With new standards in the aged care industry coming into effect this week, Australian service providers are being urged to improve the level of care they offer to those from culturally diverse backgrounds.
When 87-year-old Perth woman Nevena Kotur was diagnosed with Alzheimer’s disease, her family decided not to place her in a residential aged care facility.
Their concern was that as her condition worsened, the Serbian-speaking grandmother would be unable to communicate in English with aged care workers.
“These days the little English she did know, it’s gone completely,” her grandson Ozzie Kotur told SBS News.
“I don’t think somebody could care for her without knowing her language. It’s not possible in this situation.”
Mrs Kotur previously spoke enough English to get by in Australia, but like many seniors from migrant backgrounds, she reverted to her native Serbian as the symptoms of dementia worsened.
University student Ozzie is now her full-time carer.
“It’s vital. I think [speaking Serbian] is the most important thing,” Mr Kotur said.
“That’s another reason I have to be here … If a personal care lady comes who doesn’t speak Serbian, there’s no way she is going to be able to do her job.
“You recognise within half an hour, [my grandmother] gets a different look on her face and doesn’t seem all there. Her demeanour changes, she doesn’t know what’s going on.”
It’s a problem that many Australian families have to deal with.
Marija Popovic placed her father Antun into residential care after he was diagnosed with Lewy body dementia - the second most common type of progressive dementia after Alzheimer's.
She thought he would receive the best available care, but Ms Popovic says her father’s condition rapidly deteriorated in the Perth facility.
“When he went there he was still able to speak, he was continent, he had some symptoms but he was lucid a lot of the times,” she said.
“But very quickly, he started deteriorating. He was classed as incontinent completely.
Mr Andrijich died soon after, and Ms Popovic believes not being able to communicate with staff was a contributing factor in his declining health.
“He would be telling them he needed to go to the toilet, but they didn’t understand him because he was speaking Croatian,” she said.
“I kept saying, ‘he can’t understand you, he has dementia’. I made up cards with words and things, so he could say when he needed the toilet.
“In my experience, there’s definitely less care for [non-English speakers], no matter where they come from.
“There are a lot of staff out there wanting to do the right thing, but they just can’t give them the time to understand them.”
New charter of rights
From 1 July, Australia will have a new set of standards governing the provision of aged care services.
The ‘Aged Care Quality Standards’ outline eight areas of care that Commonwealth-funded services will be assessed on.
It’s an important step for a sector seeking to boost public confidence, after a litany of failures outlined by the ongoing royal commission into aged care. But for those working in culturally appropriate care, it’s also an opportunity to focus attention on the special needs of non-English speaking Australians.
“In the new standards that are not only being introduced but will be assessed and monitored, one of them is ensuring that people are receiving culturally appropriate services, including languages,” said Fortis Consulting national director Mary Gurgone, whose consultancy was involved in developing the charter.
“If an aged care resident can’t communicate, not only does that impact the level of care being provided, in due course that leaves the person increasingly isolated.
“And isolation, as we know, is the biggest killer of people aged over 65.”
If an aged care resident can’t communicate ... in due course that leaves the person increasingly isolated.
The Australian government has already funded cultural awareness training to aged care providers, but those commissioned to provide the training say their services often go under the radar.
“That training is fundamentally important, as is an understanding of when to use interpreters and translators,” Ms Gurgone said.
“The Department of Health does provide the Partners in Culturally Appropriate Care program … people can get support for training their staff.
“Unfortunately it’s not always known, but in every state and territory around the country there is someone like us who can find support to provide the right care for people from other cultures.”
Finding a way forward
While much of the royal commission has focused on the absence of culturally-appropriate aged care, there are some positive signs that the industry is changing.
In Perth’s northern suburbs, the MYVISTA aged care facility has created a home environment for seniors from minority backgrounds, prioritising language as a way to curb isolation.
“MYVISTA started out providing residential aged care services for seniors from a southern European background,” its CEO Irene Mooney said.
“By bringing those communities into a care facility, it enabled them to create a community within the community. The residents and their families enhance that care, provide language and communication, prevent isolation and keep them connected with their culture.”
MYVISTA employs staff from a range of different cultural and ethnic backgrounds, identifying aged care workers with specific language skills that meet the needs of residents.
“Where the staff need to specifically to speak to a resident who is non-English speaking, they will engage a staff member that we have in the service that can speak that language,” Ms Mooney said.
“But we also encourage the community and the resident’s family to come in and share in those conversations and prevent that isolation and prevent people not being heard and understood.”
Aged care worker Stanka Cica has worked at MYVISTA for 16 years, after migrating to Australia from the former-Yugoslavia in 1998 with her husband two children and a single suitcase.
“I was a registered nurse in my country – I started here in Australia as a cleaner, then after I did my certificates in aged care,” she said.
Ms Cica speaks five languages, regularly conversing in Italian, German and Macedonian with the residents in her care.
“If we need any other languages, we just need to let a colleague know. We can provide appropriate staff who speak the same language, and the residents are always happy.
“Plus we have volunteers from outside who speak all languages, we connect with the ethnic community groups to come in for lunches and social functions.”
Ms Cica said she is dismayed by negative portrayals of aged care workers in the media, but was confident her organisation’s commitment to the new standards would create change for the better.
“When we see on TV that its happened, we are always sad to see,” Ms Cica said.
“We are doing best that we can do. There is always space to improve, and we have beautiful cooperation with family members. If there is any issue that they report, our management fixes it”.
“If you fix a problem when it is small, it will never grow up.”