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Calling for culturally safe aged care for Aboriginal and Torres Strait Islander people

The Royal Commission into Aged Care Quality and Safety made several recommendations aimed at improving access to culturally safe aged care for Aboriginal and Torres Strait Islander people, as reported at Croakey in an earlier story.

Below we publish two statements responding to the Commission’s recommendations – from Jill Gallagher AO, chair of the National Advisory Group for Aboriginal and Torres Strait Islander Aged Care and CEO of CEO of the Victorian Aboriginal Community Controlled Health Organisation, and Fiona Petersen, CEO of the Healing Foundation.


Statement calls for swift action

Radical change is needed to provide appropriate aged care which draws on Aboriginal culture, says the National Advisory Group for Aboriginal and Torres Strait Islander Aged Care (NAGATSIAC).

NAGATSIAC chair Jill Gallagher AO has urged the Federal Government to swiftly adopt all recommendations from the Royal Commission into Aged Care Quality and Safety Final Report.

Ms Gallagher said the aged care system had “profoundly failed Aboriginal and/or Torres Strait Islander people and these long overdue changes would enable Aboriginal and/or Torres Strait Islanders to access aged care that meets their needs”.

The Commission recommendations also acknowledged that:

  • Services for Aboriginal and/or Torres Strait Islander Elders must be culturally safe and tailored to meet their needs.
  • Services for Aboriginal and/or Torres Strait Elders are best provided by Aboriginal people and organisations.

Ms Gallagher, who is also CEO of the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), said the aged care system had “failed our Elders” and more needed to be done to protect vulnerable Aboriginal and/or Torres Strait Islander residents.

“Elders are the keepers of Culture and the heart of our Communities,” Ms Gallagher said.

“The aged care system has failed our Elders.

“The Royal Commission’s recommendations call for radical change and acknowledge that Aboriginal and/or Torres Strait Islander people and organisations are best placed to serve Aboriginal Elders.

“We need care for Elders which draws on our culture.”

Ms Gallagher said it was pleasing that this profound failure had been openly acknowledged and the Royal Commission had hit on the only solution that made sense – services for Aboriginal Elders should be delivered for Aboriginal people and organisations.

“From now on, care, and pathways to care must be Aboriginal led and delivered,” she said.

NAGATSIAC has urged the Federal Government to action recommendations which:

  • Ensure that Aboriginal and/or Torres Strait Islander people receive culturally respectful and safe, high quality, and trauma informed needs and flexible aged care regardless of where they live.
  • Prioritise Aboriginal and/or Torres Strait Islander organisations as aged care providers to provide support for Aboriginal Community Controlled Organisations (ACCOs) to initiate or expand their aged care services.
  • Ensure that aged care assessments of Aboriginal and/or Torres Strait Islander people are conducted by Aboriginal and/or Torres Strait Islander assessors wherever possible.
  • Require care finders serving Aboriginal and/or Torres Strait Islander communities to be local Aboriginal and/or Torres Strait Islander people who are trusted by the local population.

Statement calls for services to address trauma and healing

The Healing Foundation welcomes the recommendations of the Aged Care Royal Commission Final Report that recognise the specialised aged care needs of Aboriginal and Torres Strait Islander peoples, including urgent trauma-aware and healing-informed services and care.

The final report notes that ‘… trauma-informed approaches are particularly important to the care of [survivors] of the Stolen Generations. By 2023, all Stolen Generations survivors will be aged over 50 years and potentially eligible for aged care services. Their childhood experiences further compromise their ability to seek services and should dictate and inform how such services should be provided’.

The recommendation for a new Aged Care Act acknowledges that ‘…Aboriginal and Torres Strait Islander people are entitled to receive support and care that is culturally safe and recognises the importance of their personal connection to community and country’.

The Healing Foundation CEO Fiona Petersen said the Royal Commission has responded strongly to the broader aged care crisis in Australia and reinstated that cultural safety must be at the centre of the aged care pathway for Aboriginal and Torres Strait Islander peoples.

“The Healing Foundation strongly supports key recommendations in the Final Report, most notably the appointment of a dedicated Aboriginal and Torres Strait Islander Commissioner; training in cultural safety and trauma-aware healing-informed approaches for the aged care workforce; free access to interpreters; local services to maintain connection with country and community; and flexible funding to provide care to Aboriginal and Torres Strait Islander peoples where they live,” Ms Petersen said.

