Ambassador role reduces incidents of violence and aggression in aged care

The Resident Experience Ambassador (REA) Pilot, funded by WorkCover Queensland, aimed to reduce the risk of injury to staff from resident aggression in aged care memory support units.

The pilot introduced a specific ambassador care role, with staff specifically trained to make meaningful connections with residents and de-escalate situations by addressing unmet needs.

The pilot recorded an overall reduction of incidents of aggression from residents, with no incidents occurring when the ambassadors were present. Care workers also observed an enduring improvement of residents’ behaviour after the pilot ended.

“Ambassadors were really good at making meaningful connections with residents and this met a deep-seated need that exists in all people – the need to be known and to have meaningful relationships,” Crows Nest Aged Care Service Manager Janine Elliot said.

She said the pilot sends a clear message to the industry that there is an answer to occupational violence, it’s not something we have to put up with.

“In the end it all comes down to adequate and well-trained staff,” she said.

As part of the pilot, three personal care workers and an enrolled nurse received specific training from JK Corporate Resourcing, which uniquely addressed the needs of residents living with a dual-diagnoses of dementia and helped the ambassadors to learn how to address their unmet needs.

Tatjana Jokic, JK Resourcing Principal Consultant and Psychologist, said that through the training, the ambassadors learnt how to  use a person’s life story to discern unmet needs. They were then equipped with strategies to meet those needs.

“Our face-to-face training involving workshop-style feedback and role-plays, alongside our ongoing mentoring, were key to seeing head-knowledge put into practice. It allowed care workers to be proactive instead of simply reactive,” Tatjana said.

“Internationally no one has used care staff to do behaviour management like this. This is the first time that behaviour management doesn’t use restrictive practice.”

Churches of Christ Health, Safety and Wellbeing Manager, Penny Behan, attended the training, coordinated the project and visited the staff during the pilot, and is excited about the potential impact this training can have both for staff and residents in aged care settings.

The pilot included up to 24 hours of ambassador shifts per week during the three-month trial.

“With just a small increase in well-trained staff, aged care services can experience powerful positive transformation, benefiting both residents and staff,” Penny said.

Penny said that having an ambassador present had a flow-on effect.

“The improvement in resident behaviour opened up extra time for staff to complete their tasks, leading to better quality care, better quality relationships and better working conditions.”

A key part of the program, Tatjana said, was that the ambassadors were not in uniform, removing an obstacle to normalcy and relationship-building between the residents and the ambassadors.

“A uniform represents the organisation, a position of power, and that is not normal. It says to residents they’ve been institutionalised and they’re not at home. It also represents the end of their own independence,” she said.

The ambassadors’ plain clothing made residents feel like they were engaging with an ordinary person in a normal environment.

“Normalising everyday life is very important in treating people living with dementia,” Janine said.

A male resident who’d had no visitors in his five years at the service was part of the pilot.

“The ambassadors went to see him, and because they were in plain clothes, he believed they were his visitors who had come to see him. His whole demeanor changed – he was just beaming,” Penny said.

One of the ambassadors, Linda Hanson, is an enrolled nurse with 32 years’ nursing experience.

“There has never been any training as effective as the ambassador training in turning knowledge of a resident’s life story into practical, applicable strategies and interventions. It has had such an immediate and positive impact on the living and working environment for residents and staff,” she said.

Tatjana said that they didn’t want organisations to feel dependant on the JK Corporate Training to see the successful results from this pilot overflow to benefit all staff and be implemented in other centres.  

“Once an ambassador is trained, they can go on and train the other staff. The strategies are not difficult to learn or pass on,” she said.

“It’s easy to share with other staff what we’ve learnt because we are so excited to have seen the positive changes it’s made in behaviour. It’s as simple as saying to others, ‘Did you know…?” Linda said.

With the resounding success of the ambassador in reducing incidents of aggression and upskilling other care workers, the Unit has continued to roster on a care worker for afternoon shifts. Janine said that it’s important for that person to think like an ambassador. “All our staff can now make those connections that an ambassador makes and it has made the world of difference having that extra person on,” she said.