By Louise Cantrill, Partner, and Kashi Mogensen, Law Graduate

The Broome Hearing took place from 17-19 June 2019.

Its stated focus was on the accessibility and availability of aged care services to Aboriginal and Torres Strait Islander people, particularly in remote areas. Specific inquiries were made into the unique needs and perspectives of Indigenous Australians accessing or otherwise engaging with aged care services in such regions.

Evidence

The main themes that emerged from the Hearing were as follows.

1. Lack of cultural understanding: A common conclusion drawn by witnesses was that the aged care system does not currently deliver culturally appropriate care. Witnesses highlighted how the importance to Indigenous Australians of ‘connection to country’, paired with generational distrust of institutions, deters entire communities from accessing aged care. As well as presenting as culturally ‘unsafe’, aged care is regarded by many elders as a ‘death sentence’ – and something to avoid by remaining ‘on country’ in the communities they lead.
2. Hiring and retention of staff: Another key issue raised was the hiring, retention and training of aged care workers in Indigenous communities. Witnesses testified to a distinct shortage of Indigenous people in this workforce, flagging perceived racism in the hiring process and stigma surrounding police checks as principal reasons. Staff retention was also described as generally problematic due to inadequate remuneration, training and resources. Stories were told of one enrolled nurse being tasked with the care of sixty residents; and of the discovery of maggots in a patient’s mouth following treatment by staff members “trained” via YouTube.
3. Accessibility challenges in remote communities: Logistical, language and funding issues were widely discussed as inherent challenges to aged care in remote locations. With few vehicles available, and the wet season at times rendering roads unusable, some aged care and medical providers must fly into communities. Despite such high costs involved in servicing remote locations, there is minimal funding of aged care in such communities. One witness attributed this to low funding generated under the Aged Care Funding Investment model by virtue of the small number of people available in remote areas to be assessed thereunder. Finally, language barriers and health literacy issues were raised as factors limiting understanding around aged care, and further restricting its accessibility.
4. Future development: In terms of reform, the need to develop aged care culturally was advanced as the most pressing by witnesses – being essential to building understanding and trust between aged care providers and Indigenous communities. By providing cultural education to staff, and engaging communities in a dialogue to ascertain more clearly their needs, witnesses testified to a future in which aged care services deliver to Indigenous Australians dignity and respect as they age. Practically, increasing Indigenous staff numbers was recognised as vital to this goal. Indeed, multiple witnesses recognised that, ultimately, remote aged care facilities ought to be run exclusively under the auspices of Indigenous organisations.

What’s next?

The Aged Care Royal Commission’s hearings in Western Australia will continue with a public hearing in Perth from Monday 24 June 2019 to Friday 28 June 2019. At this hearing the Commission will inquire into person-centred care. Evidence will be heard on whether aged care services are being delivered with such care in mind and how a person accessing care can exercise choice.

Stay tuned for further updates.