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Special needs seniors missing out on aged care, groups warn


Many culturally and linguistically diverse, Aboriginal and rural older Australians still don’t have adequate access to aged care services with stakeholders telling the review into aged care reforms more on-the-ground support is needed.

As previously reported by AAA, the Aged Care Legislated Review sought feedback to nine key matters including the effectiveness of arrangements for protecting equity of access to aged care services for different population groups.

The shortcoming of the system for older people from CALD background featured in many of the stakeholder responses.

Chinese Australian Services Society said the department must understand that it took more than translating and interpreting skills to service the CALD community, and that it also required understanding of the cultural  needs of seniors in aged care.

It called for the government to raise public awareness and confidence in My Aged Care through extensive promotion and address language barriers to the gateway through bilingual workers.

At a policy level, CALD peak FECCA said given the size of the migrant cohort, CALD representation on government committees and advisory groups relating to ageing and aged care, including the Aged Care Sector Committee, was crucial.

It called for a revised and resourced national ageing and aged care strategy for people from CALD backgrounds for 2017-20 that included a more nuanced approach and market segmentation of CALD communities to those at greater risk, such as people with a low socio-economic status and single women from CALD backgrounds over the age of 50.

The Ethnic Communities Council of NSW also called for bilingual and bicultural call centre staff along with regional assessment service (RAS) assessors who could appropriately respond to needs of CALD consumers. It said the introduction of the My Aged Care call centre had resulted in “a less equitable, less accessible and less responsive central intake system” for special needs groups.

“Previously, there were alternative avenues to seek appropriate support such as bilingual workers and assessors which acted as navigators to assist with identifying appropriate services. After the proposed reduction of block funding for these services, they will no longer be available and as a result clients are withdrawing from services or not linking into services at all,” it said.

New approaches needed

Also highlighting consumers dropping out of the system, Aged and Community Services Australia said current strategies were falling short because many were aimed at raising awareness of the needs of specific population groups but mistakenly assumed these consumers were able to connect with and navigate the aged care system in the same way as other older people.

My Aged Care is particularly difficult for people from CALD backgrounds, ATSI people, those from rural and remote locations, people at risk of homelessness and other vulnerable groups requiring case management type assistance, said ACSA.

It also called for additional on-the-ground support for these consumers to make contact with and navigate the aged care service system along with a new funding model for rural and regional services that acknowledged the additional, and fixed, costs these providers experience. It pointed to the block funding model of Multi-Purpose Services, where funding is received whether a bed is occupied or empty ensuring services exist in regions that could not viably support stand-alone hospitals or aged care homes.

In WA, Advocare also noted limited options for both home care and residential care in regional, rural and remote areas and added that indigenous older people were being relocated away from Country and family with serious implications on health and wellbeing, among key failings of the current situation.

“Sometimes when an Indigenous person dies the family are not told and the person is buried away from Country, then the family has the responsibility of relocating the body,” it said.

Advocare also highlighted lower quality of services accessible to those financially or socially disadvantaged, a lack of understanding of the impact of living rough then being placed in an extremely regulated and often restrictive environment for homeless people, DVA clients not having access to independent advocacy services and a reluctance by the LGBTI community to access aged care services and feel safe about disclosing their sexuality or gender identity.

“If someone has little family or social support it can be difficult finding help to access aged care facilities, especially in regards to assistance in filling out paperwork and agreements,” it said.

Leading Age Services Australia called for the true cost of care to be identified for people requiring specialist care and services and a commitment to reduce red tape in this area.

For some of the special needs groups, such as people experiencing homelessness, LASA said there needed to be an acknowledgement of the different models required and suggested an extension of the homeless or hardship supplements and its automatic application to the basic daily care fee once key criteria met and block funding.

More research, wider scope needed

In its response, the Australian Association of Gerontology said its extensive consultation identified a lack of data on the needs and challenges for people in different population groups and called for more research.

It highlighted as positive the in principle support it and fellow stakeholders received from Assistant Minister for Aged Care Ken Wyatt for the development of a diversity framework supporting different population groups to age well, with the creation of specific action plans for LGBTI, ATSI and CALD groups.

In addition to the special needs groups identified in the Aged Care Act, the AAG said the review should also consider the needs of other groups, including older Australians experiencing dementia and other cognitive impairments or aged-related conditions prior to the age of 65 not already covered as well as those in the justice system, with mental health issues or with a disability.

On those with dementia, Alzheimer’s Australia said anecdotal evidence from consumer networks indicated there was still significant unmet demand for appropriate, high-quality services, particularly those living in rural and remote areas, those with significant behavioural and psychological symptoms of dementia, and those with a need for culturally specific services, such as older people with dementia from CALD backgrounds.

“The need for interpreters and appropriate cultural training for staff is an important consideration particularly for consumers with dementia who may find it easier to communicate in their native language,” Alzheimer’s Australia said.

Australian Blindness Forum said many people who were blind or vision impaired were not enjoying equity of access to the care and support they needed including an accessible physical environment in residential care facilities to ensure people who are blind or vision impaired could live comfortably.

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2 Responses to Special needs seniors missing out on aged care, groups warn

  1. Angus Kerr (LiveWell Care) December 16, 2016 at 10:36 am #

    I operate an independent Aged Care consultancy service in Victoria supporting individuals and their families navigate the community aged care system. While the reforms will enable greater choice, our experience tells us they will also require more decision making. The proposed system in allocating and choosing a Home Care Packages will present challenges for the above mentioned special needs groups but also those consumers and their families who don’t fit within those target groups.The need for independent advocacy will be increasingly important when exploring potential Home Care Providers. We support consumers to exercise their rights to informed choice, as so they are able to engage a quality provider that will tailor an individualised support plan while also providing ‘value’ (not necessarily financial). Our experience is that choice is a good thing as long as the options are fully understood- otherwise it is just confusing. My concern is if consumers don’t fully understand their options and are unable to navigate the system, they will not be able to exercise their right rights to informed choice and may simply ‘opt out’. The overall goal is to support ‘all’ consumers to be empowered, able to exercise responsibility, make decisions as to drive competition and quality?!?

  2. Dr Rodney Jilek (St Elizabeth Home) December 18, 2016 at 8:43 am #

    The aged care system is hard enough to navigate with a full command of English, let alone for someone with English as a second or third language. The recent changes in ACAT referral and assessment that have involved yet another layer of bureaucratic nonsense with the ridiculous My Aged Care website have just made things worse.

    I have been waiting for a month for a CALD couple living in my retirement village to be assessed as they are now requiring residential care only to find out this week that the referral we made never even went to the ACAT because My Aged Care rang the couple (who are 97 & 99) and asked them if they needed services. Because the wife said “no we are fine” the referral was closed then and there. No one visited them, no one checked with us, just a phone call from some unknown person speaking a language they now struggle with.

    We were not advised (as the referrer) and the couple couldn’t understand why we weren’t offering them a place. Neither the husband or the wife could even remember the conversation.

    Now we are forced to start the whole stupid referral process over again.

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