NACCHO Aboriginal Health and #ElderCare : Broome hearing of the Royal Commission focuses on the ability of our mob to gain access to aged care services as well as the extent to which #remote areas are included in the availability of aged care services

 “Could I then turn to what is a good news story, and if we could go back to Bidyadanga. 

You will shortly hear from three people who deliver care in the Aboriginal community of Bidyadanga.  The community council there comprises two members of each of the five language groups.

 Primary medical care is delivered by the Kimberley Aboriginal Medical Service, KAMS, through the Bidyadanga Health Centre.  On Wednesday, you will hear from the general practitioner who works for both KAMS and the Broome Regional Aboriginal Medical Service. 

That’s BRAMS, and travels to Bidyadanga for two days on a weekly basis to work at the clinic.  Another doctor is also present for a number of other days during the week. 

The centre has four remote area nurses and one or two Aboriginal health workers.  One senior Aboriginal health worker, who is a senior community member, has worked at the facility for well over 10 years.

There are also currently three Aboriginal liaison officers who work part-time for the clinic and two full-time administration staff. 

KAMS also trains general practice registrars who come up on six to 12 month blocks to provide primary care and emergency services to the community.

 Through the prism of Bidyadanga, the Commission can see firsthand the critical intersection between primary health and aged care in a location where there is no residential care in the traditional sense “

Extract from Monday 17 June transcript for The Royal Commission into Aged Care Quality and Safety that is holding a public hearing in Broome this week .

See SMH media Coverage : Indigenous people believe aged care isn’t ‘culturally safe’, and ageing earlier

The Broome hearing of the Royal Commission focused on the ability of Aboriginal and Torres Strait Islander people to gain access to aged care services as well as the extent to which remote areas are included in the availability of aged care services.

Specifically, the Broome hearing inquired into:

  • the unique needs of Aboriginal and Torres Strait Islander people when it comes to aged care services
  • the perspective and experience of people who access aged care in remote areas including family members and carers
  • the nature and scope of aged care services for Aboriginal and Torres Strait Islander people living in remote areas
  • the barriers to accessing aged care services for people living in remote areas
  • the challenges of maintaining an adequately skilled and culturally appropriate workforce in remote areas
  • good practice care models for people living in remote areas

The Royal Commission heard evidence from witnesses from the local community and surrounding areas as to their experiences of aged care services.

For more information about the hearing consult the Hearings page on the website and more information about the community forum can be found on the Engagement page.

Proceedings can be viewed or listened to using the webcast on the Royal Commission website. Hearing transcripts will also be available at the end of each hearing day.

Public submissions

The Royal Commission into Aged Care Quality and Safety invites interested members of the public and institutions to make submissions to the Royal Commission using an online form (the link to the form is below). The Royal Commission will continue to accept submissions until at least the end of September 2019. A date for the closing of submissions will be announced in the second half of 2019.

The online form is designed to capture information that is relevant to the work of the Royal Commission and consistent with the areas of inquiry set out in the Royal Commission’s Terms of Reference

Online Form HERE

Download the full transcript-17-june-2019

Read all the NACCHO Aboriginal Health and Elder Care articles

Location of Indigenous-focused aged care programs See ANAO 2017 Report

”  Commissioners in this fourth substantive public hearing, the focus of the evidence will be on aged care in remote areas of Australia and the related issues of access and inclusion with specific attention being directed to Aboriginal and Torres Strait Islander people.  People who identify as being Aboriginal and Torres Strait Islander comprise 16 per cent of the remote population and 46 per cent of the very remote population.”

Mr Bolster Counsel Assisting

For this reason, it is important that the Royal Commission when inquiring into aged care in remote areas, consider aged care services for people who identify as Aboriginal and Torres Strait Islander.

It would, however, be a mistake to conflate Aboriginal and Torres Strait Islander people and life with regional and remote locations, remembering that over 60 per cent of Aboriginal and Torres Strait Islander people live in major cities or inner regional areas.

With that in mind, and while it will receive some attention in this hearing, the particular needs of Aboriginal and Torres Strait Islander people living in urban areas will be explored further in later hearings, including the Perth hearing next week.

What is remote aged care?

We commence the answer to the question by identifying examples that frame the experience of delivering aged care in some of the most remote locations imaginable.

At Docker River in the Northern Territory, close to its south-western corner, is a facility known as Tjilpi Pampaku Ngura Flexible Aged Care Service.  It services a population of 394 with a median age of 31 of whom 74 per cent are Aboriginal.

It is funded to provide care for 19 residential care places and 22 home care packages.  Tjilpi Pampaku Ngura is in the traditional lands of the Anangu people and the predominant language is Pitjantjatjara, English being spoken at home in only 14 per cent of households.

Alice Springs is nearly 700 kilometres to the east on principally dirt roads and involves an eight to nine hour drive or a chartered plane.  There are no regular airline services.  Diesel is the only fuel available.  The median annual income is $15,000, just over a quarter of what it is in Darwin.  We will be talking about Docker River shortly.

On the other side of the border in the Anangu Pitjantjatjara Yankunytjatjara or APY Lands in remote South Australia, 217 elders receive aged care services through Aboriginal Community Services SA from whom you will hear evidence, predominantly via the Commonwealth Home Support Programme as well as a limited number of home care packages.

Balgo, or Wirrimanu in the eastern Kimberley is a 250 kilometre trip south of Halls Creek and over 10 hours from Kununurra.  The drive is mainly on dirt roads that are often impassable in the wet season.

A population of between 500 and 600 is serviced by a health centre run by the Aboriginal Community Controlled Health Service with visits by doctors of the Kimberley Aboriginal Medical Service.  Aged care services, predominantly home care packages and CHSP, are delivered by Kimberley Aged and Community Services, an arm of the WA Country Health Service known as WACHS.

That’s in partnership with the local Aboriginal Corporation.  At Balgo, a loaf of bread and long-life milk cost around three times the price that you will pay for them in Kununurra.

Balgo is one of a  number of remote communities in the Kimberley where care is delivered through a place-based partnership model where there is a relationship with the local Aboriginal community corporation.  KACS, that is Kimberley Aged and Community Services,  also delivers home care packages directly at a number of other remote locations as well as undertaking client case management reviews, referrals to specialists, recruiting and training remote workers as well as quality monitoring at smaller locations.

On Thursday Island there is a 40 bed residential aged care facility known as the Star of the Sea where 80 per cent of the staff identify as Aboriginal or Torres Strait Islander.  Star of the Sea is the only residential aged care facility in the Torres Strait.  It contains a central meeting room known as the Ocean Room that overlooks the Torres Strait, thereby providing resident with a connection to the ocean to which that unique culture is inextricably attached.  As the High Court observed in Mabo v Queensland (No 2), “the Meriam people of the Torres Strait retain a strong sense of affiliation with their forebears and with the society and culture of earlier times.  They have a strong sense of identity with their islands.”  In the case of the Torres Strait, the geography is such that many of the islands are small and spread over a vast area as the map, which should be on display, identifies.

Finally, 200 kilometres south of Broome is Bidyadanga, one of the largest remote Aboriginal communities in Western Australia with a population of 700 to 1000 people.  It is home to five language groups, Karajarri, Juwalinny, Mangala, Nyungamarta and Yulpartja.  Bidyadanga has a dedicated aged care service with a CHSP-funded HACC centre, HACC being a reference to the former Western Australian Home and Community Care Program.  People in Bidyadanga have high care needs;  there are no residential care options available other than a move far away from country to Broome.  Consistent with what this Royal Commission has been told in earlier hearings, people in Bidyadanga have a strong preference for being able to stay in their own home.  Just as importantly, they want to stay on country for as long as possible.  Bidyadanga has a health centre, general store, and outposts of government agencies including Australia Post and Centrelink.  The local fishing is good.  I’m told the blue nose thread fin salmon cooked on coals is a good reason to stay there.

These are just a few practical examples of the remote places where aged care is delivered;  each will be the subject of evidence at this hearing.

Madeleine Jadai brought photos to emphasize the importance of family to Indigenous people requiring aged care. CREDIT:ROYAL COMMISSION ON AGED CARE QUALITY AND SAFETY

I turn now to the question of what “remote” means.

For the purpose of delivering services in remote Australia, the Commonwealth relies on at least two methods of classifying regions as remote or very remote.  The first of these, known as the Modified Monash Model is used for service delivery purposes by the Department of Health.  It has seven levels ranging from level 1 which represents major cities through to level 6 and 7 for remote and very remote.

It’s best explained by a chart that is – it should be coming up on the screen now.  The yellow portions are the very remote portions.  They’re MMM7.  And the MMM6 portions are the lilac colour slightly closer to the coast on the east coast.  And in the case of Tasmania, there’s another graph which we attach and the Commission will see that both in the case of King Island and the Flinders Island group, they are very remote.  There is a comparable ABS remoteness classification which is largely to the same effect and the relevant charts for that purpose will be in the evidence.  Any consideration though of remote aged care needs must extend beyond the States and the internal Territories and address the external Territories as well.

Of the seven external Territories only three support a permanent population, Christmas Island, the Cocos (Keeling) Islands and Norfolk Island.  All three are classified as very remote under the Modified Monash Model and the Commonwealth Department of Infrastructure, Regional Development and Cities has responsibility for health care on both Christmas Island and Cocos (Keeling) Island.  That is delivered through a standalone Indian Ocean Territories Health Service.  A recent March 2019 report by PricewaterhouseCoopers, prepared for the Commonwealth, noted that although each has a strong and easily accessible primary health care service, which is known as the Indian Ocean Territories Health Service, there is no aged care – residential aged care in either Territory.  Complex procedures are delivered in Western Australia.

The PwC report is currently with government and community consultations were commenced on Christmas Island in May and there will be future consultations on Cocos (Keeling) Island in June.  This is a significant issue and one that will be explored in further hearings.  The Norfolk Island situation is slightly different.  Norfolk is categorised as RA5 under the ABS remoteness classification.  It is not classified under the Modified Monash Model.  It is located within the South-East Sydney Aged Care Planning Region and the Central and Eastern Sydney Public Health Network.  Norfolk Island Health and Residential Aged Care Services is an integrated multipurpose service, and I will be talking more about multipurpose services later;  it provides 14 high-care residential aged care places on the island.

