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A welcome change

There are key PC recommendations that should benefit seniors from culturally diverse backgrounds, and the providers who care for them, writes Mark Anderson.

Australia’s population of older people from non-English speaking backgrounds is expected to increase by over 40 per cent between 2011 and 2026. Responding to diversity is already an acknowledged policy and service challenge, and it’s going to become increasingly important into the future.

Doutta Galla operates in Melbourne’s western suburbs, which are characterised by three variables – high growth, low socio-economic levels and cultural diversity. One third of the population in Melbourne’s western suburbs were born overseas and around 28 per cent were born in predominately non-English speaking countries.

This is the context for Doutta Galla’s operations across our eight aged care facilities: providing aged care to elderly people with lower financial means who originate from every continent.

Most aged care providers know that understanding culture and language is fundamental to achieving the best possible quality of life for residents. It is also very costly. Catering to cultural diversity means the development of culturally appropriate lifestyle programs, cultural entertainment, providing residents with culturally appropriate meals, and the celebration of key cultural and religious events.

Providing access to spiritual activities, subscriptions to ethnic newspapers and ethnic satellite channels are important to ensure residents remain engaged with the community. Translation and printing of in-house literature and information, and interpretation during the admissions process, are government and community expectations which lead to increased costs.

In Melbourne’s west, the most profound challenge is training personal care workers from Asian and African origins to care for elderly residents whose backgrounds are commonly European. The differences in cultural practice are great, as are the risk of conflict or misinterpretation. We are extremely lucky to have a willing workforce, but they need training and language support. Residents and family members also need education.

As an industry, we want to achieve inclusivity and accessibility. But the current system – its funding instruments and regulatory regime – act as a barrier to achieving those goals and, therefore, the level of care the Australian community rightfully expects.

Unequal pricing arrangements for accommodation services means the gap between the disadvantaged and advantaged has allowed those better off to ‘jump the queue’ into residential care through extra services, while those with poorer means wait for a place to become available.

The commission’s recommendation that accommodation bonds for all residential care is a welcome change as those less affluent will no longer be disadvantaged. The option of periodic payments or a lump sum (such as an accommodation bond) is a sound approach, as long as accommodation payments reflect the cost of supply, and aged care providers accept bonds equivalent to any alternative accommodation charge. This change will end the practice of some aged care facilities cross-subsidising supported or non-bond paying residents – a good outcome for aged care facilities operating in poorer areas where bonds are generally low.

The proposal to take into account the costs associated with cultural diversity when recommending the scheduled set of care prices and subsidies is also a welcome change. And for older people undergoing assessment, the proposed Australian Seniors Gateway Agency, and its provision of interpreter services and culturally appropriate diagnostic tools, will ensure a less confusing and stressful experience at an already daunting time of their lives.

However with choice comes complexity. It is important to note, should these recommendations be implemented, families will need information and guidance – and they will expect it from providers (not all of which are resourced to cope). Competition will also drive consolidation. It is likely single facility providers will struggle to match the marketing muscle of major groups. This is a concern as many are specialists in key care areas such as dementia, and have valuable community connections and legacies.

The government needs to consider how these and other issues which may arise can be mitigated.

Mark Anderson is the CEO of Doutta Galla Aged Services

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