Chen Li, a 98-year-old resident of the On Luck aged care facility, feels fortunate to call this unique community home. On Luck, based in Victoria, is the first and largest community-run, nonprofit aged care home. It’s made specifically for old Chinese people. After a short time in a mainstream aged care facility, Chen felt she needed to be in a more culturally sensitive place. That yearning drove her to make the move to On Luck.
Victoria has only three culturally-specific aged care facilities for the Chinese community. Combined, the two centers provide 200 beds, with a heavy emphasis on low to medium-level care. This shortage raises an issue that has increasingly come to the fore — that of whether aged care services are meeting the needs of multicultural communities. According to the Australian Bureau of Statistics, this proportion exceeded one in six Australians in 2022. This startling statistic represents the increasing population of older adults across the country. Today the need for culturally appropriate, holistic, patient-centered care is clearer than ever.
Challenges in Mainstream Aged Care Facilities
Duru Khubchandani’s story illustrates some of the challenges that seniors from culturally and linguistically diverse (CALD) backgrounds face. Her mother, Guri Nankani, experienced extreme difficulties in conventional aged care environments. Not surprisingly then, Christmas was not a holiday that Guri, a Hindu, celebrated. Unfortunately, this made it difficult for her to engage in activities that were based in Western cultural traditions. These typical offerings, like Sunday worship services and Christmas events, left her feeling excluded from the community.
Guri had a difficult time with meal options offered by the institution. When she did find non-meat meals, they were frequently tasteless and strange to her taste buds. Duru expressed her frustration, stating, “We felt that if there was one [aged care home] with [people from] the same community, maybe she would have felt more comfortable.” For many families, including mine, that sentiment does not usually lead to the elders in our lives any kind of culturally relevant caring.
Chen Li’s experience at On Luck contrasts sharply with Guri’s struggles. She enjoys meals that reflect her cultural background and stated, “First, I don’t speak English. Second, the food here suits me better.” She eats my mom’s luscious breakfast of Chinese sausage buns and Chinese steamed egg. These inherited dishes of familiar notes are grounding for her but visceral and liberating… .
Gaps in Culturally Appropriate Aged Care
Worries about the absence of culturally suitable aged care homes go further than anecdotal tales. A final key point made by Professor Lee-Fay Low is that older people from these communities often come into residential aged care facilities needing higher-level care for daily living tasks, behavioral issues, and higher level needs. Evidence suggests many older Australians from multicultural communities are reluctant to transition into aged care homes. They fail to act, only doing so when all else fails.
Lisa Ward, a leader in aged care research, raised the most important point. She illustrated the extreme lack of service provision that exists for CALD communities. “There’s no data in this space at all. We certainly know that there is a gap,” she noted. This lack of information severely hinders the ability for advocates and the public to grasp the full scope of the problem.
Ward further elaborated on the implications of language barriers, saying, “If they cannot communicate in their language, they suffer even more.” Without culturally specific training for staff, these challenges can be further intensified. Dr Wong has slammed the new Aged Care Act 2024, due to come into force on November 1. He emphasized that the guidance on providing services to multicultural residents is unclear and leaves them without actionable assistance.
Government Initiatives and Future Considerations
The Australian government has risen to the occasion to meet these challenges. To help increase access to aged care services for rural and remote, as well as culturally diverse, communities, they designated $600 million in grants. Advocates like Dr. Wong argue that without specific funding and practical measures addressing CALD needs from the start, these initiatives may fall short.
Dr. Wong stated, “So, you feel that the government seems to have the intention, but in reality, it has not translated this into funding or practical support to actually help you.” We need to think about cultural needs in policy frameworks starting today. If we fail to, all of these inequities will be ignored for years to come.
Lisa Ward, with the Los Angeles County Department of Public Health, stressed the need to create a culture where different backgrounds are honored and served. “This is their home ultimately. And this is where they should feel safe and secure and supported in the most vulnerable time of their life,” she remarked. She recognised that for many people from CALD communities, they don’t feel welcomed in these current facilities. “Unfortunately, too often … they don’t feel welcome,” she added.
