Improving First Nations access to aged care
The Aboriginal and Torres Strait Islander aged care framework has been released, revealing the five outcomes recommended to improve access.
The Department of Health and Aged Care has published the Aboriginal and Torres Strait Islander aged care framework 2025-2035 this week, outlining a range of actions needed to improve aged care access and experience for Aboriginal and Torres Strait Islander people.
The framework sets out five measurable outcomes for aged care reforms, underpinned by four guiding principles that align with the 2020 National Agreement on Closing the Gap.
Outcome One considers the need for culturally safe and responsive access to aged care. In particular, it highlights the individual need for Aboriginal and Torres Strait Islander people to obtain aged care services at rates that are at least equal to their representation in the Australian population. The framework points to the difficult to navigate nature of the current system – and its non-Indigenous perspective – which can be alienating for Aboriginal and Torres Strait Islander people who may have had previous negative experiences with mainstream institutions.
Outcome Two is responsive to the need for Aboriginal and Torres Strait Islander people to receive accurate, holistic, prioritised, culturally safe, trauma aware and healing informed aged care assessments. Currently the tools to make assessments for home and community care are not sensitive to the traumas experienced by many older Aboriginal and Torres Strait Islander people, including Stolen Generations survivors. The assessments require deeply personal information to be shared with strangers and generally fail to take the time and effort to develop the relationship to a point where older Aboriginal and Torres Strait Islander people can see the benefit in sharing their personal information.
Outcome Three outlines the need for Aboriginal and Torres Strait Islander people to be able to access culturally safe, trauma aware and healing informed, and comprehensive care either in or close to community, Country or island home. Care should promote holistic health and wellbeing and should facilitate the provision of place-based care. If it is not possible to provide place-based care, the option to return to Country or Island Home is important, particularly for end of life and palliative care. The framework highlights the need for increased cultural safety in the mainstream aged care sector to assist the implementation of this outcome, and the need for more Aboriginal and Torres Strait Islander organisations to enter and remain in aged care service delivery. This will be supported through Outcome Four.
Outcome Four relates directly to the need for more Aboriginal and Torres Strait Islander aged care providers. Many Aboriginal and Torres Strait Islander people have indicated they would prefer to receive services from Indigenous run organisations that are trusted by the community. The limited number of such organisations makes it difficult for older Aboriginal and Torres Strait Islander people to exercise choice. An effort to assist more Aboriginal and Torres Strait Islander organisations to enter and remain in aged care delivery is needed, including partnering.
Outcome Five highlights the need for more Aboriginal and Torres Strait Islander people to enter and remain in roles across the aged care. Similarly to a preference for Indigenous-run providers of aged care, there is a strong preference amongst Aboriginal and Torres Strait Islander people to receive care from members of the community, as they are often best placed to develop trust and meet the cultural and language needs of older Aboriginal and Torres Strait Islanders.
The guiding principles that underpin the five outcomes include:
- genuine partnership and shared decision-making with Aboriginal and Torres Strait Islander stakeholders and communities on aged care reforms
- prioritise Aboriginal Community-Controlled Organisations and increase their participation in the aged care sector
- all mainstream institutions, government agencies and stakeholders in the aged care system are accountable to deliver better aged care outcomes for Aboriginal and Torres Strait Islander people
- evidence based on the lived experience of Aboriginal and Torres Strait Islander people will be used to drive aged care reform for Aboriginal and Torres Strait Islander people
The vision of the framework includes recognition that older Aboriginal and Torres Strait Islander people age well by having their spiritual, physical and mental health needs met with holistic, high-quality and culturally safe aged care. The care should promote wellbeing, be delivered in a trauma-aware and healing-informed manner and should empower connection to culture, family, community and Country or Island Home. Care should also be person-centred and be underpinned by the new rights-based Aged Care Act.
The framework, available on the depertment’s website, should also be viewed as a living document to be reviewed and updated biennially, with all parties involved in the co-design to be committed to implementing the actions and monitoring progress against the outcomes.
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