Between 1910 and the 1970s, approximately one in ten Aboriginal children were stolen from their families, communities, and cultures and placed in institutions or adopted by non-Indigenous families.

On top of the grief and suffering caused by their removal, stolen children were often subjected to harsh and degrading treatment including abuse, exploitation, and racism. Many were also denied education.

As a result, many Stolen Generations survivors live with lifelong physical, mental, and economic disadvantage.

“Stolen Generations survivors are significantly more likely to depend on government payments, not own their own home, and to live alone compared to other Aboriginal and Torres Strait Islander peoples of the same age,” Ms Petersen said.

“On top of this, Stolen Generations survivors are worried about the future for their families.

“Addressing these needs requires effort at all levels to co-design policies and programs that are trauma-aware and healing-informed, and that enable Stolen Generations survivors to live with dignity and respect, with the knowledge that their families will thrive into the future.

“Stolen Generations survivors are more likely than other Aboriginal and Torres Strait Islander peoples of similar ages to feel discriminated against, and to have problems accessing services.

“They are often suspicious and fearful of government and frequently experience mainstream services as racist and exclusionary.

“With the entire Stolen Generations population eligible for aged care by 2022-23, it is essential that they are offered more holistic social and cultural support in order to access the services they need.

“It is pleasing that the Royal Commission Final Report has acknowledged and responded to the complex and tragic circumstances and needs of Stolen Generations survivors, and provided the Government with targeted, practical and compassionate recommendations.

“The Healing Foundation stands ready to work with the Federal Government and the aged care sector to put in place a culturally safe pathway to trauma-aware and healing-informed aged care for our ageing and ailing Stolen Generations survivors,” Ms Petersen said.

Key recommendations of the Aged Care Royal Commission Final Report include:

Recommendation 47: Aboriginal and Torres Strait Islander aged care pathway within the new aged care system

The Australian Government should ensure that the new aged care system makes specific and adequate provision for the diverse and changing needs of Aboriginal and Torres Strait Islander people and that:

  • Aboriginal and Torres Strait Islander people receive culturally respectful and safe, high quality, trauma-informed, needs-based, and flexible aged care services regardless of where they live.
  • Priority is given to existing and new Aboriginal and Torres Strait Islander organisations, including health, disability and social service providers, to cooperate and become providers of integrated aged care services.
  • Regional service delivery models that promote integrated care are deployed wherever possible.
  • There is a focus on providing services within, or close to, Aboriginal and Torres Strait Islander populations while maximising opportunities for people to remain on, and maintain connection with, their Country and communities.
  • Aged care is available and providers are engaged at the local aged care planning region level on the basis of objectively established need that is determined in consultation with Aboriginal and Torres Strait Islander populations and communities, and recognising that aged care needs and service delivery preferences may vary between locations and population centres.
  • Older Aboriginal and Torres Strait Islander people are given access to interpreters on at least the same basis as members of culturally and linguistically diverse communities when seeking or obtaining aged care, including health care services.

Recommendation 48: Cultural safety

  1. By 1 July 2022, the Australian Government and the System Governor should: require all of its employees who are involved in the aged care system, and any care finders who are not its employees, to undertake regular training about cultural safety and trauma-informed service delivery; require all aged care providers which promote their services to Aboriginal and Torres Strait Islander people to train their staff in culturally safe and trauma-informed care, and demonstrate to the System Governor that they have reached an advanced stage of implementation of the Aboriginal and Torres Strait Islander Action Plan under the Diversity Framework.
  2. From 1 July 2023, the System Governor should: Ensure care finders serving Aboriginal and Torres Strait Islander communities are local Aboriginal and Torres Strait Islander people who are culturally trained and familiar with existing Aboriginal and Torres Strait Islander service providers who are trusted by the local population. Ensure, wherever possible, that aged care assessments of Aboriginal and Torres Strait Islander people are conducted by assessors who are Aboriginal or Torres Strait Islander people, or others who have undertaken training in cultural safety and trauma-informed approaches. Work with State and Territory Governments to establish culturally appropriate advance care directive processes, guidance material and training for aged care providers that account for the diversity of cultural practices and traditions within each State and Territory.
  3. From 1 July 2023, the System Governor should require its employees, and any care finders who are not its employees, to undertake regular training about cultural safety and trauma-informed service delivery.

To ensure effective aged care services are provided to Stolen Generations survivors, The Healing Foundation is sharing this fact sheet.

The statement above is available here.

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