NAIDOC week is a time to reflect on Aboriginal and Torres Strait Islander experiences and how we can provide further support. This year’s theme is: Get Up! Stand Up! Show Up! With that in mind, this article examines the findings of the Older Australians Report in relation to Aboriginal and Torres Strait Islander people (November 2021) and outlines the current programs and reforms for residential aged care services to improve their approach to caring for Indigenous Australian People.

The Older Australians Report

The Older Australians Report in relation to Aboriginal and Torres Strait Islander people outlined the experience of an aged care population of 5,300 Indigenous Australian people as at 30 June 2020. The population of Aboriginal and Torres Strait Islander people includes people 50 years and older due to the population’s need for care at a younger age compared with the non-Indigenous population. The age profile of the Indigenous population was considerably different to the non-Indigenous population with as examples:

• 8% aged 55 – 59
• 6% aged 75 – 79
• 3% aged 90 – 94.

This contrasts with the statistics of the general population where:

• 6% were aged 55 – 59
• 8% were aged 75 – 79
• 4% were aged 90 – 94.

The 90-94 age statistic reflects the lower life expectancy of Aboriginal and Torres Strait Islander Australians.

In June 2020, there were 1,900 Aboriginal and Torres Strait Islander people using residential aged care services. The most common medical conditions that they experienced were:

• depression or other mood disorders, such as bipolar (40% of residents)
• dementia (34%)
• arthritis (30%)
• type 2 diabetes (25%).

National Aboriginal and Torres Strait Islander Flexible Aged Care Program

The National Aboriginal and Torres Strait Islander Flexible Aged Care Program, managed by the Department of Health, provides funding to aged care providers to assist them in providing care that makes Aboriginal and Torres Strait Islander people feel culturally safe. This means ensuring that aged care providers can recognise and support cultural identities as well as meet consumers’ unique wants and needs.

To provide culturally appropriate care, a provider can implement any of the following initiatives:

• have buildings suited to cultural activities and ceremonies
• provide access to bushland gardens
• employ Aboriginal or Torres Strait Islander peoples to provide care
• include the local community in aged care planning
• develop a health model reflective of the physical, emotional, cultural and spiritual needs of Aboriginal and Torres Strait Islander needs
• respect cultural traditions, such as men’s and women’s business.

Funding can be requested in grant rounds and will be open to all organisations or on a targeted basis if there is a specific need for specialised services in certain locations. You can read more about this Program in the National Aboriginal and Torres Strait Islander Flexible Aged Care Program Manual.

Care Service Development Assistance Panel Program

The Remote and Aboriginal and Torres Strait Islander Aged Care Service Development Assistance Panel (SDAP) is a mentoring and support program designed to improve the way that services address challenges like clinical care or governance and registration. The SDAP also provides culturally appropriate support to Aboriginal and Torres Strait Islander aged care services.

To be considered for the SDAP, a provider needs to meet one or both of the following conditions:

• you’re located in a rural or remote area
• you provide care and services to a significant number of Aboriginal and Torres Strait Islander peoples anywhere in Australia.

The SDAP is important to help combat the unique challenges that accompany rural and remote aged care service providers such as the higher costs of providing services, lower supply of skilled workers and keeping up with changes to aged care legislation.

You can find further information about the SDAP and make an application here.

Reforms Budget

The 2022-2023 budget, released in March 2022, targets delivering better health and aged care outcomes for Aboriginal and Torres Strait Islander peoples. The Australian Government has committed $133.5 million to this effort. The budget includes the following initiatives to improve support, experience, and care of older Aboriginal and Torres Strait Islander peoples:

• $6.1 million to continue the Government’s Strengthening Regional Stewardship of Aged Care initiative to enhance engagement and links between government, aged care providers and local workforces to improve aged care and health outcomes for those living in regional and remote locations, including Aboriginal and Torres Strait Islander peoples
• $20.1 million in additional funding to support the transition to the Australian National Aged Care Classification (AN-ACC) as the new funding model for residential aged care from 1 October 2022
• $50.4 million to deliver Authorised Nurse Immuniser Training to support all aged care providers across Australia, including Aboriginal and Torres Strait Islander Flexible Aged Care Providers
• $37.6 million to deliver the Aged Care Infection Prevention and Control Training Measure to enhance capability at all aged care providers across Australia, including Aboriginal and Torres Strait Islander Flexible Aged Care Providers
• $32.8 million for clinical placements and targeted training in the care and support and mental health sectors.

This budget aims to further work towards the commitments in the National Agreement on Closing the Gap, a national agreement developed in consultation with Aboriginal and Torres Strait Islander organisations and the Australian Government to work towards equality.

Conclusion

Aged care providers can make improvements to their services through different initiatives and grants provided by the Australian Government. Aged care services must consider cultural sensitivity when providing care to Aboriginal and Torres Strait Islander residents.

My Aged Care outlines discussions for Aboriginal or Torres Strait Islanders to have with providers to assist in supporting their care and services. Key questions that providers can ask themselves in relation to this include:

• How can Aboriginal or Torres Strait Islander people be involved in care and services (e.g. as staff, volunteers or community members)?
• How can your aged care facility promote cultural and spiritual needs as part of a resident’s care and services plan?
• How will you support connections to culture through social activities and outings?
• How can you better understand and respect Aboriginal history change practices to better support Aboriginal and Torres Strait Islander Australians’ needs and choices?
• How will culturally-respectful support during illness, palliative care and/ or end of life, such as return to Country, be provided?

It is important to ask these questions and make gradual changes to a provider’s approach to Aboriginal and Torres Strait Islander consumer services and care to combat inequality and work towards a future where all Australians in aged care have the same level of quality care.