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Vivian Isaac
Are rural aged care workers stressed out?

Dr Vivian Isaac is a Senior Lecturer, Rural Mental Health at Flinders University Rural Health South Australia (FRHSA) and a Topic Lecturer for ‘Research Skills in Clinical Education’, Masters of Clinical Education, Flinders University. He has a PhD in Rural Health (University of New South Wales) focused on social-cognitive models in rural health services and rural workforce. Previously, he was a Wellcome Trust Masters Research Fellow and completed MSc Research Methods at the Institute of Psychiatry, King’s College, London (2004-2007) and an experienced social worker with tertiary degrees in Social Work (2002). As an early-career researcher, he has an H-index of 8, 370 citations (>75 percentile). He has nine first author publications in high-impact journals such as American Journal of Geriatric Psychiatry, Medicine, BMJ Open and BMC Human Resources for Health. Dr Isaac contributes to the rural community-engaged medical education program in Renmark, South Australia, particularly in regards to mental health clinical education and research. He supports rural clinical placements and supervision for medical and allied health students in rural communities. He is also a chief investigator for ‘Harmony in the Bush—Rural Dementia Care Study’ Commonwealth Department of Health, Australia.


The purpose of this presentation is to explore caregiver stress among aged-care staff working with people with advanced dementia in rural residential care

A major source of stress for aged-care staff arise from the residents who have challenging psychological and behavioural symptoms in advanced dementia. Such behavioural disturbances, including verbal or physical aggression, and excessive wandering, indicate distress in the residents, and cause stress for care staff. Caregiver stress may impact on staff turnover, absenteeism, and be detrimental to their mental health. Data for this analysis were derived from the larger rural multi-site Harmony in Bush (HiB) Dementia Study. HiB Dementia Studyis a quasi-experimental study aimed at developing a personalised plan of care based on the Progressively Lowered Stress Threshold (PLST) Model” (Hall & Buckwalter, 1987), including a music/arts program and institutional changes in five (5) rural residental facilites. The study uses method triangulation with both qualitative and quantitative methodologies. The present analysis focuses on staff stress measured using the Caregiver Stress Inventory (Maas and Buckwalter, 1990), a 7-point Lickert scale. Staff stress is defined as the response that individual staff members’ experience to incidents that occur in the daily care of persons with dementia.

Preliminary results indicate 75% of aged-care staff are personal carers. Mean score on the total caregiver stress inventory was 4.0 (SD 0.7) for nurses and 3.3 (SD 0.9) for personal carers. The domain scores were indicators of the source of their stress including: aggressive behaviour 4.0 (1.0); resident safety 3.8 (SD 1.1); inappropriate behaviour 2.8 (1.0) and resource deficiency 3.3 (1.2).  Interestingly, there was significant higher stress for carers born overseas than those in Australia (t=2.3, p=0.02). Qualitative data would be used to triangulate the findings and will be presented.  

Australian aged-settings are going through significant changes in the past decade; with all personal care provided by personal care workers. The study findings would have strong implications in developing systematic education programs for aged-care staff and to alleviate their stress.