Dr Raechel Damarell2, Ms Nurul Adnan1, Professor Jennifer Tieman2
1Caresearch, Adelaide, Australia, 2Research Centre for Palliative Care, Death and Dying, Flinders University, Adelaide, Australia
Biography:
Raechel Damarell is Senior Research Fellow with CareSearch and palliAGED, Commonwealth funded projects that consolidate online palliative care knowledge for health professionals, people needing palliative care and their families, and the general community. She is a member of the Research Centre for Palliative Care, Death and Dying (RePaDD) at Flinders University and is currently the Bibliography Editor for the journal Progress in Palliative Care.
Abstract:
Background: Aged care workers are confronted with unique challenges heightening burnout risk, including exposure to death, advanced dementia, and COVID-19. Although complex factors contribute to burnout, organisations often emphasise individual self-care practices to prevent or lessen its impact. Irrespective of benefits, self-care options should not divert attention from the sector's responsibility to tackle root causes. Targeted interventions should distinguish individual from organisational causes and mitigating factors.
Aims: This study aims to discern individual versus organisational risk and protective factors for aged care staff burnout in the context of end-of-life care. It also seeks to evaluate the effectiveness of personal self-care approaches compared to organisational initiatives in preventing burnout.
Methods: A rapid review of English-language research (2012-2023) reporting aged care burnout causes, preventive factors, experiences, and interventions.
Results: The review identified 88 relevant studies. Evidence suggests moderate-to-high rates of aged care staff burnout pre-COVID-19, with increased risks during the pandemic. Burnout was pronounced among staff caring for individuals with advanced dementia, especially when they lacked sufficient knowledge about the condition. Organisational factors such as insufficient acknowledgement of and support for staff grief and inappropriate space provision for dying residents exacerbated burnout. Individual self-care practices such as yoga and mindfulness showed inconclusive effectiveness on burnout, while those focused on improving resident quality of life demonstrated incidental positive effects. Conversely, organisations might reduce burnout risk by emphasising the value and meaningfulness associated with end-of-life care, allowing time for staff-resident interaction, acknowledging and supporting grieving staff, and providing end-of-life care training opportunities.
Conclusion: Aged care staff may experience burnout due to end-of-life care responsibilities when lacking organisational support to alleviate stressors. Organisations might offer self-care to staff to address coping without examining contributing local and systemic factors. Further research on organisational initiatives to prevent burnout and support staff wellbeing is needed.