Can we turn now to the Kimberley.  The Kimberley Aged Care Planning Region is one of 73 planning regions across Australia and you’ve already heard evidence about the significance of such regions for aged care planning and funding purposes.  The Kimberley region provides a useful snapshot of the features of aged care in remote and very remote Australia.

Although it must be acknowledged that there are many differences between regions across the country, including cultural and geographic differences.  According to ABS census data from 2016 published by the Australian Institute of Health and Welfare on the generation aged care website, just over 31 and a half per cent of the region’s population aged 50 or over identifies as an Aboriginal or Torres Strait Islander person.  That’s to be contrasted with the national or state average of about one and a half per cent.  23 – 21.3 per cent of the population over 65 was born overseas as opposed to around 36 per cent nationally.  But there is a higher proportion of people over 65 for whom English is not their preferred language.

In terms of service delivery there are a number of features that stand out.  Although there are more residential aged care places per 1000 people than the state and national average, the vast majority of residential care places are provided by not for profit providers.  This equates to around 83 places per 1000 people over 70.  At this hearing you will hear evidence from and about providers that operate in Western Australia, particularly in the Kimberley, the Northern Territory, South Australia and Far North Queensland, servicing the Torres Strait.  Whilst a number of places are provided by government providers, roughly six per 1000, there are no residential aged care places provided by for profit organisations in the Kimberley, whereas on average there are 30 places per 1000 people aged 70 or over nationally and around 22 per 1000 in Western Australia provided by for profits.

In the Kimberley, unlike the position nationally, slightly more males use permanent residential aged care than females.  Similarly, unlike the position nationally and in the rest of the State, the majority of residents in the Kimberley are Aboriginal and/or Torres Strait Islander.  There is also a markedly higher proportion of people whose preferred language is not English, even though such residents were born in Australia or another English speaking country.  Perhaps the most significant comparison between the Kimberley and urban Australia is to be seen in the age profiles of those that use aged care and there’s a graph that should be coming up on the screen now.

Focusing for the moment on those that use residential aged care, it can be seen that as of 30 June 2017, the demand by Aboriginal and Torres Strait Islander males presents at a much earlier age than is the case in the typical urban cohort.  The graphs that follow provide a comparison between the demand for residential care and home care in the Kimberley, Alice Springs and inner west Sydney regions.  It gives much the same impression establishing that the largest cohort of men in the city is likely to be between 80 and 90 years old, whereas in the Alice Springs and the Kimberley the corresponding cohort is much young, spanning the years 65 to 79.  The position is roughly comparable in the case of women, although the gap would seem to be slightly smaller given that Aboriginal women tend to enter aged care later than males.

I turn now to the question of culturally safe care. 

There are also particular important considerations that arise in relation to the provision of aged care for Aboriginal and Torres Strait Islander people which will be explored at this hearing.  It’s important to note the diversity of Aboriginal and Torres Strait Islander cultures and language.  There are over 500 indigenous nations and over 250 different language groups across Australia.  An approach that works for one particular cultural group may not be appropriate in another setting.  At the forefront of these challenges, whether care is delivered in the city, rural or remote Australia, it needs to be culturally safe and culturally appropriate.  Whilst this encompasses many things and will hold different meanings for different cultural groups, for Aboriginal and Torres Strait Islander people we will hear that at its centre is the acknowledgement of the identity of the person and their connection to community and country, their community and their country.

One witness will tell you that this may mean different things in different parts of the country, and in that sense it has aspects that are location based and dependent on the particular cultural practices of the region.  It also has an individual element that depends upon the personal history of the person and in this respect, the perspective of people in the Stolen Generation comes to mind.  The following are common themes that the evidence is likely to demonstrate.

The first, as I’ve said, is connection to country.

We will hear about the importance of having connection with country and staying on country as people age.  For people who are no longer living in their country, having the opportunity to return to country is important.

You will hear how in Derby and in other places, the Juniper facilities, like other facilities across the country, arrange to transfer residents to country with support staff.  You will hear of the challenges for older people who may be forced with having to go off country to access health and aged care services, in particular when it comes to residential care.

 Secondly, there is the connection to family and community.

In this respect, we will explore the unique role of the elder in traditional Aboriginal and Torres Strait Islander communities and how the important cultural responsibilities associated with that role need to be understood when attempts are made to provide care.  We expect that you will hear evidence about a collectivist culture where there is a sharing of resources and the challenges in delivering home care to an older person in that setting.

Thirdly, there is language.

Language plays an important role for many Aboriginal and Torres Strait Islander people in their connection to culture, kinship, land and family.  And languages are the foundation upon which the capacity to learn, interact and to shape identity is built.  Fourthly, there are important cultural requirements in the lead-up to and immediately following the passing of an Aboriginal person.  You will hear evidence about how for some cultures a smoking ceremony is conducted in the deceased’s living space for religious and cultural purposes, together with ceremonies after death that may involve keeping the body in place for a period of time before burial in country.

In some cultures it may be appropriate for attendance by kin or community members at ceremonies associated with an impending death.  It would appear that there may be a need to provide notice that a person is dying so that arrangements can be made for necessary attendances for sorry time or sorry business.  Singing ceremonies before and after death need to be understood and respected.  You will hear of one service that has sought to have a separate palliative care residence where there is space for family and community to spend time with the older person.  At the same time, it needs to be borne in mind that some Aboriginal and Torres Strait Islander people have cultural reservations about discussing these matters.  We seek to approach this matter respectfully and in good faith so that these matters can ensure better delivery of culturally safe care.

Food, of course, plays an important role in culture.

You will hear evidence that delivery of cultural food at least once a week in a residential facility will enhance the experience of Aboriginal and Torres Strait Islander Elders.  Awareness of these relationships and a commitment to embrace them is critical to delivering culturally safe care and obtaining the trust of the resident and their community.  We will also explore what is culturally safe palliative care, an issue that can be complicated by some traditional approaches to death.

On another level, the everyday delivery of care may involve attention to significant male and female roles and kinship relationships.  Gender, clan and kinship can impact on whether it is appropriate for a particular person to provide care to another person.  This can present challenges in terms of workforce and recruitment.  Overall, the delivery of cultural safe care is based on trust on the part of the care recipient and this is an issue that will be considered by a number of the witnesses.  One witness is likely to tell you that it is best where care is provided as close as possible to home, by people who are sensitive to the history and culture and needs of that resident, and you will hear from some of those witnesses today.

Another witness will talk about place-based models of care.  You will also hear about the time that it takes to develop trusted relationships that are required to deliver care.  Ruth Crawford, a nurse for 45 years, is the manager of the Kimberley Aged and Community Services and she will give evidence tomorrow about the partnership model of care that operates in places such as Balgo, Bidyadanga and a number of other remote communities within the Kimberley.  You will hear that where care is not culturally safe, Aboriginal and Torres Strait Islander people are not likely to access services.  You will also hear about the challenges that Aboriginal and Torres Strait Islander people face in navigating My Aged Care.

The barriers that prevent access to the aged care system or getting the types of level of assistance they need come in many forms.  The aged care assessment process requires a person to talk about their intimate and personal health, their domestic situation;  all of this with a complete stranger.  That stranger may be of the opposite sex and may not have had any cultural awareness training.  You will hear that this framework leads to Aboriginal and Torres Strait Islander people avoiding the aged care system, withdrawing from the ACAT discussion.

You will also hear how My Aged Care assumes a level of literacy and good access to postal services as well as e-literacy and connection that is not a reality in some parts of Australia.  You will hear about the services that work to get around these barriers by wrapping around the older Aboriginal or Torres Strait Islander person.  They use their pre-existing relationship of trust to get the person to an ACAT assessment and support them through it.  Much of this work is done without aged care funding and depends upon the goodwill and flexibility of committed services and staff and members of the local community.  Language is also a barrier.  When an Aboriginal or Torres Strait Islander interpreter is required, in the limited circumstances that there is a professional interpreting service available, the person can be required to pay for this out of their home care package.

Can I turn then to funding structures.

Commissioners, you have already heard evidence about how aged care is predominantly delivered through residential aged care, home care packages, as well as the Commonwealth Home Support Program.  Some providers of residential and home care are also eligible for viability supplements in recognition of the additional costs of delivering care in remote settings or to people defined as special needs groups under the Aged Care Act, and that includes Aboriginal and Torres Strait Islander people.  While each of these programs operate in the context of remote and very remote Australia, there are additional programs that is will be under examination in this hearing which we would like to outline briefly.

The first and largest of those is the National Aboriginal and Torres Strait Islander Flexible Aged Care Program known as NATSIFACP or sometimes NATSIFlex which I will use because I think it’s easier.  The stated objects of that program are to deliver a range of services to meet the changing aged care needs of the community, to provide aged care services to Aboriginal and Torres Strait Islander people close to home and community, to improve access to aged care services for Aboriginal and Torres Strait Island people, to improve the quality of culturally appropriate aged care services for Aboriginal and Torres Strait Islander people and to develop financially viable cost effective and coordinated services outside of the existing mainstream programs.

NATSIFlex operates, as I said, outside of the Aged Care Act and providers are block funded based on an agreed allocation of aged care places and the types of places.  Unlike ACFI funding, there are two levels of residential care and two levels of home care, one high and one low.  The intention is to provide stability of funding and flexibility.  Nationally, the program funds 453 residential aged care beds, 11 respite places and 396 home care services in 30 organisations delivered through 35 services.  Currently the Commonwealth is prioritising the conversion to NATSIFlex status for which there are only limited opportunities, and this is to a very small number of services, those that are likely to struggle under mainstream funding arrangements.

Debate surrounds whether this is the right criteria or whether there should be any restriction on conversion of mainstream services to NATSIFlex status.  You will hear from the provider Juniper about how their 40 bed facility at Kununurra, built with a Commonwealth grant, is precluded from NATSIFlex funding by reason of these criteria.  There may, however, be reasons to prefer services that operate in the mainstream wherever possible and that they only – the conversion to NATSIFlex only be allowed if it’s necessary to ensure ongoing viability.

