Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People

Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People is a free 30 minute course that is jointly funded by the Australian Government and ACC. This course explains how to recognise the cultural needs of older Aboriginal and Torres Strait Islander people receiving care. It also describes how to provide culturally appropriate support. The learning outcomes are: •  Discuss the impact of historical events on Aboriginal and Torres Strait Islander

people •  Understand the culture of Aboriginal and Torres Strait Islander people •  Discuss the health status of older Aboriginal and Torres Strait Islander people •  Explain how to provide culturally appropriate support •  Discuss government strategies that are currently being implemented

We are proud to introduce the course subject matter expert, Mark Elliott. Mark Elliott is a Ngarrindjeri Aboriginal man whose family are the Trevorrow’s from the Coorong area of South Australia. Mark spent 6 years as the Aboriginal Community Development Officer for the Adelaide Hills Community Health Service (Country Health SA) and managed the Tumake Yande Aboriginal Elders Program in Murray Bridge SA. Most recently he worked as the Aboriginal Project Officer for the Catalyst Foundation (formally the Seniors Information Service SA part time until he retired in June 2017). Mark has helped to organise major events in Mt Barker SA to celebrate NAIDOC and Reconciliation week winning a state NAIDOC award for best community event in 2010. Mark was a member of the National Aboriginal and Torres Strait Islander Dementia Advisory Group (NATSIDAG) for Alzheimer’s Australia since its inception until it disbanded in 2015 and continues to have a passion for working in the area of dementia, especially within Indigenous communities, has facilitated training in the Dementia Learning Resource for Aboriginal and Torres Strait Islander Communities and spent two years developing and delivering the Strengthening Dementia Care in Indigenous Communities project for Alzheimer’s Australia South Australia in conjunction with the Aboriginal Health Council of SA. Mark Chairs the Aboriginal and Torres Strait Islander Ageing Advisory Group which is supported by the Australian Association of Gerontology and continues to deliver training in Indigenous culture diversity. 1 Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People

The Aboriginal and Torres Strait Islander definition of health is much more than physical – it’s social, emotional, cultural and spiritual well-being of the individual and the community. The connection to country and family lies at the heart of Indigenous wellbeing. Many underlying causes of poor Indigenous health can be attributed to social and economic exclusion, unemployment, low income, poor housing and sanitation, poor education, and lack of adequate nutrition. Historically, Indigenous people have had little power to influence these factors and the public policy decisions that affect their lives and health. The support needs of older Aboriginal and Torres Strait Islander people differ from those of other older Australians as conditions associated with ageing affect Aboriginal and Torres Strait Islander people at a younger age than non- Indigenous Australians. Planning for aged care services should begin for the Aboriginal and Torres Strait Islander population at age 50 and over rather than 65 and over for non-Indigenous Australians. Understanding Culture Aboriginal and Torres Strait Islander cultures are complex and diverse. The Indigenous cultures of Australia are the oldest living cultural history in the world – they go back at least 50,000 years and some argue closer to 65,000 years. Aboriginal and Torres Strait Islander cultures have adapted dramatically to accommodate all that has been introduced into Australia since 1788. First Australians have proved to be rich and resilient. It is a strong part of who they are and it is a strong part of the Australian identity. It is important for all Australians to understand the essential features of Aboriginal and Torres Strait Islander cultures, including the special connection to the land and the commitment to family and community. Health Status There are a number of health conditions that significantly contribute to the disparity in the health status between Aboriginal and Torres Strait Islander people and non-Indigenous Australians . These include: •  Smoking- which leads to higher incidence of a number of diseases including

chronic lung disease, cardiovascular disease and many forms of cancer. •  Obesity- which can result from the poor nutrition and physical inactivity, which

can increase the risk of cardiovascular disease and type 2 diabetes. •  Nutrition-influenced by socio-economic disadvantage and geographical

environmental and social factors. The food supply can be limited in rural and remote areas and high food costs are factors.

•  Violence and hospitalisations for injuries arising from assault are higher for Aboriginal and Torres Strait Islander people.

•  Disability- greater risk due to increased exposure to factors such as low birth weight, chronic disease, infectious disease, accidents and violence, mental health problems, substance use and limited access to treatment and rehabilitation services.

