Our Aboriginal and Torres Strait Islander aged care system isn’t “culturally safe”, WA geriatrician tells Royal Commission

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Aboriginal and Torres Strait Islander (ATSI) people are significantly under-represented in the aged care system – and the system needs to get better at building “trust”, says Professor Leon Flicker (pictured), a Professor of Geriatric Medicine at the University of Western Australia.

Many ATSI people don’t feel “culturally safe” in mainstream aged care services – which he believes should be solved at the front line, by educating staff.

ATSI people comprise 3% of the national population, but only occupy 1% of RAC beds – the most immediate cause of which for those in remote areas is distance and moving “from country.”

At the heart of the low representation of Aboriginal and Torres Strait Islander people in the aged care system, however, is trust – and Professor Flicker says mistreatment of Indigenous people in care can often discourage them from ever accessing services.

“When [racism]does occur, people become immediately distrustful of the entire service . . . particularly with the history of Aboriginal and Torres Strait Islander people, the history is so recent and often quite raw.”

He says that, particularly for those who are part of the Stolen Generation and are now in their 50s and 60s, the trauma of the recent past has caused an extreme cynicism around institutions.

“There’s not the immediate acceptance that the person from authority is here to do them some good.” 

The Professor emphasised to the Commissioners that the system must change fundamentally if it’s to be genuinely inclusive for Indigenous Australians – or low RAC occupancy rates will continue to dwindle in relation to the larger Aboriginal and Torres Strait population.

“Cultural safety is of paramount importance. Aboriginal and Torres Strait Islander people will not access culturally unsafe services. They just won’t take them on.”

He pointed out that many staff in RAC and health services are often not Australian-born, and therefore don’t have the background knowledge and historical perspective to completely understand the context around specialised care for Indigenous or Torres Strait Islander people.

The current system makes several misguided “assumptions” that marginalise Aboriginal and Torres Strait Islander users at the very first stages – i.e. the My Aged Care website.

“There’s literacy assumptions, computer literacy assumptions, assumptions about hat’s available in the surrounding environment . . . language . . . even [about]getting proper assessments”, he said.

“The idea that this is a system that is navigable by the average client is basically absurd . . . It’s very, very difficult for people in remote communities to navigate [it].”

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