To put the matter in perspective, the Commonwealth projects that by 2029 the use of ACFI-funded residential care in remote and very remote Australia will have increased by nearly 700 places or 63 per cent on current levels.  Similarly the use of NATSIFlex-funded places will have increased by 227 or 61 per cent.  Resident pathways into NATSIFlex care are broader and more flexible than the pathways under the Aged Care Act.  ACAT assessment is not required and referral can be from a range of sources, including My Aged Care, CHSP assessors, GPs, social workers, etcetera.  Residential care can be either permanent or short term and you will hear evidence that in some locations residents take up the care, particularly during the wet season when travel is difficult.

At least one witness is likely to criticise the program on the basis that the flexibility of the system means that admission to residential care is often premature, expressing the view that care at home, funded by other programs, including the NDIS, would suffice and that such a result may be driven by providers looking to increase occupancy rates so as to increase their funding.

Witnesses are also likely to consider whether the number of Aboriginal and Torres Strait Islander people receiving aged care at an earlier age reflects gaps, whether current or historical, in primary health care and disability services, rather than premature ageing.  There is a real issue as to whether NATSIFlex funding enables service providers to respond to the pressures associated with the remote delivery of care, particularly having regard to the challenges of providing culturally appropriate care.  Grants only operate for periods of between two or three years and seem geared to provide the revenue associated with providing care to residents, not providing the basis for any capital development or improvement.  There are other avenues through which support, including for capital grants, is provided by the government, including the Aboriginal and Torres Strait Islander Aged Care Service Development Assistance Panel, the SDAP.

This program provides funding to enable providers to obtain specialist advice and assistance in a range of areas, including service delivery, sector support and financial and project management.

Australian Regional and Remote Community Services, or ARRCS as we will refer to it, is the largest NATSIFlex provider in the country, operating the facility at Docker River, previously referred to, and facilities at Mutitjulu, Tennant Creek in the Northern Territory.  Its related organisation, Pinangba, which operates in Queensland, is the operator of the Star of the Sea facility on Thursday Island.  ARRCS is one of the two providers through whom UnitingCare Queensland delivers aged care services to Aboriginal and Torres Strait Islanders.  You will hear from the group general manager of that organisation responsible for the regional and remote community services, along with the CEO of UnitingCare Queensland, the parent company.

A second relevant program is the funding of Multi-Purpose Services or MPS which are partnerships between the Commonwealth and State and Territory Governments to deliver integrated health and aged care services in very small communities, particularly in regions where it is not viable to operate a standalone hospital or a standalone aged care service.  Mention also needs to be made of the Aged Care Regional, Rural and Remote Infrastructure Grants funding round which provide support to regional, rural and remote aged care service providers to undertake infrastructure works.

Could I then turn to the issue of home care packages in this region.

Waiting times for the delivery of remote home care packages are a matter of concern and largely mirror the position in the rest of Australia.  Evidence from the Commonwealth is to the effect that in remote and very remote Australia there were 1480 approvals for home care packages in calendar year 2018.  Of those living in remote or very remote regions who were assigned their first package, regardless of level, in that period, only 38.8 per cent, that is 608 people, received that assignment within nine months.  For most people, the time between approval and assignment exceeds nine months.  There were significant numbers who had not been assigned a provider after 18 months:  218.

At the two year and beyond period, the figure was 68 and at the three year period, there were 28 people.  Evidence from the Commonwealth is that in the case of Aboriginal and Torres Strait Islander people they represent 3.1 per cent of participants, although it is not at all clear the extent to which they are required to wait for packages.

There is also a viability supplement paid to all of the providers referred to above, including NATSIFlex and MPS to recognise the higher costs of providing care due to the location, size and client mix of a service.  Despite all of this, the Aged Care Financing Authority warned in September of last year that there were a number of facilities in regional and remote areas that were experiencing significant financial difficulties and were likely to be forced to merge with or sell to a larger provider.

Could I then turn to what is a good news story, and if we could go back to Bidyadanga.

You will shortly hear from three people who deliver care in the Aboriginal community of Bidyadanga.  The community council there comprises two members of each of the five language groups.  Primary medical care is delivered by the Kimberley Aboriginal Medical Service, KAMS, through the Bidyadanga Health Centre.  On Wednesday, you will hear from the general practitioner who works for both KAMS and the Broome Regional Aboriginal Medical Service.

That’s BRAMS, and travels to Bidyadanga for two days on a weekly basis to work at the clinic.  Another doctor is also present for a number of other days during the week.

The centre has four remote area nurses and one or two Aboriginal health workers.  One senior Aboriginal health worker, who is a senior community member, has worked at the facility for well over 10 years.

There are also currently three Aboriginal liaison officers who work part-time for the clinic and two full-time administration staff.  KAMS also trains general practice registrars who come up on six to 12 month blocks to provide primary care and emergency services to the community.  Through the prism of Bidyadanga, the Commission can see firsthand the critical intersection between primary health and aged care in a location where there is no residential care in the traditional sense.

You will hear from Dr Martin Laverty, the CEO of the Royal Flying Doctor Service, on the importance of that sort of primary health care as a means of avoiding admissions to hospital, often far away, and unwanted entry into residential aged care, also far away from that country.

Tomorrow, you will hear from representatives of two providers from the eastern part of the Kimberley.  The first provider is Uniting Church who provide aged care services under the name of Juniper.  It operates the Juniper Ngamang Bawoona and Juniper Numbala Nunga facilities in Derby.  Juniper, from whom you heard evidence at the first Adelaide hearing, cross-subsidises its remote residential facilities with revenue from its more traditional aged care operations in Perth.  The second provider, Southern Cross Care, operates the Germanus Kent House here in Broome, and the associated Bran Nue Dae Day Centre.

We also expect that you will hear evidence from an Aboriginal enrolled nurse who has worked at Germanus Kent House, and that should occur within the next hour or so.

See full transcript to continue transcript-17-june-2019

 

 

 

 

 

 

 

 

 

 

 

NACCHO Aboriginal #Agedcare Health : Minister @KenWyattMP Download : The Aboriginal and Torres Strait Islander Aged Care #Consumer and Provider Action Plans to support the distinctive needs of our mob

” The Aboriginal and Torres Strait Islander Aged Care Action Plan Actions to support older Aboriginal and Torres Strait Islander people, to be launched today, addresses the distinctive support needs of older Aboriginal and Torres Strait Islander peoples and represents the first such aged care strategy since 1994. 

It is one of three aged care action plans being released under the Commonwealth’s Aged Care Diversity Framework, with the other two encompassing the needs of CALD communities and LGBTI people.( see below )

The action plan provides specific guidance to aged care providers on how to address the needs of Aboriginal peoples in enacting the overarching principles of the Aged Care Diversity Framework, which takes a human rights approach to driving cultural and systemic change in the aged care system, and to ensure that all Australians access safe, equitable and high-quality aged care services regardless of their ethnicity, culture, sexuality and life experiences.

Implementation of the plan will increase the accessibility of culturally safe aged care support and services to older Aboriginal and Torres Strait Islander peoples, and provide guidance to mainstream service providers seeking to increase the cultural safety and appropriateness of the services they offer to Aboriginal people.

In particular this plan emphasises the need for mainstream service providers to collaborate and/or co-design services with Aboriginal community-controlled organisations.

Noeleen Tunny is manager of VACCHO’s Policy and Advocacy Unit

Originally published in Croakey

Read all NACCHO Aboriginal Health and Elder care Articles HERE

Download the Action Plans HERE

actions-to-support-older-aboriginal-and-torres-strait-islander-people-a-guide-for-consumers

actions-to-support-older-aboriginal-and-torres-strait-islander-people-a-guide-for-aged-care-providers

Minister Wyatt honoured to join Elders & such an amazing group of dedicated and talented advocates for Aboriginal & Torres Strait Islander Aged Care, launching Australia’s first Aged Care Diversity Action Plan for First Nations people. Thanks – at Parliament House

Part 1 : Aged Care Diversity Framework

From Here

The Hon Ken Wyatt AM MP, Minister for Senior Australians and Aged Care and Minister for Indigenous Health, established an Aged Care Sector Committee Diversity Sub-Group to advise the Government on the development of an Aged Care Diversity Framework and action plans.

The Aged Care Diversity Framework (the Framework) was launched on 6 December 2017.

The Framework is an overarching set of principles designed to ensure an accessible aged care system where people, regardless of their individual social, cultural, linguistic, religious, spiritual, psychological, medical and care needs are able to access respectful and inclusive aged care services. The Framework takes a human-rights based approach in line with the World Health Organization principles of:

  • non-discrimination
  • availability
  • accessibility
  • acceptability
  • quality
  • accountability

Development of the Framework was informed through:

Action plans

Three action plans have been developed under the Framework to assist aged care service providers and government to address specific barriers and challenges faced by:

  • Older Aboriginal and Torres Strait Islander peoples
  • Older people from Culturally and Linguistically Diverse Backgrounds
  • Older lesbian, gay, bisexual, trans and gender diverse, and intersex peoples

In addition there is a shared action plan and government action plan to support all diverse older people.

The action plans are informed by extensive public and aged care sector consultations.

An action plan for older people who are homeless, or at risk of homelessness, is currently being developed.

Part 2 : Actions to support older Aboriginal and Torres Strait Islander people in aged care

Originally published in Croakey

While the gap in life expectancy for Aboriginal and Torres Strait Islander peoples is still significant, there are people living into their older years who require aged care support that meets their diverse needs.

The 65 and over Aboriginal population is projected to grow by 200 per cent by 2031, making it critical for us to get aged care right now.

Aboriginal Australians are affected by chronic disease more frequently and at a younger age than non-Indigenous people. In some areas the prevalence of dementia is almost five times that of non-Indigenous Australians, with higher rates of self-reported falls, incontinence and pain. Yet despite these statistics, Aboriginal and Torres Strait Islander peoples are less likely than the general population to access aged care.

Successive iterations of the Productivity Commission’s Report on Government Services indicate that Aboriginal and Torres Strait Islander peoples who are eligible to receive an aged care assessment are less likely to be assessed than their counterparts in both the general population and in culturally and linguistically diverse (CALD) communities. This disparity was evident both at a national level and in each Australian jurisdiction and suggests a need to support better engagement of older Aboriginal people within the aged care system.

