(MENAFN- The Conversation) The Royal Commission into Aged Care Quality and Safety recognised the aged care system has failed to provide culturally safe care for Aboriginal and Torres Strait Islander people as they age. It recommended major reforms, including active partnership with Aboriginal and Torres Strait Islander people.
The Australian government has also committed more funding for Aboriginal and Torres Strait Islander aged care services, with a foon boosting the role of Aboriginal community-controlled organisations.
So what do older Aboriginal people need to age well? And how can aged care funding and systems enable that?
This was at the centre of our study , led by the Dharriwaa Elders Group in its long-term partnership with UNSW, known as Yuwaya Ngarra-li .
The study involved speaking with 22 Elders in the remote New South Wales town of Walgett about what ageing well means to them.
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Elders are the 'wellspring' for younger people
Aboriginal Elders play an important role as community leaders and protectors of cultural heritage. This involves passing down knowledge and stories, leadership, care-giving and safeguarding family, community and intergenerational wellbeing. Supporting this aspect of ageing well is crucial. As one Elder explained:
For Elders who have worked away from Walgett in varicareers, this means a kind of“active retirement” – returning to Country to bring back knowledge and continue a legacy for future generations.
One said:
Virginia Robinson from the Dharriwaa Elders Group speaks with students at Walgett Community College. Dharriwaa Elders Group, Author provided (no reuse) Addressing the ongoing impacts of colonisation
Elders explained how community health and wellbeing continue to be harmed by dispossession and climate change, drought and water insecurity:
Many Elders described experiencing institutional racism in mainstream services, including aged care services, and identified that current systems are not designed with consideration of the wellbeing of Aboriginal people:
Elders highlighted the need to acknowledge the intergenerational trauma of being placed in institutions for Aboriginal people, especially for survivors of the Stolen Generations who were taken from their families and put in government and church-run institutions.
A holistic concept of wellbeing
For Elders, wellbeing isn't just about individual health. It also involves social, mental, physical, cultural, spiritual, political, family and community dimensions.
They saw the Dharriwaa Elders Group Centre – a space used for daily meetings, events, cultural exhibitions and other community activities – as vital:
Another said:
Elders saw staying politically engaged and active in the community through Aboriginal community-controlled organisations as crucial to wellbeing.
Dharriwaa Elders Group's Clem Dodd and Virginia Robinson meet with other First Nations water advocates, convened by the Stockholm Water Institute. Dharriwaa Elders Group., Author provided (no reuse) A culturally safe model of aged care
Elders talked passionately about how culturally safe aged care means being truly cared for, not just having your needs met. They described the traditional way of caring as based on being loved, valued, respected and safe. A culturally safe model of aged care would integrate these values into practice.
Elders felt strongly that mainstream models didn't help show what aged care should look like. One said:
Many feared becoming dependent on the aged care system.
Building community capacity in aged care
Walgett is a small remote community, which presents service delivery challenges. But enabling Elders to age on and care for Country, and to stay connected to extended family, would bring many benefits and opportunities.
For example, unemployment among Aboriginal people in Walgett is high; family and community members could be trained and employed to provide in-home support and transport for Elders:
Local community-controlled organisations are ideally placed to do this, with appropriate resourcing.
Lewis Beale and Clem Dodd tell the story of Galigurrunhaa Spring to the Walgett River Rangers. Aboriginal Elders play an important role as community leaders and protectors of cultural heritage. Dharriwaa Elders Group, Author provided (no reuse) What now?
Aged care reform is underway. The Dharriwaa Elders Group and others have raised concerns about a fee-for-service aged care funding model with NDIS-like individualised entitlements.
Elders' perspectives could guide a different kind of policy and service design reform.
The Dharriwaa Elders Group is an example of how Aboriginal community-controlled organisations provide places to gather and connect, and share knowledge and humour. They can be a hub for community leadership and advocacy. Governments could resource such organisations across Australia to support Elders to age well on Country.
A whole of system approach is required. Elders toldany policy reform must fonot just on aged care, but also on the health, housing and social sectors. This is vital as a non-medical approach to ageing well, enabling Elders to stay on Country, in their community, connected to peers.
This research is leading to possible solutions already. For example, an award-winning Masters project arising from this research drew on what Elders said they needed to design a culturally led model of housing that could be built in Walgett and other remote communities.
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