This week the royal commission has been hearing about the aged care needs of diverse communities, such as the LGBTI community, migrants, and Aboriginal and Torres Strait Islander people.
“Diversity is a hallmark of humanity, yet aged care providers and the aged care system as a whole have not always responded to needs that are out of the so-called ordinary,” said counsel assisting the royal commission, Peter Gray, in his opening remarks.
If not attended to, the cultural, linguistic and experiential needs of older people may not be met, leaving them “isolated and neglected”, Mr Gray said.
Mr Gray said the new Aged Care Quality Standards and the Charter of Rights stipulate that diversity should be catered to in aged care.
Standard 1 requires that aged care consumers must feel ‘I am treated with dignity and respect and can maintain my identity.’
Standard 7, the human resources requirement, states ‘Workforce interactions with consumers are kind, caring and respectful of each consumer’ s identity, culture and diversity.’
But “What happens in practice?”, Mr Gray asked.
Mr Gray said demand for culturally-appropriate services is likely to “increase considerably” in the future.
Heather Brown, who lived in a number of state homes from the age of two, said she “would be terrified if someone told me I had to move into a residential aged care facility.”
The 79 year old says she sees aged care facilities as institutions, “just like the ones I grew up in.”
“Lots of Forgotten Australians are terrified of when they are no longer able to care for themselves. Some say to me that they would rather be given injections and killed than go back into an institution,” Ms Brown told the commission.
But Ms Brown said she is happy living in her current retirement village. “I live independently… I can move and have total freedom. I can come and go as I like. I eat what I like. I have the freedom for people to come and visit me.”
Ms Brown said it’s time she should register for My Aged Care, but she hasn’t because “I feel that these agencies don’t understand Forgotten Australians.”
A panel of representatives from the Aged Care Sector Committee Diversity Sub-Group, which consisted of Samantha Edmonds, Noeleen Tunny and Mary Patetsos, said trauma-informed care should be a core part of all aged care services because so many people have experienced trauma in one form or another over their lifetime.
Ms Edmonds, who is policy and research manager with the National LGBTI Health Alliance, said facilities should not treat everyone the same way.
“When we hear providers saying, ‘We treat everyone the same’, we see that as not recognising the diversity of the people that were in that service… if you treat everybody exactly the same, then you’re not delivering person-centred care and you’re not meeting the diverse needs of those people,” she said.
Ms Edmonds gave the example of a transgender woman receiving aged care services who has not revealed she is transgender. “I would not come out because this environment isn’t safe,” Ms Edmonds quotes her as saying.
“I would believe the provider thinks they’re delivering fantastic person-centred care to this person but they’re actually not because that person is not feeling safe, is not feeling included, is listening to transphobic slurs that are happening across the organisation… so they’re just sort of hiding themselves and… pretending that everything is fine,” Ms Edmonds said.
Ms Edmonds said aged care’s peak bodies were “very supportive” of diversity and
inclusion, but a Diversity Framework never became mandatory because it was seen to “create additional red tape”. The Diversity Framework instead became part of “guidance materials”.
Ms Tunny said it was “absolutely essential” the human rights of Aboriginal people are aligned with the services that they receive.
Mary Petetsos, chair of the Federation of Ethnic Communities’ Councils of Australia, said language was particularly important in aged care.
“A lack of capacity to communicate undermines people’s wellbeing,” she said.
“It undermines people’s right to be understood and to understand.
“And it also undermines their capacity to control their care plans and their experience in care, regardless of whether that care is happening at home, but particularly so if it’s happening in a residential facility, where they get less access to family members who can assist.”
“Without resolving that issue, anything else we do falls short,” she said.
“Without language, not only are you left with less information, but you’re also in a position where you’re socially isolated,” Ms Petetsos said.
Angelos Angeli, a social worker and only child whose mother is at risk of becoming isolated and depressed due to her lack of English, said his mother receives home care, but Greek-speaking carers are often unavailable, leaving her isolated and alone.
“We did request Greek speakers… because it was really difficult for mum to communicate and get her… wants and her needs met… especially around attending GP clinics… because she couldn’t communicate what she wanted,” Mr Angeli said.
Consequently, she relies on Mr Angeli for care.
“It has gotten worse because unfortunately a lot of her friends have become unwell, and so they’ve been put in homes or they’ve passed. So, she has become socially isolated more and more,” he said.
The due date for submissions to the royal commission has been changed to the end of April 2020, due to the commission’s extension.
Submissions can be made through the Royal Commission website, by post, or by calling 1800 960 711.