Stolen Generations

Adding further complexity to the space is the fact that 100% of the Stolen Generation will be at least 50 years old by 2023, i.e. eligible for aged care as Aboriginal people can access these services earlier due to their broader lower life expectancy. This group will require sensitive, trauma-informed care that does not re-traumatise them.

The Aboriginal and Torres Strait Islander Aged Care Action Plan Actions to support older Aboriginal and Torres Strait Islander people, to be launched tomorrow, addresses the distinctive support needs of older Aboriginal and Torres Strait Islander peoples and represents the first such aged care strategy since 1994.  It is one of three aged care action plans being released under the Commonwealth’s Aged Care Diversity Framework, with the other two encompassing the needs of CALD communities and LGBTI people.

The action plan provides specific guidance to aged care providers on how to address the needs of Aboriginal peoples in enacting the overarching principles of the Aged Care Diversity Framework, which takes a human rights approach to driving cultural and systemic change in the aged care system, and to ensure that all Australians access safe, equitable and high-quality aged care services regardless of their ethnicity, culture, sexuality and life experiences.

Collaboration

The Institute of Urban Indigenous Health (based in Brisbane) and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) collaborated in the development of the plan. VACCHO coordinated the consultation process in NSW, Victoria, Tasmania and SA.

Consultations with Aboriginal and Torres Strait Islander people, and aged care providers included:

  • 629 completed surveys
  • 51 individual consultations carried out by the project team and members of the working group = these complemented the survey data and explored in more detail issues being raised in the survey responses and views expressed by members of the Working Group; and
  • a written submission from the Healing Foundation in recognition of the specific issues related to ageing and the needs of the Stolen Generations.

Implementation of the plan will increase the accessibility of culturally safe aged care support and services to older Aboriginal and Torres Strait Islander peoples, and provide guidance to mainstream service providers seeking to increase the cultural safety and appropriateness of the services they offer to Aboriginal people. In particular this plan emphasises the need for mainstream service providers to collaborate and/or co-design services with Aboriginal community-controlled organisations.

To quote the plan: “The plan can assist providers to identify actions they could take to deliver more inclusive and culturally appropriate services for consumers. It acknowledges that there is no ‘one-size-fits-all’ approach to diversity, and that each provider will be starting from a different place and operating in a different context.”

VACCHO and its members, including those members who themselves provide aged care supports,  look forward to working with aged care providers to ensure the best, culturally appropriate care is provided to older Aboriginal people; they are the keepers of culture, and deserve to be respected and valued.

Noeleen Tunny is manager of VACCHO’s Policy and Advocacy Unit

NACCHO Aboriginal #Eldercare Health #Apology11 and #CaringForOurStolenGenerations How you can get involved ? : Stolen Generations want a commitment on aged care @KenWyattMP

Even compared to their Aboriginal and Torres Strait Islanders contemporaries, who are already at a disadvantage in Australia, Stolen Generations members aged 50 and over are suffering more – financially, socially and in areas of health and wellbeing,

Aboriginal and Torres Strait Islander people who were removed from their families are two times as likely to have been incarcerated and almost three times as likely to rely on government payments, compared to those who were not removed as children.

We’ve just been scratching the surface. We need government and service providers to commit to long term and widespread healing programs, trauma informed resources and culturally appropriate care.”

Chair of The Healing Foundation’s Stolen Generations Reference Group Ian Hamm said the data draws a clear distinction in the health and welfare outcomes between ageing Stolen Generations and the general Indigenous population.

Read NACCHO Elder Care Articles HERE 

Read NACCHO Stolen Generation Articles HERE

This year we will commemorate the National Apology to the Stolen Generations by sharing stories that have been shared with us over the years.

Witnessing the stories of Stolen Generation members who were removed from their homes, families and communities allows all Australians to join in on the healing journey and be part of the solution moving forward. This is the spirit of commemorating the National Apology.

We are sharing Stolen Generations stories via Facebook. Tune in on 13 February at 2pm and 6pm (AEST)

Share the Facebook event: http://bit.ly/2WUynLv

Eleven years on from the National Apology, members of the Stolen Generations are calling on governments to ensure aged care services are sensitive to their needs and support publicly funded alternatives to residential care that deal with trauma related issues arising from re-institutionalisation.

Hope Beyond the Window by Jacqui Stewart. The painting represents children from a Stolen Generation. The church symbolises religion and the window represents ‘hope’ looking through to the sky. The children are portraying despair but also at the same time hopefulness and belief for a better future. The old tree beside the church symbolises an Aboriginal Elder who is protecting and watching the children while the leaves illustrate “free spirits” flying through the wind. The painting was influenced by photographs of the Moore River Native Settlement in WA and the movie Rabbit Proof Fence. Image reproduced with kind permission from the artist.

Source: Stolen Generations stories – Creative Spirits, retrieved from 

It follows the release of data from the Australian Institute of Health and Welfare that uncovers alarming and disproportionate levels of disadvantage for Stolen Generations aged 50 and over.

The AIHW report forecasts that by 2023 all remaining Stolen Generations survivors will be eligible for aged care. The data shows that 89 per cent of those aged 50 and over were not in good health and 76 per cent relied on government payments as their main source of income.

The Healing Foundation CEO Richard Weston said the report provides a clear evidence base to the complex needs of Stolen Generations aged 50 and over who suffered profound childhood trauma when they were forcibly removed from their homes, isolated from family and culture and often institutionalised, abused and assaulted.

“While appalling, this level of disadvantage should not come as a surprise. If people don’t have an opportunity to heal from trauma, it continues to impact on the way they think and behave, leading to a range of negative outcomes including poor health and isolation, which in turn leads to social and economic disadvantage,” Mr Weston said.

“The Aged Care Royal Commission has been running for less than a week and we’re already hearing about the profound trauma experienced by those in care. Clearly, the Stolen Generations need and deserve assistance in their aging years, but given their past experiences with institutionalisation, it’s vital that we find public funded alternatives that respond to trauma related issues.”

How you can get involved

-Share the Facebook event: http://bit.ly/2WUynLv
-Share the Stolen Generations stories via YouTube
-Visit our webpage to learn more about Apology11
-Share the factsheet: http://bit.ly/2I7xjk4
-Talk about the recent findings in the Australian Institute of Health and Welfare’s Aboriginal and Torres Strait Islander Stolen Generations aged 50 and over report.

Tag us on Facebook: @Healing Foundation and Twitter: @healingourway using #Apology11 and#CaringForOurStolenGenerations

Read more: https://healingfoundation.org.au/app/uploads/2019/02/190212-Apology11-Caring-for-Stolen-Generations-InformationSheet.pdf

NACCHO Aboriginal Health #NACCHOagm2018 Report 4 of 5 : Minister @KenWyattMP full text keynote speech launching @AIHW  report report solely focusing on the health and wellbeing of young Indigenous people aged 10–24

” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people. In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates 

In Noongar language I say, kaya wangju. I acknowledge the traditional custodians on the land on which we meet and join together in acknowledging this fellowship and sharing of ideas.

I acknowledge Elders, past and present and I also want to acknowledge some individuals who have done an outstanding job in the work that you all do and I thank you for the impact that you have at the local community level: John Singer, chair of NACCHO; Pat Turner AM, CEO of NACCHO; Donnella Mills; Dr Dawn Casey; Dr Fadwa Al-Yaman; Professor Sandra Eades; Donna Ah Chee; LaVerne Bellear; Chris Bin Kali; Adrian Carson – and I’m sorry to hear that Adrian’s not with us because of a family loss – Kieran Chilcott; Raylene Foster; Rod Jackson; Vicki Holmes; John Mitchell; Scott Monaghan; Lesley Nelson; Julie Tongs; Olga Havnen.

All of you I have known over a long period of time and the work and commitment that you have made to the pathways that you have taken has been outstanding. I’d also like to acknowledge Dr Tim Howle, Prajali Dangol, and Helen Johnstone, the report authors.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do.

Providing strong pointers for this is a new report from the Australian Institute of Health and Welfare.

I understand this is the very first study by the Institute that focuses solely on First Nations people aged 10 to 24.

Download a copy of report aihw-ihw-198

As such, it is a critical document.

Firstly because it puts at your fingertips high quality, targeted research about our young people.

Secondly, it gives us a clear understanding of where they are doing well, but also the challenges young people still face.

And thirdly, equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing.

I’m always passionate about all young people having the best start in life and marshalling the human resources necessary so that this care extends right through to early adulthood, laying strong foundations for the rest of their lives.

I want to run through some of the key findings of this report and then talk about Closing the Gap Refresh in our Government’s commitment to and support for our young people. I’m pleased some real positives have been identified.

The report found a majority of the 242,000 young First Australians, or 63 per cent, assessed their health as either excellent or very good. Further, 61 per cent of young people had a connection to country and 69 per cent were involved in cultural events in the previous 12 months.

As the oldest continuous culture, we know that maintaining our connections to country and our cultural traditions is a key to our health and wellbeing. Education is another important factor in our ability to live well and reach our full potential.

In the 20 to 24 age group, the number of young people who have completed Year 12 or the equivalent has increased from 47 per cent in 2006 to 65 per cent in 2016. Smoking rates have declined and there is also an increase in the number of young people who have never taken up smoking in the first place.

Eighty-three per cent of respondents reported they had access to a GP and between 2010 and 2016, the proportion of young people aged 15 to 24 who had an Indigenous health check – that’s the MBS Item 715 – almost quadrupled from 6 per cent to 22 per cent. These are some of the encouraging results, but challenges remain.

In 2016, 42 per cent of young First Australians were not engaged in education, employment or training. Although there has been a decline in smoking rates for young people, one in three aged between 15 and 24 was still smoking daily.

Sixty-two per cent of our young people aged 10 to 24 had a longer-term health challenge such as respiratory disease, eye and vision problems, or mental health conditions. These statistics inform us, and, critically in the work we are doing, point to an evidence-based pathway forward.

I know you’ll be interested to know that the Prime Minister has now confirmed the refresh of the Closing the Gap will be considered at the next COAG meeting on 12 December.

Closing the Gap requires us to raise our sights from a focus on problems and deficits to actively supporting the full participation of Aboriginal and Torres Strait Islander people in the social and economic life of the nation. There is a need to focus on the long term and on future generations to strengthen prevention and early intervention initiatives that help build strong families and communities.

