Nurse helping woman walk with walker
Credit: JGI/Tom Grill/Getty Images

The odds of experiencing verbal threats, hitting and other behavioral responses from nursing facility residents with cognitive impairment are higher when caregivers rush through care tasks, a new study has found. Strategic workplace management may help to prevent these behaviors from occurring, the researchers say.

Investigators based in Canada surveyed more than 3,500 care aides across 87 nursing homes in Western Canada. Respondents self-reported instances of verbal and physical responsive behavior and of rushed physical and/or social care. 

Fully 62% of care aides reported that they had rushed at least one physical care task on their most recent shift, and 50% said that they had rushed communicating with residents. Those who said that they had rushed a social care task (talking with residents) were 70% more likely to report that the resident responded by yelling and screaming. Aides also were 8% more likely to experience these resident behaviors when an additional physical care task was rushed.

The same pattern was observed for the other types of responsive behaviors as well, reported Yuting Song, Ph.D., of Qingdao University in China and the University of Alberta, Canada.

Correcting the problem

Research suggests that residents with dementia and other cognitive impairment favor “slow nursing,” in which caregivers allow time for them to respond, the researchers explained. Rushed care contributes to missed opportunities to assess and attend to residents’ care needs, preferences, and rhythms. This may threaten residents’ quality of life, leading to frustration and responsive behaviors such as verbal and physical aggression directed toward staff.

There are multiple reasons why facility caregivers may resort to rushing care, Song and colleagues added. These include failures related to the physical environment, inadequate buffering of resources and ineffective staff interactions with coworkers.

There are many opportunities to correct the problem, they added. Improving the layout of the physical environment may reduce the amount of time that care aides spend on nonvalue-added activities such as walking around the unit to find supplies, for example. In addition, improved teamwork and communication between nurses and aides may provide a buffer for the care aides, helping them to feel less rushed when faced with interruptions.

“Ensuring adequate staffing and care resources, and a favorable work environment, should be top priorities for policy makers and nursing home managers to reduce rushed care,” Song and colleagues concluded.

Full findings were published in JAMDA.