New research has highlighted the importance of home care workers treating their clients like individuals rather than a “task” and calls for greater inclusion of diversity principles in workforce training.
The study, The inter-relationship of diversity principles for the enhanced participation of older people in their care published in the Journal for Equity in Health interviewed fifteen Victorian home care recipients aged between 71-85 about their experience of diversity.
The results show that older people want and expect to be treated as individuals and are acutely aware of biases and prejudice among care workers.
“The people that get up my nose are the people that don’t show any interest”, one respondent said.
Another said “…she is very competent at her job. But I like to have something more with the carers than just their care function”, while another identified two types of carer: “the class of people that are extremely good and they care about what they’re doing, and you’ve got another class down here who don’t give a shit”.
And another expressed annoyance about assumptions that are made about older people:
“I think sometimes when you’re older, that people think they’re doing you a favour,” they said. “Well, I would think that that is irritating to people because you’re being treated as if you’ve lost your mind or … that you’re not aware of things. Well lots of old people, they are aware of things”.
Five principles of diversity
The report said the results highlight the need for the health and aged care workforce to support diversity in order to enhance the experience of care.
It recommends the incorporation of five diversity principles in training:
- Awareness of unconscious bias and prejudice
- Promotion of inclusion, including the use of inclusive language and inclusive environments
- Access and equity
- Engagement and involvement in care decision
- Intersectionality, or not viewing older people “through a single lense”
The report says that although the provision of care services are usually instigated to manage a health issue, this goes beyond being simply a task-orientated service.
“It means someone becomes a part of their life, spending time with them through regular care visits to their home,” the authors say.
“Participants recognised that the health and aged care worker was there to address a health issue, but participants were adamant they were more than the health issue, they were an individual seeking a more personal interaction with acknowledgment of them as a person.”
Trust and rapport
Bolton Clarke Research Institute Senior Research Fellow and lead author Dr Rajna Ogrin says those surveyed identified human connection built on trust on rapport as crucial and placed importance on care workers viewing them as complex, layered individuals.
“It is critical to human connection and participation in health care that older people are viewed as autonomous individuals with a unique set of needs and preferences, who can be supported by the health and aged care workforce in an inclusive and respectful manner,” she says.
The study builds on research by Bolton Clarke around its Diversity Conceptual Model which is the basis for diversity training for its employees.
Bolton Clarke has also published a consumer white paper titled Breaking down the barriers which stresses the need to recognise and support LGBTI clients as individuals with their own unique set of challenges.
The paper says one in ten Australians aged 65 and over identify as LGBTI and this group faces unique health challenges as well as barriers to accessing appropriate care.
The paper says they also hold concerns about their choices not being respected, particularly in the event that they developed dementia.
“Older LGBTI adults have a higher risk of disability and poorer mental health”, the paper says, adding that transgender elders are at particular risk of poor physical health, disability, depression and stress.
Providers are required by the Aged Care Quality Standards to deliver culturally appropriate care for LGBTI people.