The importance of developing aged care services that are inclusive for all elders was emphasised by the Older Person Advocacy Network (OPAN) in their latest webinar Who’s missing? Diversity and Inclusion in Aged Care on June 7.
The webinar supported the release of OPAN’s free Diversity Education Program, which aims to educate providers and aged care program coordinators on how to make older persons from diverse backgrounds feel welcomed and valued; listened to and understood; and that their identity and preferences are supported.
Diversity, in the context of aged care, can refer to older Australians who:
- Are Aboriginal or Torres Strait Islanders
- Are from culturally and linguistically diverse (CALD) backgrounds
- Are veterans
- Are LGBTI+
- Are living in rural and remote areas
- Are living with a disability
- Are living with cognitive impairments, including dementia
- Are impacted by forced adoption or removal of children
- Are currently or have previously experienced homelessness
- Are socioeconomically disadvantaged
Dr Kay Patterson, Australia’s Age Discrimination Commissioner, opened the webinar, emphasising the importance of diversity education in ensuring quality aged care for all.
“Putting people at the centre of aged care requires that no one is left behind,” she said.
“The culture we set now is the culture we will inherit when we need aged care services.”
Mona Orszulak, a member of OPAN’s National Older Persons Reference Group, said that whilst ageism makes life tough for any older Australian, those who are culturally and/or sexually diverse face added challenges.
“Once a person reaches a certain age, they are viewed as redundant, useless, unable to make their own decisions— how hurtful and demeaning would it be for someone who struggles to speak English to have those issues compounded.”
She said it is vital for all persons involved in the aged care industry to be trained in how to kindly and sensitively deal with those with added cultural and linguistic needs.
“Look at each person as a unique individual … don’t assume that because someone can’t speak English that they are illiterate or stupid.”
Isolde Kauffmann, director of the Department of Health, said that such initiatives build upon requests made by the Royal Commission into Aged Care Quality and Safety.
“The royal commission’s final report found that diversity should be core business in aged care.
“It identified communities that were not well served by the system and it called out the aged care sector for a lack of understanding for people’s diverse cultures and experiences.”
Royal Commission Recommendation 30 specifically addresses the need for systemic accommodation of diversity, identifying a number of steps to be taken in order to bring the Australian aged care facilities up to scratch.
Kauffman said that hopefully OPAN’s materials will provide a valuable starting point whilst the Government works to respond to the royal commission recommendations in full.
“Our community is diverse and diversity is the norm as opposed to the exception… hopefully this educational initiative will become a prompt to think about the community and diversity that they are situated in.
“We hope the project will help aged care providers to build their capacity in responding to the diversity in their community.
Providers need to step up and lead the process
Samantha Edmonds, OPAN’s manager of policy and systemic advocacy, said that reforms need to start at the very top of organisations
“Leadership from the top down is important,” she said.
Making sure that diverse voices are represented in the planning process is incredibly important, with a system of co-design with diverse communities most effective.
“If you do have representatives from different groups [within your organisation] it’s actually important to have sub-groups or committees to ensure those voices are being heard,” Edmonds said.
Whether an elder be CALD or LGBTQI+, the aged care industry must understand that there is a high possibility of trauma being a feature of their lives.
“You need to understand people and their life experiences; many have had lives of adversity and exclusion,” Edmonds said.
With this in mind, providers must consider how a history of trauma can impact elders behaviour as they enter an aged care facility or receive a home care service for the first time.
A withdrawn, stubborn, or combative elder may not be meaning to be difficult, but instead may be struggling to comfortably assimilate.
“It’s a person living their life and living their experiences … unless you can understand that through empathy, then these people will continue to feel excluded in aged care,” Edmonds said.
Case studies from the coalface
Where embracing diversity has been prioritised, organisations have found that resident outcomes are far more positive.
Rhonda Smith, is the Aboriginal sector support & development officer at Booroongen Djugun, an aged care facility in Kempsey, NSW.
She says Booroongen Djugun was developed with the specific cultural needs of Aboriginal elders in mind, with the whole facility co-designed with local elders.
“We ensure that elements such as fire and water are incorporated into elements of the building.”
Importantly, the facility has provided an unprecedented number of jobs for First Nations nurses and care workers.
“We employ Aboriginal staff so it’s by our people, for our people.”
LGBTI Connect was developed by ECH Aged Care, which in 2017 became the first South Australian aged care provider to receive a Rainbow tick for its LGBTI-safe services.
Robyn Lierton, ECH’s community engagement and diversity manager, said that the program was developed via an extensive co-design process, which included interviews, role plays and mock simulation of services.
“Co-design goes a little bit further than consultation with people,” she noted.
“If you could wave a magic wand, what would the perfect aged care service look like,” she asked the community, and sought to develop services best in line with those needs.
“There’s a range of programs that come under LGBTI Connect, one of them is a visiting program.”
Going forward, she said that ongoing challenge for providers is finding members of diverse communities who feel confident enough to come forward and engage with the process.
“That was our biggest challenge, to find those people in the community. People in marginalised groups often don’t put their hands up and say ‘yes, that’s me.’
“We had to use lots of networks in South Australia … and word of mouth was very important.”
She emphasises that being consistent and genuine in your engagements with diverse elders is vital, in the development process of any community-based programmes.
“People from marginalised groups will quickly realise if you’re being tokenistic.”
OPAN’s full series of webinars can be found via this link.