•  Eye, ear and oral hygiene and safe sexual health practices. In recent years dementia has emerged as a significant health issue among Aboriginal and Torres Strait Islander people at comparatively young ages (under 65 years). 2 Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People

Culture can influence Aboriginal and Torres Strait Islander people’s decisions about when and why they should seek health services, their acceptance of treatment, the likelihood of adherence to treatment and follow up, and the likely success of prevention and health promotion strategies. Ensuring that health services and providers are culturally competent will lead to more effective health service delivery and better health outcomes. Many older Aboriginal and Torres Strait Islander people experience problems accessing services. This may be because of social isolation, personal and health problems, or because available services are not perceived as culture-friendly. Aged care providers can take special steps to develop appropriate, culturally sensitive services for Aboriginal and Torres Strait Islander clients. Several strategies are outlined below: •  Involve the community in planning and delivering services: building trust,

understanding and mutual respect is fundamental in making services accessible and appropriate to Indigenous Australians.

•  Respect and respond to Indigenous relationships and gendered behaviour protocols: Aboriginal and Torres Strait Islander societies can have clear gender boundaries and avoidance relationships surrounding interactions between males and females, or between different kin groups. Some Aboriginal and Torres Strait Islander clients may refuse to use services that breach these boundaries.

•  Ensure Services are well - coordinated and flexible •  Employ Aboriginal and Torres Strait Islander staff in non-specific services •  Train non- Indigenous staff in cultural competence skills. Aged care providers should be culturally sensitive to the needs of Aboriginal and Torres Strait Islander elders and health care workers need to have the skills to meet this need.

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Providing Culturally Appropriate Care There are over 150 different Indigenous languages. There are significant regional differences in culture, this means that aged care organisations should include cultural aspects that are regionally appropriate. Aboriginal and Torres Strait Islander people may have a deep seated fear of moving into an aged care home. Organisations can make some small changes that might help Aboriginal and Torres Strait Islander people feel more culturally accepted: ü  Signs in the foyer that pay respect to the Elders of the local Aboriginal Land Council

(specify which Land Council) ü  Regional Indigenous art in common areas ü  Regional Indigenous music or performers ü  Celebration of NAIDOC week ü  Including aspects of Indigenous culture in diversional therapy activities i.e. making

damper, painting, singing ü  Posters showing a mix of people from different cultures The most important aspect is as always, asking the person what’s important to them and how they would like their culture to be recognised and celebrated. Government Strategies Links ü  National Aboriginal and Torres Strait Islander Health Plan 2013-2023 http://www.health.gov.au/internet/main/publishing.nsf/content/B92E980680486C3BCA257BF0001BAF01/$File/health-plan.pdf ü  Closing the Gap http://closingthegap.pmc.gov.au/sites/default/files/ctg-report-2017.pdf ü  The National Aboriginal and Torres Strait Islander Flexible Aged Care Program https://agedcare.health.gov.au/programs-services/flexible-care/national-aboriginal-and-torres-strait-islander-flexible-aged-care-program ü  Dementia and Aged Care Services Fund Grants https://agedcare.health.gov.au/dementia-and-aged-care-services-fund-dacs ü  Aboriginal and Torres Strait Islander Aged Care Workforce Programs https://agedcare.health.gov.au/tools-and-resources/working-in-aged-care/aboriginal-and-torres-strait-islander-aged-care-workers

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References National Aboriginal and Torres Strait Islander Health Plan 2013-2023 http://www.health.gov.au/internet/main/publishing.nsf/content/B92E980680486C3BCA257BF0001BAF01/$File/health-plan.pdf Closing the Gap- Prime Minister’s Report 2017 http://closingthegap.pmc.gov.au/sites/default/files/ctg-report-2017.pdf Working with Aboriginal People and Communities http://www.carersaustralia.com.au/storage/2011Working%20with%20Aboriginal%20People%20and%20Communities.pdf Indigenous.gov.au http://www.indigenous.gov.au/ Care Leavers Resources https://agedcare.health.gov.au/support-services/people-from-diverse-backgrounds/care-leavers-resources

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© 2017 Commonwealth of Australia as represented by the Department of Health. Enquiries Requests and inquiries concerning reproduction and other rights to use this video are to be sent to the Communication Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or via e-mail to copyright@health.gov.au. Disclaimer While all care has been exercised in ensuring the accuracy of the information in this video, the Department of Health does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information. The information in this video is for general use and a guide only. The Department of Health is not providing professional or medical advice on any particular matter.

Unless otherwise stated, scenarios depicted in this course are fictional and any resemblance to any person or event is purely coincidental. The information in this course has been prepared as general information only. It is not intended to provide legal, industrial or other specialist advice and should not be relied upon as such. All advice and information are professionally sourced and provided in good faith and, while all care has been taken, no legal liability or responsibility is accepted for any possible error. For direction concerning your particular circumstances, independent advice should be sought. Copyright 2017. The contents of this course and associated documents remain the property of ACC.

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Produced by ACC | September 2017 | www.acctv.co