As aged care professionals, we set the tone in inclusive aged care and palliative care settings. Whether caring for people in facilities or the home, how we react, respond and articulate our approach makes all the difference.
Championing truly inclusive aged care and palliative care is as much about policy as it is about attitude.
Here’s a guide to championing inclusive aged care and palliative care in a meaningful way
Understand the history of exclusion
There are real reasons why the LGBT, Indigenous and Disability communities may feel reluctance about care institutions and institutionalised settings. After a lifetime of facing everything from policies to physical barriers that have made their entry to places non-marginalised people take for granted, palliative care and aged care can be confronting concepts.
We’re talking about people who have been through their entire lives in school, work and life where their identity has been a barrier to acceptance. In many instances, the legal and medical systems have not been fit-for-purpose. It’s difficult when you don’t feel as though you can openly talk about your health, mental health or cultural considerations and relationships.
As practitioners in inclusive aged care and palliative care, we have to recognise that many members of marginalised communities have faced abuse when they have sought protection. They’ve faced denial of their Aboriginality, sexuality, and even their personhood as a person with disability or as Transgender.
It’s incredibly hard to walk back several decades of mistreatment and suddenly trust the system again.
Recognising this fact is part and parcel of building meaningful inclusion strategies. We’re not talking about past events. These are people who have experienced exclusion in their lifetime. And are likely to have continually experienced it throughout various life-cycles.
This is a situation that requires deep thought and reflection – as well as meaningful, well-informed and culturally appropriate action.
Exclusion informs behaviour
We’re all informed by the things we experience. We all have emotional, physical and intellectual responses and reactions that guide us in daily life. Addressing exclusion and creating inclusive aged care and palliative care policies and procedures is no different.
To address exclusion, we need to understand how exclusion has influenced people’s responses and reactions.
Some of the ways exclusion informs your approach is to consider:
Safety must be assured repeatedly
Marginalised communities often feel a lower sense of safety and greater chance of a loss of autonomy upon entry into many forms of healthcare. Aged care and palliative care are no different. Being able to not only promote messages that directly address these fears but also having a consistent level of service and policy that doesn’t reinvite these fears to resurface is paramount.
And this includes but is not limited to understanding mental health impacts as well as trauma-informed decision-making.
Trust is earned over time
It is not as easy as showing up to share information and invite people to take part in your services. You may have to revisit specific communities over and over again to be heard. And your actions will always speak louder than your words.
Trust is a process of building brick by brick. Instead of thinking it is a conversation over a cup of tea, it is about being there weekly for a tea party.
Fear of discrimination isn’t only about the client
Before anyone enters the aged care and palliative care systems as an individual, they have likely experienced it as a visitor. How people are treated as they care for their family, friends and loved ones makes a strong impression.
Remember, you are already informing a person’s decision-making in how you treat them as a guest.
Would you want to return each week or month to a place that made you feel unwanted? No? Then how can you make the day-to-day experience less confronting?
Control is key to empowering clients
Many marginalised communities have faced times in their life where policy was forced upon them.
Intersex people have a history of a history of non-consensual medical intervention. This is shared across some sectors of disability and Indigenous community.
Many within the Disability and Indigenous community faced partial or full removal of their persons from their family in the same of care provision.
While attitudes and approaches have changed, the scars remain.
Creating policies where clients maintain as much control over their care and healthcare decisions is essential. And it has to be central to the inclusive aged care and palliative care experience.
Understand that ‘next of kin’ can be a tricky concept
LGBTI, Indigenous and Disability community members may not have the clear-cut path to family. There may be issues of rejection, ostracisation and even forced removal to navigate.
‘Family’ may mean a grouping of people not related by blood. Or it may mean an extended and expansive array of people involved in the aged care or palliative care journey.
Ensuring you don’t have policies and procedures that dismiss the individual’s version of ‘next of kin’ or ‘family’ and/or make them choose and potentially alienated people within larger family make-ups is part and parcel of cultural sensitivity and the bedrock of inclusive aged care and palliative care.
Be visible in our support
A truly inclusive aged care and palliative care is a process of building trust. You can’t hold a digital webinar or promote an Inclusion Day and expect it will all be OK. Recognise that training and education consist of two streams. Both staff and your intended clients have barriers to understanding inclusive palliative care and aged care.
This means you have to make sure your aged care facility is:
- Transparent about your policies and how they address the concerns of and cater to the LGBT, Indigenous, Person of Colour and Disability communities
- Accessible in the true sense of the word. And that includes having a website and centre that is accessible for people with disabilities. Or that carries an acknowledgement to country. And one that proudly wears their certification in the appropriate training for all to see
- Actively engaged with different communities. This means exploring meaningful activities as part of inclusion, pride and community building within your aged care facilities
- Facilitating advance care planning through places that understand inclusion. ExSitu is one such body that you can draw on to make sure your advance care planning experience is inclusive on staff and individual level
- Supportive of the wider communities, too. Create culturally appropriate grief, carer support and bereavement rituals and information for partners, families and friends
- Helping the elderly to stay home longer. Each aged care facility, advocate for the elderly or professional within the industry knows what would be needed to help people stay at home longer. We need to be vocal and talk about it! Our responsibility should extend outside our four walls to ensure aged care includes training on fall hazards, the use of the Internet of Things to promote safety, encouraging conversation about the warning signs of dementia and so on
- Including dying at home as part of palliative care. We need to allay fears about entering the system by explaining just how expansive the system is.
Only a concerted, evidence-based approach with true community consultation can make meaningful in-roads towards inclusive aged care and palliative care. It has to be consistent, person-centred and purpose-driven approaches that understand the impact of exclusion on a society, community and individual level.
Want to know more about inclusive aged care and palliative care? Contact ExSitu now.