Healthcare assistants play an unacknowledged managerial role in the care of dementia patients, research has revealed.
The study, from Nottingham University and funded by a Department of Health research programme found HCAs provided the type of care most important to dementia patients themselves and created a “positive therapeutic environment”.
HCAs provide virtually all of the hands-on care. How they are fed, dressed and bathed is what people with severe dementia care about
The National Audit Office has estimated over half a million people in England have dementia and expect this to double in the next 30 years – posing questions around the workforce and skill mix requirements to meet that need.
Researchers spent three months working as HCAs and interviewing them. They found HCAs managed families and gave emotional and practical support to informal carers as well as controlling the level of general activity on the ward.
Lead researcher on the project Justine Schneider told Nursing Times: “HCAs provide virtually all of the hands-on care. How they are fed, dressed and bathed is what people with severe dementia care about.”
Professor Schneider said that managing the ward atmosphere was the “distinctive contribution” that HCAs made which had a therapeutic effect on the patients.
“They determine the level of stimulation in the ward. They facilitate family members coming onto the ward, they would make sure the level of stimulation was not too high or too low, taking someone out of the group environment if necessary or putting music on to liven things up if they had got a bit sluggish.”
The research poses questions about whether the job descriptions and supervision policies HCAs are subject to actually recognise the distinctive contributions they make. It also proposed more use was made of the band 4 position to recognise HCAs who were managing other HCAs.
“Much of what HCAs do is not codified in formal academic learning” Professor Schneider said. “More attention needs to be paid to the unqualified whose skills are so important to the growing number of people with dementia.”
Jeremy Wright MP, who chaired last June’s Parliamentary group on dementia, said in his preface to their report: “It is truly remarkable that those who work in care settings receive so little training in dementia care and that the training which is available is of such variable quality.”