The aged care sector’s one size-fits-all approach to care services and heavy regulation are barriers to providing tailored and safe care to Forgotten Australians, a Flinders University study has found.

The study, published in the Australasian Journal on Ageing, explored service provider and advocate perspectives on the barriers to appropriate and safe care for Forgotten Australians and care leavers.

The terms Forgotten Australian and care leavers refer to people who have experienced trauma as a child after being placed into out-of-home or institutional care prior to 1989.

The study involved three focus groups with 16 aged care stakeholders.

It found Forgotten Australians have little opportunity for choice or to be in charge of their own lives and care, said lead researcher Dr Monica Cations.

“When we’re dealing with people who have been traumatised in their lives and who have dealt with very adverse experiences, the importance of choice, control and autonomy is paramount,” Dr Cations told Australian Ageing Agenda.

Dr Monica Cations

“It’s important for everyone, but for this group of people it is absolutely essential to their wellbeing and to their recovery,” said Dr Cations, a provisional psychologist and epidemiologist.

The key barriers to providing the flexibility and choice that Forgotten Australians need are provider requirements related to regulations, accreditation and funding, she said.

“It creates a risk averse culture that when we do things according to the letter, we avoid sanctions and the media. But on a practical level on the ground, it means that it’s a one-size-fits-all approach and so when you have a person who has a very complex history behind them, it’s very difficult to provide the kind of bespoke care that that person needs,” Dr Cations said.

She said improving flexibility and choice could occur through minor changes, such as allowing residents to decide what they eat for lunch or what tea they drink.

Workforce needs support

The study also found there was a risk of more trauma for Forgotten Australians when accessing aged care services due to the limited skills staff have to recognise when a person is distressed.

“The aged care workforce has a lot of strengths but one thing that there’s not a lot of is access to psychological supports or even psychological and mental health literacy among the staff,” Dr Cations said.

“The aged care workforce needs a lot more support and more access to allied health services that support them to meet the mental health and the psychological needs of aged care users, including people who survived very traumatic events.”

Aged care providers should be building the psychological literacy of the workforce to improve care for Forgotten Australians, Dr Cations said.

“It means that all the staff who work there are capable of recognising when a person is distressed, and knows what to do about that,” she said. “Environmental changes can also go a long way where people have the opportunity for quiet spaces, privacy, and places to be safe and calm.”

Access Perspectives of professionals on the safety and accessibility of aged care for Care Leavers and Forgotten Australians.

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