Reshaping aged care in an age of increasing diversity

The Australian population is getting older and living longer, as well as becoming more culturally and linguistically diverse than ever before. This diversity needs to be kept in mind as Australia’s aged care system is reshaped in the wake of the ‘Final report of the Aged Care Taskforce’, writes CATH SCARTH, CEO of AMES Australia.

Nowadays, around one in five Australians over 65 were born overseas and one-third have at least one parent born overseas.

In 2022, 40,000 Australians from diverse cultural backgrounds were in some form of aged care and this number is expected to grow to 160,000 in the next 30 years, according to the Scanlon Foundation.

The Foundation also states that around 28% of people using home care were from multicultural backgrounds, although the Australian Institute of Health and Welfare (AIHW) suggests this proportion may be even higher.

Since 2020–21, across all mainstream aged care services, about 33% of people were born overseas — of whom 66% were born in non-English-speaking countries. These figures paint a picture of the rich tapestry of cultural backgrounds among aged people in Australia — a cohort which is projected to nearly double by 2025.

Catering to diverse cultural backgrounds

This evolving cultural and linguistic landscape of Australia’s aging population is becoming a critical consideration for aged care providers. Projections highlight the need for aged care services to adapt and increasingly cater to the nuanced needs of CALD communities.

A significant proportion of aged care users — particularly those over 65 who were born overseas — may face language barriers, with less than one-third speaking English proficiently, according to data from the AIHW. In addition, people from non-English-speaking backgrounds often revert to their first language as they age.

But the challenges faced by individuals from CALD backgrounds extend beyond language barriers.

Limited digital literacy, smaller social networks and historical experiences of marginalisation can contribute to feelings of loneliness and isolation among these populations, exacerbating the complexities of aging.

Indigenous Australians also confront unique challenges stemming from historical trauma, cultural disparities and geographical isolation, which impede their access to and engagement with aged care services.

These issues can affect the ability of older adults to access and engage with essential support and services that can improve their quality of life and contribute to generally better outcomes.

Dementia on the rise

Leaving aside issues around cultural diversity, the prevalence of dementia and cognitive impairment among elderly populations also significantly impacts aged care needs.

Dementia not only affects cognitive function but also requires specialised care and support tailored to individual needs.

From memory loss to difficulties with communication and daily activities, dementia can profoundly affect an individual’s ability to live independently, necessitating comprehensive and person-centred aged care services.

As Australia’s population ages, addressing the unique needs of individuals living with dementia and cognitive impairment becomes increasingly crucial for ensuring quality aged care provision and enhancing the wellbeing of older adults across diverse communities.

For example, AMES Australia recently met with ‘Ellie’, an elderly migrant women who was beset by dementia. She was reverting to first language, struggling to look after herself and hadn’t left the home she shared with her son for five years.

AMES Australia was able to match Ellie with a carer who had appropriate language skills, and set up a care plan. Six weeks later, Ellie was again able to access community services and attend a Christmas party.

Ellie’s case shows that understanding the nuanced demographics and needs of aging populations within service areas is imperative for delivering tailored, relevant and sensitive aged care assessments.

Customising care

Across Australia, regions exhibit distinct demographic compositions and care requirements, necessitating customised approaches to service provision.

For instance, regions within Victoria reveal varying proportions of CALD populations, ranging from higher concentrations in some places to significant Indigenous representation in others.

Looking at this data, it’s obvious that Australia’s aged care needs are multifaceted and dynamic, requiring a paradigm shift towards culturally competent and community-centric, client-led care models.

The experience AMES Australia has had working with multicultural communities across the country demonstrates that culturally competent communication is the first step in removing some of the difficulties and barriers.

Including members of CALD communities within the aged care workforce, while also providing cultural competency training and resources to all of the work force, is also a step in the right direction.

Adopting an aged care framework that recognises that individuals flourish when they are connected to family, to co-ethnic groups and to the broader community provides a significant opportunity to improve the wellbeing and outcomes of older Australians from non-European-Australian backgrounds.

By embracing diversity as a cornerstone of aged care provision and by fostering inclusive and responsive services, Australia can navigate the complexities of an aging population while honouring the diverse cultural identities and experiences of its older citizens.

Cath Scarth is the CEO of AMES Australia, a migrant and refugee settlement agency supporting both aged and disabled people who are new to Australia. Cath has worked in the settlement and humanitarian sector for more than 20 years in Australia and the UK designing, implementing and overseeing a wide range of innovative social programs and enterprises.

Image credit: iStock.com/FG Trade