The Government has hosted 29 national roundtables from November 2017 to August 2018 in each state and territory capital city and major regional centres. We’ve also met with a significant number of stakeholders. In total, we reached more than 1200 participants. More than 170 written submissions were also received on the public discussion paper about Refresh.

The Refresh is expected to settle on 10 to 15 targets. These targets are aimed at building our strengths and successes to support intergenerational change. Existing targets on life expectancy, Year 12 enrolment, and early childhood will continue.

Action plans will set out the concrete steps each government will take to achieve the new Closing the Gap targets, and we have to hold state and territory governments to account. The plans to be developed in the first half of 2019 will be informed by the lived experience of Aboriginal and Torres Strait Islander people, community leaders, service providers, and peak bodies.

Dedicated and continuous dialogue along with meaningful engagement with Aboriginal and Torres Strait Islander people and communities is fundamental to ensuring the refreshed agenda and revised targets meets the expectations and aspirations of First Australians and the nation as a whole.

These actions will be backed by positive policy changes in both prevention and treatment, such as the introduction from tomorrow of the new Medicare Benefits Schedule item to fund delivery of remote kidney dialysis by nurses and Aboriginal and Torres Strait Islander health workers and practitioners, further improving access to dialysis on country.

The COAG health ministers in Alice Springs just recently on 3 August met with Indigenous leaders and asked for their views on a range of issues, and all of the leaders in attendance had an incredible impact on each state and territory Minister.

I know that because I attended the Ministers’ dinner later in which the discussion came to the very issues that were raised by our leaders from all over the nation.

And COAG, the next morning, made the decision that Aboriginal health will be a priority on the COAG agenda for all future meetings, and that whoever the Minister for Indigenous Health is will be ex officio on the Health Ministers’ Forum to inform and to engage in a dialogue around the key issues that were identified, not only by the leadership, but by the evidence of the work that we do; and there are six national priorities now that COAG will turn its mind to, the COAG health ministers.

Over the next decade, the Australian Government has committed $10 billion to improve the health of First Australians.

This is a substantial sum of money, but we are only going to achieve better health and wellbeing outcomes if we work and walk together. We have to build mutual trust and respect in all that we do, and I include in this every state and territory system.

We have to increase cultural capability and responsibility in all health settings and services. We must support and encourage the development of local and family-based approaches for health. As I’ve said before, we need every one of our men and women to take the lead and perpetuate our proud traditions that have kept us healthy for 65,000 years.

Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people. In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

And while they’re widely canvassing the importance of supporting the growth and potential of children and young adults, I would like to make special mention of the support required for our senior people as well, our Elders.

We must ensure that all older First Nations Australians who are eligible for age or disability support can access the care they deserve; either through the My Aged Care System or the National Disability Insurance Scheme. With a holistic grassroots approach of the Aboriginal Community Controlled Health Organisations, I believe ACCHOs should work to ensure that our older, Indigenous leaders receive assessments and support options that are available.

In August, as I indicated, I met with Indigenous leaders as part of the COAG Health Council Roundtable. Coming out of this was not only a resolution to make First Peoples health a continuing council priority, but a commitment to develop a National Aboriginal and Torres Strait Islander Health and Medical Workforce plan. I see this as being more about Aboriginal doctors, nurses and health workers working on country and in our towns and cities. It’s also about building capacity of health professionals across the entire health system to provide culturally safe services.

I was talking with Shelly Strickland some time ago, and she asked me a couple of questions, and I said to her: watch the movie Hidden Figures.

And at the time, I know she left me thinking what the hell is he talking about and why would you recommend a movie? When you look at that movie, it was about Afro-American women who put man on the moon.

The movie is based on the work of the women who gave the scientists the solutions to putting a rocket into space, landing man on the moon, and bringing them back; it was an untold story. And there are multiple layers when you look at that movie of overt racism. They were not allowed to use the same toilets as their white counterparts, they had to run two car parks away in any condition to use a toilet.

When something went wrong, people looked at them and saw them as the fault. But what they did very superbly was take their knowledge, apply science, apply the thinking that was needed, and demonstrated mathematically that man could land on the moon.

Not one NASA, non-Indigenous or non-American Afro-American had reached that solution. Those four women – I think it was four – provided the solution, but their story was never told. And they were the true leaders of space adventure and discovery. If they had not done the thinking and the tackling of the issue, then the solution would never have been reached. There are parallels in Aboriginal health.

We think of GP super clinics – they were modelled on our AMSs, about a holistic approach. There are other elements of what you do, and what we as a people do, that health systems have taken note of. But what we have to be better at is sharing where we have leadership.

I look at the work that Donna Murray is doing with Allied Health Staff – the outcomes that she achieves, they are stunning.

The work which she puts into helping make the journey a positive journey achieves outcomes that are disproportional to the work that we do as a government in many other areas in mainstream.

And we do lead – and if you haven’t seen that movie, you have to look at it and think of the parallels that our people went through. But, I think the other most salient point is, is that it was the Afro-American women who were the backbone of the space and science discovery program of America.

And I would like to acknowledge our women as well. I think the NAIDOC theme is one of the best themes I have seen in a long time; and I’ve been around a while. And I see it in health where our women play a very pivotal role and are the backbone of the frontline services that are delivered. Men always gravitate to the top; we tend to do that.

But, I do see that the actual hands-on work is done by our women, and so I thank you for that, because the progress we’ve made is because of the way in which you, like those Afro-American women, have helped shape the destiny and future. And I think of some of the people that I’ve known over the years who would be in a similar category.

And certainly, I’ll single out one because she was a great friend and taught me a lot, was Naomi Myers, whose leadership and dedication was parallel to that of the women in that movie Hidden Figures.

While the Medical Health Workforce Plan will be positive for Aboriginal Torres Islander jobs across Australia, it has particular potential for tackling chronic disease and improving the lives of our people in remote communities.

We are all well aware of the importance of health and wellbeing of our young children. There is ample evidence that investment in child and family health supports the health and development of children in the first five years; setting strong foundations for life.

And Kerry Arabena’s work certainly epitomises that along with many others. Good health and learning behaviours set in the early years continue throughout a young person’s life. Young people are more likely to remain engaged in education and make healthy choices when they’re happy, healthy and resilient, and supported by strong families and communities that have access to services and support their needs.

Connected Beginnings program is using a collective impact placed based approach to prepare children for the transition to school so they are able to learn and thrive. The program is providing children and their families with access to cohesive and coordinated support and services in their communities.

The Australian Nurse Family Partnership Program targets mothers from early pregnancy through to the child’s second birthday, and aims to improve pregnancy outcomes by helping women engage in good preventive health practices, supporting parents to improve their child’s health and development, and helping parents develop a vision for their own child’s future; including continuing education and work. Increasingly, research is also highlighting the long term value of investing in youth.

This investment benefits young people now as they become adults, and as they then have children of their own.

So I want to focus on some of the things that we are doing that is important, the take up of MBS 175, access to MBS items.

We’re improving the Practice Incentives Program, Indigenous Health Incentive which promotes best practice and culturally safe chronic disease care. We are reducing preventable chronic disease caused by poor nutrition through the EON Thriving Community programs in remote communities.

We’re tackling smoking rates through the Tackling Indigenous Smoking Program; and encouragingly, youth had the biggest drop. And we’re prioritising Aboriginal and Torres Strait Islander mental health in the first round of funding under the Million Minds Research Mission.

More broadly, for our First Australians and the wider population, we are investing in services for the one in four who experience mental illness each year.

And this also includes through Minister Hunt funding to headspace Centres, Orygen, beyondblue’s new school-based initiative BU, Digital Mental Health child, and youth mental health research and working alongside Greg has been a tremendous opportunity, because I’ve been able to get into his ear about the need for him also to consider our people in key initiatives that he launches, and he’s been a great ally.

And our work on the 10-year National Action Plan for Children’s Health continues. I want to continue setting strong foundations for making sure our people have access to culturally safe and appropriate health services.

Let me also just go quickly to the report. I had a look at the report online, and I was impressed with the way in which the writers – and FAD were in AIHW and have pulled together this one and have taken elements out of the two major better health reports.

And it was great to see our profiling, in some cases being better, in some cases being challenging. But this is a good guide for all of us to use and I commend everybody who’s been involved, and it gives me great pleasure to launch the Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report.

So, congratulations to all of those involved and congratulations to each and every one of you who have contributed to this report in the data that you provide, the work that you do but your commitment to our people. Thank you.

NACCHO Aboriginal Health and #ElderCare funding up to $46 million : Applications close on 26 Nov 2018: Donna Ah Chee CEO @CAACongress welcomes @KenWyattMP announcement of increased funding to assist Aboriginal people growing old with their families in their own communities


Improvements in Aboriginal health have more of our people living into old age than there were even a decade ago and necessitates a need to meet the increasing demand for these types of services.

Being on country as you grow old is a very strong cultural obligation for Aboriginal people and for too long our people have had to move into population centres to access services.

We now have two major recent initiatives that will help our older people stay on country. Firstly, the announcement of the new Medicare item for nurse assisted dialysis on country and now this announcement from Minister Wyatt.

This continuing connection to country is vital for the spiritual foundation and quality of life of Aboriginal people.

It is a key part of keeping our older people healthy and happy.

Our people have a very strong desire to be on country when they die and announcements like this will help to make sure that people grow old and die on country and with family. We know that social isolation is very damaging to older people’s health and this will ensure people remain socially and culturally connected.

While keeping people at home with aged care packages is a key goal there are some very successful aged care facilities on country at places like Mutitjulu. This also is important for people who need this level of care

Central Australian Aboriginal Congress (Congress) Chief Executive Officer, Donna Ah Chee, welcomes the announcement of increased funding to assist Aboriginal people growing old in a well-supported way, with their families in their own communities

Originally published Talking Aged Care 

Photos above Ken Wyatt meeting with the elders from the Yindjibarndi Aboriginal Corporation in Roebourne WA 2017

Read NACCHO Aboriginal Health and Elder Care Articles HERE

Ageing First Australians living remotely will now have increased access to residential and home aged care services close to family, home or country following an announcement by Federal Government to expand their Budget initiative – the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) program

The $105.7 million Government commitment, which will benefit more than 900 additional First Australians, is set to be expanded progressively over the next four years.

