This address was delivered by Jegarra man Kevyn Morris at Informa’s 12th annual National Dementia and Aged Care Reform Conference. Kevyn is a member of the network’s National Older Persons Reference Group, Dementia Australia’s Advisory Committee and Dental Health Victoria’s Community Advisory Committee. He is a passionate advocate for Indigenous peoples and the rights of people living with dementia, and a keen photographer.
Good morning everyone,
Believe it or not, until yesterday afternoon, I hadn’t settled on my contribution to this panel, which is about Indigenous people and the aged care system.
But a conversation I had with a lady in a rural area about a 20-minute drive from Wodonga changed that. Much has been made of the recommendations that came out of the Aged Care Royal Commission regarding changes to the aged care system, care facilities, home care packages and caring for people with dementia. Over the last few months, I have sat in on many presentations, webinars and conferences, some of which I had little to say regarding Indigenous people, whilst others made much of telling us what we need. To begin to marry the two together, I asked at one event regarding care providers that provided both residential and home care just what their cultural awareness program was currently, to which the reply was: “We don’t have one”. Something that should change is for there to be a cultural awareness program within the proposed changes to the aged care system and that it must be taught by Indigenous people.
This brings me to navigating the aged care system online. Anyone who has tried finding their way through the NDIS, home care and the aged care system knows it is complicated with a much-needed overhaul. Now imagine you’re living in a regional, rural or remote area where not every home has a computer or even access to the internet, and you have dementia. The lady I mentioned earlier lives, as I said, not twenty minutes from Wodonga, yet her internet provider charges her family $400 a month for internet. I will give you a second or two to calculate how much per year that is. As I said, this is not even remotely rural as she lives in a small town, nor is it by any stretch of the imagination considered remote. Many remote communities of not only Indigenous but also non-Indigenous peoples do not have access to the internet, and at those prices, could any of us on fixed incomes, disability pensions, unemployment or aged pensions actually afford these prices even if there were reliable internet connections in remote communities?
Now that I have placed the two stories together let us move on to care facilities or home care providers in these same rural and remote communities or the lack of or any choice in the providers, even if there is one. One such question led to this answer that it was the 60 to 80-bed that is the sweet spot for people in a care facility to get the 200 minutes a day required by the new legislation. It was disappointing to hear some providers already trying to figure out how to get around even this requirement. But moving along, it was pointed out at a recent conference that a 40-bed facility was the minimum to bear profit and the ability to cover the 200 minutes per resident per day average. It was also revealed that as a way of adding up those precious 40 minutes with a registered nurse per day per resident, it is now a wish of providers to include personal care assistants in that required time.
That is, if the local community even has a care facility, as this one spokesman for a provider said that it is only in the highly populated areas that it would most certainly be left to local community organisations and groups to raise funds or approach governments for funding. It would seem by that statement that Indigenous peoples, which by far and large will be either left with no option but to move, in some cases, hundreds and hundreds of kilometres from their people, family, friends and the land they love. Now having dementia is an insidious disease. Just close your eyes and try to imagine not only leaving everything you know to go somewhere and not know why you must go.
As can be seen in the COVID-19 vaccine rollout, just how little thought is given to rural towns and remote areas or Indigenous people in those communities. We have home care providers charging exorbitant rates to people who, by date of birth, can’t get the NDIS and are stuck with the abysmal and thoroughly insufficient home care packages. For Indigenous people who need assistance to travel to doctors or even to visit a store, if they even have a provider, simply do not have the same access to options or services that we as people living in large towns and cities take for granted.
If these providers, be they aged care or home care, can stick their hands out for hundreds of thousands of dollars in government funding, then they should contribute to a system that provides for disabled older Indigenous and non-Indigenous people, along with those that suffer from dementia. I know this may never happen because we have all heard the excuses that so-called care providers are using to justify claiming more money and assistance from the public purse strings and people who can ill afford it. From $300,000 to a million dollars per bed, per resident, along with money from the federal government to supply a bed for someone like me who doesn’t have that kind of money. But to then have the audacity to charge those people most of their pensions or fixed income and charge them for extras.
I’ve heard the terms gold standard minimum standard, and ideal standards. There are good and bad providers, and hopefully, in time, the bad ones will leave. But in the meantime, I think there should be one standard for everyone and that they’re all treated, fed and cared for the same.