Janelle McFarlane, Hall & Prior Health & Aged Care Organisation, Australia
Western Australia has unique cultural and geographical considerations when delivering aged care to indigenous communities. Aboriginal Australian’s are part of the oldest living culture that is more than 40,000 years old. Western Australia is so isolated that in 1984 the last nomadic desert dwelling family learned of the European arrival, 200 years earlier. They were unaware of the hardships their people had endured, such as the forced removal of children, now called the Stolen Generation in Australia.
Intergenerational trauma and ongoing injustices have contributed to some Aboriginal Australians experiencing poor health outcomes and at risk of premature ageing.
Residential aged care is often a difficult choice for Aboriginal elders because it can involve forced separation from ‘Country’. Aboriginal Australians view Country as family, culture and identity. Never returning to Country can cause existential crises and compound past trauma. Through establishing an Aboriginal Health Program, our service has been able to support the cultural sensitivities around kinship, Country and institutional distrust. The Aboriginal Health program employs indigenous workers and has enjoyed excellent social and health outcomes, including returning over 40 people back to Country. Our residential care staff endeavour to overcome some of the challenges of intergenerational trauma, whilst respecting kinship laws and building trust to improve the likelihood of accessing health care services in the future.
Most Aboriginal Australians do not access residential aged care through choice. When they do access residential aged care, it is rarely on Country. Given that Western Australia is four times the size of Texas and only has a population of 2.6 million people, it can be difficult for people to receive home based community care. Community based nursing care is particularly challenging if home is 8 hours’ drive to the nearest hospital. The Aboriginal Health Program is operated out of a residential aged care service in Perth and aims to stabilise resident’s health and then takes the approach of establishing referral and support networks back on Country. Ongoing support can often overcome past challenges to ensure that trauma informed, spiritually and culturally safe care can be undertaken on Country.
The program is now in its second decade and there have been considerable learnings and by sharing these, we hope to provoke thought and conversations around best practice cultural care in residential aged care environments.