Federal Minister for Senior Australians, Aged Care and Indigenous Health Ken Wyatt announced the first round of expansion funding under the program – up to $46 million – to increase the number of home care places delivered through NATSIFAC program in remote and very remote areas.

“Aged care providers are invited to apply for funding under the expanded NATSIFAC program’s first grants round, which is designed to improve access to culturally-safe aged services in remote Aboriginal and Torres Strait Islander communities,” the Minister explains.

“The program funds service providers to provide flexible, culturally-appropriate aged care to older Aboriginal and Torres Strait Islander people close to home and community.

“Service providers can deliver a mix of residential and home care services in accordance with the needs of the community.”

Minister Wyatt reiterates the importance of home care in enabling senior Australians to receive aged care to live independently in their own homes and familiar surroundings for as long as possible, and says the initiative is all about “flexibility and stability”.

“It is improving access to aged care for older people living in remote and very remote locations, and enables more Aboriginal and Torres Strait Islander people to receive culturally-safe aged  care services close to family, home or country, rather than having to relocate hundreds of kilometres away,” he says.

“At the same time, it helps build the viability of remote aged care providers through funding certainty.”

Applicants can apply for new or additional home care places under the NATSIFAC program or approved providers can apply to convert their existing Home Care Packages, administered under the Aged Care Act 1997, to home care places under the NATSIFAC program.

Applications close on 26 November 2018 with more details about the expansion round available online.

GO ID: GO1606
Agency:Department of Health

Close Date & Time:

26-Nov-2018 2:00 pm (ACT Local Time)
Primary Category:
101001 – Aged Care

Publish Date:

4-Oct-2018

Location:

ACT, NSW, VIC, SA, WA, QLD, NT, TAS

Selection Process:

Targeted or Restricted Competitive

Description:

This Grant Opportunity is to increase the number of home care places under the NATSIFAC Program in remote and very remote Australia (geographical locations defined as Modified Monash Model (MMM) 6 and 7).

Eligibility:

To be eligible you must be one of the following:

Type A:

Existing NATSIFAC Program providers delivering services in geographical locations MMM 6-7

Type B:

Approved providers currently delivering Commonwealth funded home care services (administered under the Aged Care Act 1997) to Aboriginal and Torres Strait Islander people in geographical locations MMM 6-7, with up to 50 home care recipients per service, for conversion to the NATSIFAC Program

Type C:

Organisations not currently delivering aged care services in geographical locations MMM 6-7, however but existing infrastructure and the capability to deliver aged care services to Aboriginal and Torres Strait Islander people

Total Amount Available (AUD):

$46,000,000.00

Instructions for Lodgement:

Applications must be submitted to the Department of Health by the closing date and time.

Other Instructions:

$46 million (GST exclusive) over 4 years, 2018-2022.

 

 

NACCHO Aboriginal #Mentalhealth #SuicidePrevention and #RUOKday : If you ask #RUOK ? What do you do if someone says ‘no’? Plus Sponsorships for 10 #Indigenous young people to take participate #chatsafe campaign

R U OK Day today encouraging all of us to check in with others to see if they’re OK.

But what if someone says “no”? What should you say or do? Should you tell someone else?

What resources can you point to, and what help is available?

Read NACCHO Aboriginal Health articles over the past 6 Years

Mental Health 189 posts 

Suicide Prevention 124 Posts

Here is a guide 

Stop and listen, with curiosity and compassion

We underestimate the power of simply listening to someone else when they’re going through a rough time. You don’t need to be an expert with ten years of study in psychology to be a good listener. Here are some tips:

Listen actively. Pay attention, be present and allow the person time to speak.

Be curious. Ask about the person’s experience using open questions such as

what’s been going on lately?

you don’t seem your usual self, how are you doing/feeling?

Validate their concerns. See the situation from the person’s perspective and try not to dismiss their problems or feelings as unimportant or stupid. You can say things like

I can see you’re going through a tough time

it’s understandable to feel that way given everything you’ve been going through.

There are more examples of good phrases to use here.

Don’t try to fix the problem right now

Often our first instinct is wanting to fix the person’s problems. It hurts to see others in pain, and we can feel awkward or helpless not knowing how to help. But you don’t have to have all of the answers.

Instead of jumping into “fix it” mode right away, accept the conversation may be uncomfortable and allow the person to speak about their difficulties and experiences.

Sometimes it’s not the actual suggestion or practical help that’s most useful but giving the person a chance to talk openly about their struggles. Also, the more we understand the person’s experience, the more likely we are to be able to offer the right type of help.

Encourage them to seek help.

Ask:

how can I help?

is there something I can do for you right now?

Sometimes it’s about keeping them company (making plans to do a pleasant activity together), providing practical support (help minding their kids to give them time out), or linking them in with other health professionals.

Check whether they need urgent help

It’s possible this person is suffering more than you realise: they may be contemplating suicide or self-harm. Asking about suicidal thoughts does not worsen those thoughts, but instead can help ease distress.

It’s OK to ask them if they’re thinking about suicide, but try not to be judgemental (“you’re not thinking of doing anything stupid, are you?”). Listen to their responses without judgement, and let them know you care and you’d like to help.

Read more: How to ask someone you’re worried about if they’re thinking of suicide

There are resources and programs to help you learn how to support suicidal loved ones, and crisis support lines to call:

  • Contact the Social and Emotional team at your nearest ACCHO
  • Lifeline (24-hour crisis telephone counselling) 13 11 14
  • Suicide Callback Service 1300 659 467
  • Mental health crisis lines

If it is an emergency, or the person is at immediate risk of harm to themselves or others, call 000.

Encourage them to seek professional help

We’re fortunate to be living in Australia, with access to high quality mental health care, resources and support services. But it can be overwhelming to know what and where to seek help. You can help by pointing the person in the right direction.

The first place to seek help is the general practitioner (GP). The GP can discuss treatment options (psychological support and/or medication), provide referrals to a mental health professional or arrange access to local support groups. You can help by encouraging your friend to make an appointment with their GP.

There are great evidence-based online courses and self-help programseducational resources and free self-help workbooks that can be accessed at any time.

There are also online tools to check emotional health. These tools help indicate if a person’s stress, anxiety and depression levels are healthy or elevated.

What if they don’t want help?

People with mental health difficulties sometimes take years between first noticing the problem and seeking professional help. Research shows approximately one in three people experiencing mental health problems accesses treatment.

So even if they don’t want help now, your conversation may have started them thinking about getting help. You can try understanding what’s stopping them from seeking help and see if there’s anything you can do to help connect them to a professional. You don’t need to push this, but simply inviting the person to keep the options in mind and offering your ongoing support can be useful in the long run.

Follow up. If appropriate, organise a time to check in with the person again to see how they’re doing after your conversation. You can also let the person know you’re around and they are always welcome to have a chat with you. Knowing someone is there for you can itself be a great source of emotional support.

Read more: Five types of food to increase your psychological well-being

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.).

The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

SEE CONFERENCE WEBSITE

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.). The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at jo.robinson@orygen.org.au. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

Anyone seeking support and information about mental health can contact beyondblue on 1300 22 46 36. For information about suicide and crisis support, contact Lifeline on 13 11 14 or the Suicide Callback Service on 1300 659 467

 

NACCHO Aboriginal Health and #ElderCare : @KenWyattMP launches @genrontologyau #ATSIAAG Report : Assuring equity of access and quality outcomes for older Aboriginal peoples: What needs to be done

“This report details valuable recommendations to improve aged care access for our First Peoples and I commend the Australian Association of Gerontology and its special Aboriginal and Torres Strait Islander Ageing Advisory Group.

It highlights the importance of respect for culture, to instill confidence in older First Nations people, and I look forward to its findings helping guide the development of effective pathways to quality aged care.”

The report was launched by Minister for Aged Care and Indigenous Health Ken Wyatt at Parliament House on Wednesday.

A new report is calling for an expansion of specialist targeted services for older Aboriginal and Torres Strait Islander people and more work to embed cultural safety in mainstream care to improve the aged care system for Indigenous Australians.

Photo above : From left: Graham Aitken, Ken Wyatt, Ros Malay and James Beckford Saunders at the launch of a report focused on improving aged care access and quality for Aboriginal and Torres Strait Islander people

Download here

ASSURING EQUITY OF ACCESS FOR OLDER Aboriginal people

Elder Facts

In the 2016 Census, 649,171 people identified as Aboriginal and/or Torres Strait Islander, representing 2.8% of the population – up from 2.5% in the 2011 Census, and 2.3% in 2006.

Although the Aboriginal and Torres Strait Islander population has a much younger age profile and structure than the non-Indigenous population, the median age of Aboriginal and Torres Strait Islander people is gradually rising.

The proportion of Aboriginal and Torres Strait Islander people aged 65 years and over is only 4.8%, much smaller than for non-Indigenous people at 16%.

However, the number of Aboriginal and Torres Strait Islander people aged 55 years and over is increasing, and is projected to more than double from 59,400 in 2011 to up to 130,800 in 2026.

Aboriginal and Torres Strait Islander Elders need access to culturally appropriate services, and they generally want to be cared for in their communities where they are close to family, and where they can die on their land.

Aboriginal and Torres Strait Islander people face ongoing challenges finding services that are appropriate to their needs and circumstances, and often have problems accessing services where they exist.

Press Release

The Australian Association of Gerontology report also recommends strategies to improve the ability of the aged care workforce to provide more appropriate care, an expansion of advocacy services and a more appropriate needs assessment process.

The report was developed by the AAG’s Aboriginal and Torres Strait Islander Ageing Advisory Group (ATSIAAG) with findings from its national workshop in Perth in November 2017 that explored barriers to equity in access and outcomes in aged care for Aboriginal and Torres Strait Islander peoples.

A lack of service connectivity, the challenges vulnerable groups experience with consumer directed care and My Aged Care, high costs and gaps in policy, education and advocacy are among roadblocks to access and equity outlined in the report.

The report was launched by Minister for Aged Care and Indigenous Health Ken Wyatt at Parliament House on Wednesday.

