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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