Culturally respectful and safe dementia care

Everyone involved in optimising the health and wellbeing of older Aboriginal and Torres Strait Islander peoples (from now on referred to with respect as Aboriginal people) needs to know of the work of the Royal Commission into Aged Care Quality and Safety. This Royal Commission has highlighted the need for older Aboriginal people to receive culturally respectful and safe, high-quality, trauma-informed, needs-based and flexible services regardless of where they live – and to receive such services from people who are appropriately educated and trained.

The Royal Commission’s recommendations come from understanding that older Aboriginal people are at greater risk for dementia, disability, food insecurity and psychological distress, and that many have difficulty accessing and receiving culturally respectful and safe health care.

We know that the number of older Aboriginal people is increasing rapidly, impacting the need for culturally appropriate health and aged-care services in regional, rural and remote areas, as well as in urban areas. We also know that, while older Aboriginal people prefer aged care provided by Aboriginal services, the capacity of existing services is limited. Mainstream home, community or residential care for older Aboriginal people is only available from 120 aged care organisations across Australia and primarily from non-Aboriginal healthcare staff.

While we wait for the Aboriginal community-controlled sector to be adequately resourced and supported, it is important to educate non-Aboriginal healthcare providers about culturally respectful and safe care for Aboriginal people with dementia. We must also change the conversation from a focus on deficit to one based on strength, resilience and holistic approaches.

We have begun nationally funded work to address this issue. Our work is founded upon four published initiatives that have been developed by and for Aboriginal people: the Good Spirit, Good Life quality-of-life framework and assessment package; the online Caring for Spirit program; Let’s CHAT (Community Health Approaches To) Dementia in Aboriginal and Torres Strait Islander Communities and Aboriginal women learning on Country.

Our new work is guided by Aboriginal Elders from lutruwita (Tasmania), the Koori regions of Victoria and New South Wales, and the Noongar Country of Western Australia. Working together, we are co-creating, co-delivering and measuring the impact of a 12-week online university unit where content, delivery and assessment privilege the spirit, voices and culture of Aboriginal people.

This unit, commencing in 2024, is part of the tuition-free online Diploma of Dementia Care, offered by the Wicking Dementia Research and Education Centre at the University of Tasmania. The online offering of this innovative diploma makes it readily accessible for people in rural, regional and remote areas who want to learn about dementia and provide culturally respectful and safe support to improve health care for Aboriginal people.

After the online unit has been offered and evaluated, we will scale up the most impactful content for nationwide availability through a co-created, free massive open online course (MOOC). Through the online unit, diploma and MOOC, we can contribute to reducing the many challenges Australia’s Aboriginal people face related to their health and wellbeing – and highlight how non-Aboriginal healthcare professionals can provide culturally respectful, safe and holistic care that recognises and builds upon Aboriginal people’s strength and resilience.