“This report details valuable recommendations to improve aged care access for our First Peoples and I commend the Australian Association of Gerontology and its special Aboriginal and Torres Strait Islander Ageing Advisory Group,” Minister Wyatt said.

“It highlights the importance of respect for culture, to instil confidence in older First Nations people, and I look forward to its findings helping guide the development of effective pathways to quality aged care.”

ATSIAAG co-chair Graham Aitken said he was delighted Minister Wyatt gave the report the prominence it deserved.

“We are looking forward to seeing a response from government to the suggestions put forward in the report,” he said.

 

Fellow ATSIAAG co-chair Ros Malay said the report was timely given the work underway to develop an action plan for Aboriginal and Torres Strait Islander people under the Aged Care Diversity Framework, which was launched in December.

“The report has some great ideas that could be picked up in the action plan,” Ms Malay said.

The report was launched during a ATSIAAG roundtable of key stakeholders from government agencies, academia, aged care, and Aboriginal and Torres Strait Islander organisations who discussed how better data would drive improved aged care for older Aboriginal and Torres Strait Islander people.

A greater uptake of evidence from research and data to ensure greater understanding of the aged care service and support needs of older Aboriginal and Torres Strait Islander people and how they can best be met is another strategy proposed in the report.

Mr Wyatt said understanding how better data could build a better aged care system for the nation’s First Peoples was a priority for the Turnbull Government.

“Following last year’s Australian National Audit Office report into Indigenous aged care, we have taken steps to improve data,” he said.

AAG CEO James Beckford Saunders said a report from this week’s roundtable would be published within the next few months.

Access the report, Assuring equity of access and quality outcomes for older Aboriginal and Torres Strait Islander peoples: What needs to be done, here

NACCHO Aboriginal Health and Palliative Care Week @Pall_Care_Aus @RuralDoctorsAus @KenWyattMP #NPCW18 NEWS ; 1. Updated culturally appropriate version of the Dying to Talk Discussion Starter. 2. My Health Record improving outcomes for people in palliative care

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“Death is hard. It brings us grief. But I think the other side of grief is when we know that we’ve met the wishes of a loved one.

I’m impressed with the quality of thought underpinning the Dying to Talk resources, which would ease people gently into the discussions that we need to have . The resource is helpful, constructive and compassionate”.

Such was the wisdom offered by Minister for Indigenous Health, Ken Wyatt, when he launched in 2017 resources designed to help Aboriginal and Torres Strait Islander people discuss end-of-life care wishes with their families or health care teams. See Part 1 Below

Read all NACCHO Articles about Aboriginal Health and Palliative Care

Picture above : The Minister for Indigenous Health, Ken Wyatt with Palliative Care Australia CEO Liz Callaghan (left) and Congress of Aboriginal and Torres Strait Islander Nurses and Midwives CEO Janine Mohamed. Originally published 2017

 

 ” Australians are being encouraged to include My Health Record in the discussion of ‘What Matters Most?’ during National Palliative Care Week for 20 -26 May 2018

What matters most for a lot of people is being able to take control of their own health and their digital health information.

My Health Record is an online summary of your key health information, which is controlled by the individual, allowing health care providers involved in a person’s care to securely share health information. For people who require palliative care, this takes a lot of the pressure off. ”

See Part 2 Below

“Many rural and remote patients want to be able to spend the last months and weeks of their life in their own community, and ideally on their own farm or in their own home, rather than at a major hospital in a distant city” he said.

While improving access to palliative care remains a critical need in rural and remote communities, rural doctors and other rural health professionals do a great job in providing quality end-of-life care in a patient’s own community, wherever that is possible.

This whole team approach can include palliative care nurses, Aboriginal Health Workers, community nurses and others, with support from the Royal Flying Doctor Service.

Rural doctors are frequently on the front-line of palliative care provision in rural and remote communities”

Rural Doctors Assoc. of Aust. See Part 4 below

The resources include a set of cards, each printed with a statement, which healthcare workers can use to facilitate discussion with individuals or groups.

Also launched was a culturally appropriate version of the Dying to Talk Discussion Starter.

Among questions about family, possessions and health care, it asks about the importance of visiting country if you were sick and not going to get better, or being on country when you die.

Download Aboriginal-and-Torres-Strait-Islander-Discussion-Starter

Mr Wyatt congratulated the organisations that collaborated to develop the “invaluable” resources: Palliative Care Australia, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, The Indigenous Allied Health Australia and the Australian Indigenous Doctors’ Association.

“Your step-by-step guide will make those difficult discussions about death a little bit easier. It is structured, it’s succinct and it’s clear.”

During the launch, Dr Wyatt reflected on what he had learned while working as an undertaker and talking with relatives of people who had died. Often they said they had never discussed death and so didn’t know what their loved one had wanted. They wished they had had this important discussion, or taken the time to listen when their loved one had asked to talk about death.

“It was a salient experience and taught me to live life fully on a day-by-day basis, but to also have a long term plan as to where I wanted to go to. And that is why talking about death is important. Because you can signal your intentions but at the same time prepare your family for the event whenever it does occur, because we are all mortal.”

PCA CEO Liz Callaghan said the original Dying to Talk Discussion Starter was launched in 2016. The new culturally appropriate resources were developed after consultations with Indigenous health organisations that identified the need for a specific resource for Aboriginal and Torres Strait Islander people.

“The Aboriginal and Torres Strait Islander specific resources have been developed to support advance care planning and end-of-life discussions,” Ms Callaghan said.

“Focus groups were held with Aboriginal and Torres Strait Islander people to understand what barriers they had in discussing their end-of-life care wishes and planning for death. Those focus groups informed the design and content of the Discussion Starter and the Dying to Talk Cards to ensure they were culturally safe and useful.”

Development of the new resources was funded by the Australian Government. They will be distributed across Australia, to Aboriginal Health Services and Aboriginal Medical Services.

The Discussion Starter can be downloaded from http://dyingtotalk.org.au/aboriginal-torres-strait-islander-discussion-starter/.

The resources feature artwork by Indigenous artist, Allan Sumner. The artwork conveys the journey of palliative care patients over the course of their lives, reflecting memories, loved ones, what is important, and what they have done and achieved.

 Part 2 My Health Record improving outcomes for people in palliative care

Australians are being encouraged to include My Health Record in the discussion of ‘What Matters Most?’ during National Palliative Care Week for 20 -26 May.

What matters most for a lot of people is being able to take control of their own health and their digital health information. My Health Record is an online summary of your key health information, which is controlled by the individual, allowing health care providers involved in a person’s care to securely share health information. For people who require palliative care, this takes a lot of the pressure off.

While most people think palliative care to be just for those in their last days of their illness, Palliative Care Australia CEO Liz Callaghan said that palliative care is not just care provided in the final stages of life, but helps those affected to live well with a terminal illness.

“People accessing palliative care services often have complex needs and their care team includes many health professionals including pharmacists, doctors, nurses, and allied health professionals. My Health Record makes it easier for those professionals to share information about medications, test results, and care plans.

“Australians can also share their advance care planning documents through their My Health record, ensuring all health professionals know what their wishes for their future care are,” Ms Callaghan said.

Agency Chief Clinical Information Officer and Executive General Manager Dr Monica Trujillo said palliative care is for people of any age who have been told that they have a serious illness that cannot be cured; it’s about assisting in managing symptoms and improving quality of life.

“For some people, palliative care may be beneficial from the time of diagnosis with a serious life-limiting illness. Palliative care can be given alongside treatments given by doctors and members of the treating team. Having a My Health Record means all medical practitioners and treating team can be kept up to date.

My Health Record can enable important health information including allergies, medical conditions, medicines, pathology and imaging reports to be accessed through one system. The benefits could include reduced hospital admissions, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions,” Dr Trujillo said.

Carers Australia CEO Ara Cresswell said My Health Record can also assist with carers or loved ones who want to assist the patient going through palliative care.

“My Health Record can lessen the stress of having to remember details of the diagnoses and treatments of others, and help prevent adverse medication events. The ability to upload the patient’s end-of-life preferences can also lessen the distress of those forced into making very difficult decisions on behalf of a family member not able to communicate their own wishes.”

A My Health Record will be created for every Australian, unless they choose not to have one. The opt out period will run from 16 July to 15 October 2018. Records will then be created for interested Australians by the end of the year.

For further information visit http://www.myhealthrecord.gov.au or call 1800 723 471

Part 3 Dying on Country

 Part 4 Rural Aussies urged to talk end-of-life care
with their doctor and families
National Palliative Care Week – 20-26 May 2018

 

While it may seem like a confronting conversation to have, the Rural Doctors Association of Australia (RDAA) is urging rural and remote Australians to take the time to discuss with their local doctor and family how they want to be looked after towards the end of their life.

Speaking during National Palliative Care Week 2018, RDAA President, Dr Adam Coltzau, said talking about end-of-life care now can help ensure patients are better able to have the palliative care journey they choose, rather than have it decided by others.

“Many rural and remote patients want to be able to spend the last months and weeks of their life in their own community, and ideally on their own farm or in their own home, rather than at a major hospital in a distant city” he said.

“While improving access to palliative care remains a critical need in rural and remote communities, rural doctors and other rural health professionals do a great job in providing quality end-of-life care in a patient’s own community, wherever that is possible.

“This whole team approach can include palliative care nurses, Aboriginal Health Workers, community nurses and others, with support from the Royal Flying Doctor Service.

“Rural doctors are frequently on the front-line of palliative care provision in rural and remote communities. They provide care for patients throughout the trajectory of their disease and then, as the doctor at the local hospital, aged care facility or hospice, they often also provide care right through to the end of life.

“A number of welcome new initiatives will make it even easier for rural patients to stay in their community towards the end of their life.

“The increased use of telehealth – where a rural patient and their GP can consult via videolink with relevant specialists, who may be in a distant city location – can greatly reduce the need for seriously ill rural patients to travel from their community for medical care.

“For patients with life-limiting conditions, often the last thing they want to be doing is commuting back and forth to a distant city for medical appointments, which can affect both their physical and mental well-being.

“The other important step forward is the development of the National Rural Generalist Pathway, which will deliver more of the next generation of rural doctors with advanced skills training in a wide range of areas including palliative care.

