A flexible mix of services and culturally-appropriate health staff are a must, writes Gareth Mahon.
At The CareSide, we firmly believe that creating culturally-appropriate and safe healthcare starts with personable two-way communications. But it must also include an Indigenous health care workforce, mutual respect and trust within the Aboriginal and Torres Strait Islander communities, and flexibility to accommodate Indigenous culture, practices, beliefs and values.
In our experience, successfully engaging in two-way communication with Indigenous people requires good interpersonal skills. You must demonstrate that you are sincere, trustworthy and honest. Many Indigenous people do not speak English as their first language. A person’s cultural beliefs, values, and experience will influence their thinking, behaviour and interactions with others.
Mistakes are easy to make when concepts of personal space, non-verbal cues, eye contact, use of silence and even perceptions of time are different from your own.
We maintain that all non-Indigenous aged care providers benefit from participating in cultural awareness and effective communication classes regarding Aboriginal and Torres Strait Islander peoples.
Employing local Aboriginal or Torres Strait Islander peoples is an effective solution. Indigenous staff members can assist with cultural knowledge, interpreting services, establishing local community relationships and determining the most impactful way to distribute information in the community. Especially when providing direct personal care, someone of the same culture and gender may be more accepted and capable of fostering a positive, safe and trusting relationship.
The Indigenous populations of Australia may decline mainstream healthcare or aged care service providers. Past generations of negative experiences by these close-knit communities with inadequate, inconsistent, unreliable services, and a culturally insensitive bureaucracy have served to widen the gap of health disparity already created by colonial racism and discrimination inherent in the healthcare system.
To us, it’s evident that service providers must first build community and personal relationships within the Aboriginal and Torres Strait Islander communities. Aboriginal Australians will most often choose the trusted services provided by Aboriginal-led organisations within their local communities.That’s where they can find the care they need, in a culturally appropriate framework of family and community involvement.
There are 145 Aboriginal Community Controlled Health Organisations currently participating in over 300 clinics across Australia’s remote and urban regions. These service providers have unique and admirable cultural competency and offer holistic and comprehensive primary health care services.
Mainstream service providers would benefit greatly by seeking out these organisations to develop strategic partnerships in delivering aged care services in the underserved areas of Australia, and to learn from their successful model of providing culturally appropriate services to Indigenous communities.
To ensure service providers can deliver flexible, culturally safe care to meet the individual needs of Australia’s Indigenous local communities, the Department of Health and Aged Care’s National Aboriginal and Torres Strait Islander Flexible Aged Care Program funds residential and home care services for older Aboriginal and Torres Strait Islander peoples. These services allow seniors to remain close to home and community, feel safe while receiving aged care services, respect cultural practices and include the local community in aged care planning.
Based on what we’ve learned over the years, service providers can give culturally appropriate care in a number of ways. They can provide access to bushland gardens, create spaces suitable for cultural activities and ceremonies, employ Indigenous workers to provide care, and accommodate cultural traditions such as the separation of men’s and women’s business and the role of family kinship structures in decision-making.
According to the 2021 recommendations in the final report issued by the Aged Care Royal Commission, to be successful in providing culturally appropriate aged care services to older Aboriginal and Torres Strait Islander peoples, a flexible mix of residential and home care services is necessary. We’ve prioritised that balance while acknowledging that aged care service providers must recognise, respect and support the unique cultural identity of Australia’s Indigenous people – all while providing services to meet the needs, preferences, and rights of the individual.
Gareth Mahon is the co-founder and chief executive officer of The CareSide, a family-owned home care and disability support provider with offices throughout Australia