Stigma, fear and geography among barriers to First Nations aged care
The theme for NAIDOC Week 2023 is ‘For Our Elders’, acknowledging the respected role older people play within Aboriginal and Torres Strait Islander communities.
But when it comes to health and aged care services, however, the research tells us First Nations people are not getting the support they need.
Queensland advocate Barry Fewquandie, one of the 10 members of OPAN’s National Aboriginal and Torres Strait Islander Advocates Network, identifies some of the major challenges and outlines the work his team is doing to address them.
Why are Aboriginal and Torres Strait Islander people under-represented in aged care services?
One thing, right off the bat, is that a lot of our mob are eligible for aged care at 55 or even 50, but they don’t know that, so they don’t access it.
That’s our shortened lifespan. There’s a lot of research that indicates Aboriginal and Torres Strait Islander peoples are ageing younger: we don’t take care of ourselves, we are getting chronic diseases that aren’t managed the way they can be, and so there are consequences to that.
Then there’s the stigma. A lot of aged care is aimed at people who are 65 and up. We’re not ready to age at 50 or 55 (or 45 for those who are homeless or at risk of homelessness). We’ll do a self-assessment and say: ‘I’m good, I’m right’. Which is not as accurate as it should be. That’s a human thing, not a Murri thing.
A big reason our mob are reluctant to go into residential aged care is that those facilities are run by the churches and the church groups that ran the missions in the segregation and integration policy eras. They might be saying: ‘trust us, we’ll get it right the second time’, but many of our mob were in institutional care as children and young people and probably as adults in prison because they were non-conformist.
They were in institutions as children and as young people and then as adults and now, again, at the end of their lives. And they are feeling that they are powerless to do anything about it.
What are the issues specific to people who live in remote communities?
Dementia is a big issue now, with our mob. And accepting that it’s dementia and that it’s a medical thing. There is a lot of work going on in how to support people with dementia, especially those living in remote areas. It’s about ageing in place. You shouldn’t have to leave your community to get the type of help you need.
Most of these communities have a long history of governance and getting it right. My view is that there is plenty of people from the community who can do the job and it would be best to take that approach. It can’t be someone who is parachuted in, a fly-in, fly-out worker. That’s expensive and it doesn’t always work.
How can the National Aboriginal and Torres Strait Islander Advocates Network help?
Not all Aboriginal and Torres Strait Islander people want to talk to another Aboriginal and Torres Strait Islander person. It’s an assumption that we do.
Having the option of talking to someone that you are comfortable with is great. At the same time, we don’t want to talk to people who know us because we don’t want other people knowing our business. It can go either way. We won’t use a service because there’s mob there. Or we will use a service because there is mob there. It all depends on that interaction. But our old people and people with disability are the two most vulnerable groups and we need to go above and beyond to protect their interests.
Is there a bigger picture here?
It’s about informing OPAN’s organisational culture, so that non-Indigenous people also have the skillset to respond appropriately or sensitively when they work with Aboriginal and Torres Strait Islander peoples, in the same way I get Russian clients, Asian clients, people from diverse backgrounds. If you can’t communicate effectively with people from other cultural backgrounds, our mob, care leavers who are very reluctant to go back into care, then you’ll miss out and they will miss out.
Do the upcoming reforms make you feel hopeful about the future of aged care?
It’s hard to be excited about something that hasn’t happened yet and a lot of these reforms have a date two years or four years into the future. But there’s the promise of an Aboriginal and Torres Strait Islander Aged Care Commissioner. I think that will help people have confidence in using the service. If we see Aboriginal people in these roles, and in the sector, talking up, we can see it’s for us, and about us.
If you need individual advocacy support, call an OPAN advocate on 1800 700 600. You can request the assistance of a specialist Aboriginal and Torres Strait Islander advocate when you call.