“Dealing with death and dying is difficult, but it is an important conversation to have with your family and your doctor if you are suffering from a life-limiting condition.

“Palliative care patients deserve to have a high level of care available to them within their local community, and planning for this can reduce stress on both the patient and their loved ones as their condition progresses.

“Talk to your doctor about the options available to you, and put a plan in place early to ensure your needs will be met.”

NACCHO Aboriginal Health #CloseTheGap #Elders #Agedcare #Diversity framework : Online Survey to assist developing an Action Plan for Aboriginal and Torres Strait Islanders #Agedcare @IUIH_ @VACCHO_org

 ” There are more than 100,000 older people from Aboriginal and Torres Strait Islanders, communities in Australia, who often have health care and support needs that differ from those of other older Australians.”

Australia ‘s aged care system is changing.

To have your say on the aged care needs of our Aboriginal and Torres Strait Islander communities, go to

www.surveymonkey.com/r/IUHAgedcare.

  • Making informed choices
  • Adopting systemic approaches to planning and implementation
  • Accessible care and support
  • Supporting a proactive and flexible system
  • Respectful and inclusive services
  • Meeting the needs of the most vulnerable

Priority outcomes specified in the Aged Care Framework, launched in Canberra by The Hon Ken Wyatt AM MP, Minister for Aged Care and Minister for Indigenous Health.

Before this study people were aware of the impact of social disadvantage and poverty on poorer mental health in older Aboriginal people, but we didn’t really appreciate the important role that living with chronic illness and physical disability has in driving these mental health problems,”

The Baker Heart and Diabetes Institute’s Dr Sandra Eades said the results should influence the Federal Government’s redesign of its Close the Gap targets. See Article in full Part 2

Read previous NACCHO Aged Elder Care articles HERE

Part 1 Survey Developing an Action Plan for Aboriginal and Torres Strait islanders aged care

Australia is a diverse nation, and older people display the same diversity of characteristics and life experiences as the broader population.

Our aged care systems is evolving to offer increased choice and control for consumers, and this transition to person centred care requires care to be tailored to meet an individual’s diverse needs.

To help ensure these needs are appropriately met, the Australian Government have announced an Aged Care Diversity Strategy Framework, which will include implementation Action Plans for Culturally and Linguistically Diverse communities, Lesbian, Gay, Bisexual and Trans and /or Intersex and Aboriginal and Torres Strait islander Australians.

The Institute for Urban Indigenous Health (UIH) has been funded to lead the Action Plan for Aboriginal and Torres Strait Islanders, in collaboration with the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), and we need your help!

Have your say

To ensure appropriate input from all stakeholders, an online survey has been developed and interviews will be held throughout the country.

We want to hear from you, if you are:

  • a consumer of aged care services, or the family member, carer or representative of one;
  • an aged care provider;
  • a peak organisation or representative group

What do we want to achieve?

It is expected that the project will deliver three significant outcomes:

  • a proposed Action Plan for Aboriginal and Torres Strait Islander Aged Care that will be an integral part of the national Aged Care Diversity Framework
  • a detailed consultation report that will inform local issues as well as national priorities and the development of the action plan
  • identified evidence based best practice for aged care service delivery to Indigenous communities based on a comprehensive literature review.

To have your say on the aged care needs of our Aboriginal and Torres Strait Islander communities, go to

www.surveymonkey.com/r/IUHAgedcare.

The online survey will be open until 26 February, 2018

Part 2

Resources for Aboriginal and Torres Strait Islander people

The Australian Government’s My Aged Care phone line and website can help you access aged care services to support you.

Download HERE

Part 3 Older Indigenous Australians with illness or disability at high risk of depression, study finds

By national Indigenous affairs correspondent Bridget Brennan and Specialist Reporting Team’s Naomi Selvaratnam

For the first time there’s evidence that disability, renal failure and diabetes are causing high levels of psychological distress in older Indigenous Australians.

Key points:

  • Half of all Aboriginal people with chronic illness or a disability have mental health problems, study finds
  • Expert says policy changes are needed to improve the health and life expectancy of Indigenous community
  • There’s also calls for an overhaul of the NDIS to better accommodate Indigenous people

The Baker Heart and Diabetes Institute’s Dr Sandra Eades said the results should influence the Federal Government’s redesign of its Close the Gap targets.

“Before this study people were aware of the impact of social disadvantage and poverty on poorer mental health in older Aboriginal people, but we didn’t really appreciate the important role that living with chronic illness and physical disability has in driving these mental health problems,”

Dr Eades said.In the month before completing an interview for the study, a fifth of Indigenous patients aged 45 or over had experienced anxiety and depression requiring professional help, as well as feelings of restlessness and hopelessness.

“We would say it would be exceptional for an Aboriginal person with disability not to have experienced anxiety or post-traumatic stress disorder.

Physical health impacts mental health

“Physical health impacts on mental health. It really highlights the need for the importance of the refresh of the Closing the Gap targets,” Dr Eades said.

“The Aboriginal share of the NDIS is between $1.6 billion and $2 billion, so that’s indicative of how much unmet need there is out there,” he said.

He added that many rural Indigenous communities require greater funding to care for those people living with disabilities.”So this requires a greater investment in communities so that people can support themselves, like it was always done in the past.”

“There are Aboriginal people that provide very good, high-quality care for their community members with disabilities, but what’s lacking often is the resources for them to be able to do that in a more substantive way,” Mr Griffis said.

“But there’s really no money being spent of any great note in this area, despite the urgent need.”

Mr Griffis has called for an overhaul of the National Disability Insurance Scheme (NDIS) to better accommodate Indigenous people.

Dr Eades urged the federal and state governments to put a “stronger focus on [Indigenous] mental health in the next 10 years”.

“If you don’t have an opportunity to participate both in your community, and in the wider community, then naturally that can lead you to feel very depressed and very down.”

“They feel marginalised and they feel at the edges and periphery of society,” said Damian Griffis, the chief executive of First Peoples Disability Network Australia.

Australians with severe physical limitations are more prone to being highly distressed, but that is especially a risk for Aboriginal people, the study said.

The policy to improve the life expectancy of the Indigenous community is being reviewed, because it has seen little success so far.

New research by the Baker Heart and Diabetes Institute shows this is the case for half of all Aboriginal people suffering from significant health problems.

Aboriginal Health and #Respectourelders @KenWyattMP Launching education for aged care facilities cultural considerations caring for elders

 

Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People is an important program which will help address the fundamental need for culturally appropriate care for Aboriginal people, some who may need to use aged care services at an earlier stage of their lives

Programs like this are a vital part of ensuring the care of senior Indigenous people is as culturally continuous as possible”

Minister for Aged Care and Indigenous Health Ken Wyatt has welcomed the new course, which coincides with his announcement of a new North West Ageing and Aged Care Strategy which aims to create age-friendly communities across the Pilbara and the Kimberley, while encouraging more seniors support services and greater local employment in aged care.

Photos above Ken Wyatt meeting with the elders from the Yindjibarndi Aboriginal Corporation in Roebourne WA\.

The launch of Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People will be streamed live via the Aged Care Channel at 10.45am AEDT on 22 November with Aboriginal Elder Mr Elliot taking part in answering live questions from members.

Developed by the Aged Care Channel (ACC) in partnership with the Department of Health, the Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People course aims to help inform aged care facilities across Australia of the cultural considerations of caring for Indigenous Australians.

ACC Group Manager Content and Production, Steve Iliffe says the program took six months to put together with the help of research, lots of resources, government input and guidance of Indigenous people as well as visits to different aged care facilities in Pilbara and northern Adelaide.

“We thought it was an important program to do because Indigenous Australians do have a series of complex needs different to the rest of the population due to their history and access to health in areas,” he explains.

“They have a connection to the land, a connection to their family and want to still have access to bush tucker and do things that they traditionally do.

“We went out to a number of different aged care facilities to talk to the people there about what they do to provide tailored care.”

ACC Learning and Development Manager Nicola Burton says providing culturally-appropriate care is a crucial part of the person-centred approach.

“The goal of this program is to recognise how to respond to the cultural needs of Indigenous Australians receiving care,” she says.

“There are significant regional differences between Aboriginal and Torres Strait Islander groups, each with complex and diverse ways of life.

“Language, music and art vary in each area, but a connection with culture, community and the land seems to be common to all Aboriginal and Torres Strait Islander people.”

While working of the course and program, the ACC team spoke to and sought the advice of subject matter expert Ngarrindjeri elder and Chair of the Aboriginal and Torres Strait Islander Ageing Advisory Group Mark Elliott.

“It was important for us to work with an indigenous leader – he guided us through the process and the research,” Mr Iliffe says.

“With this new course, we hope that we can increase understanding between cultures because at the end of the day, it’s about creating a home for people in aged care and providing them with a life they are still living.”

The new Strategy announced by the Minister includes short, medium and long-term goals, from the engagement and inclusion of seniors in local communities, through to tailored home and residential care support.

“[Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People] is an important program which will help address the fundamental need for culturally appropriate care for Aboriginal people, some who may need to use aged care services at an earlier stage of their lives,” Minister Wyatt says.

“Programs like this are a vital part of ensuring the care of senior Indigenous people is as culturally continuous as possible.

“It will contribute to this goal by helping staff understand the impact of historical events and past government policies, along with broadening their appreciation of Indigenous culture and the health challenges faced by some people.

“Giving staff these insights can contribute to better care, and I encourage everyone involved in indigenous aged care to take the course.”

He adds that the aim of the North West Ageing and Aged Care Strategy is to foster quality and culturally relevant residential aged care facilities that allow people to stay connected to community and age safely with dignity.

“Hopefully the new course will contribute to achieving this outcome,” he says.

“The program showcases the Pilbara’s Yaandina residential aged care facility, whose staff are experienced in providing residents with culturally sensitive care.”

Mr Iliffe says the result of the research and creation of the program is close to the hearts of all involved.

“The people involved had the most amazing time and it is something they will cherish forever,” he says.

“These experiences help us more closer to closing the gap.”

The launch of Caring for Indigenous Australians: Aboriginal and Torres Strait Islander People will be streamed live via the Aged Care Channel at 10.45am AEDT on 22 November with Aboriginal Elder Mr Elliot taking part in answering live questions from members.