementia-specific information is available to routinely monitor the workforce and their training and qualifications. Once feasibility is assessed and reported on as part of the data improvement work program, workforce monitoring would become part of routine monitoring of dementia.
Outcome: Collated national reporting of dementia-specific training and qualification data to monitor dementia workforce capability
Priority: Medium
| Alignment | Foundational | Dependency | Priority Group Data | Priority score (Maximum 10) |
|---|---|---|---|---|
| 4 | 1 | 1 | 0 | 6 |
- Alignment: multiple highly important data gaps (NDAP objectives 5 and 6)
- Foundational data: method development
- Dependencies: on dementia workforce training information available from Wicking Centre, Dementia Training Australia, Dementia Australia, TAFEs and universities
- Priority group reporting: unlikely
Level of investment: Medium
Timeframe: Short term (initial) to Long term (once routine)
Responsible stakeholder: AIHW NCMD
AIHW (Australian Institute of Health and Welfare) (2023) Dementia in Australia, AIHW, Australian Government, accessed 23 February 2023.
DoHAC (Department of Health and Aged Care) (2022) Dementia Training Program, DoHAC website, accessed 19 July 2023.
DoHAC (2023) Aged Care Data Collection, DoHAC website, accessed 1 June 2023.
Royal Commission (Royal Commission into Aged Care Quality and Safety) (2021) Final Report: Care, Dignity and Respect: Volume 1 Summary and recommendations, accessed 16 May 2023.