The care workforce, and people receiving care, are a very diverse bunch.
Differences in ethnic and cultural background, gender and sexuality, physical or cognitive conditions, and family and care roles are some of these important areas we are taking a closer look at today.
Special thanks to all our guests, and to the organisations that helped:
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SNACK has been produced by COTA Queensland as part of the Homecare Workforce Support Program, which receives grant funding from the Australian Government.
Andrea Petriwskyj 00:00
We acknowledge the traditional owners of the lands on which this podcast has been produced and we pay our respects to elder’s past and present. When
00:07
you engage with people as a whole person, and you’re respectful of their identity and learn those things about them, it actually makes your job so much easier and so much more enjoyable.
00:18
It would be such a boring environment, if we were all the same.
Andrea Petriwskyj 00:32
Welcome to snack, the aged care podcast where we break down some of the big questions around what it really means to be person centred. I’m Dr. Andrea Petrovsky. I’m a gerontologist, and I’m passionate about hearing and sharing the real life experiences of ageing. The care workforce and people receiving care are a very diverse bunch. Now, we’ve talked a lot in this series about the importance of seeing and treating people as individuals. But there are also some aspects of our diversity we need to be aware of in how we approach those individuals and their care. Differences in ethnic and cultural background, gender, and sexuality, physical or cognitive conditions. And family and care roles are just some of those important areas that we’re going to take a closer look at today. The first conversation I want to share with you today is with Renee from Ada, Australia. Renee is a professional advocate and sees issues around inclusion across a range of different areas. So we asked Renee about some of the common issues or problems they see.
01:39
I think the main thing, and this also feeds into ageism, and those sorts of things is people taking that one size fits all approach to providing care. But sadly, we’re actually seeing people that are from diverse backgrounds, and intersectionalities, who are reluctant or refusing to engage with aged care services, because they’re afraid of that risk of discrimination or not having their identity respected, which actually places them at a much higher risk if they’re not receiving the care that they need to be independent and to remain safely within their home. Yeah.
Andrea Petriwskyj 02:14
So we’ve talked a lot in this podcast series about the importance of understanding people as unique individuals. Yeah. How does that relate to recognising and understanding diverse identities?
02:28
I think it feeds into people being able to disclose the things that are really important to them. And also to ensure that as workers within the field that we’re not unintentionally doing things that may cause harm to somebody else, say that I was somebody providing personal care to somebody, but I wasn’t doing that in a way that was culturally appropriate or safe. And then they might think, Well, I’m just going to let them know that I don’t require that anymore. So their hygiene might be impacted. They could have UTIs, which can lead to delirium and all sorts of other health problems. Or it may be that initially, they didn’t require personal care, but from their engagements with staff, they sort of put that off the table as something that’s safe or something that they’re able to do. So they might just hide the fact that that’s deteriorating.
Andrea Petriwskyj 03:20
Of course, both the aged care workforce and people receiving care come from very diverse cultural and language backgrounds. We spoke with Mona, who not only received services in her home, but has also worked in aged care herself and has been an active consumer representative and advocate nationally, we asked moaner about some of the things she’s seen and experienced in regard to cultural and language differences. And she raised the issue of racism being experienced by care staff.
03:50
Regardless of age and circumstances, such attitudes and behaviours are unacceptable, and shouldn’t be swept under the carpet. It’s really a two way street of respect, appreciation and confession. I cannot understand how this can go on.
Andrea Petriwskyj 04:09
Do you hear about instances like that among your national community of consumers that you work with?
04:16
Yes. One person on our Facebook page actually said, I don’t want any of these foreigners coming in look, look after me. So yes, we see a lot of what is happening on the other side is unacceptable. You know, we are all humans. These people are trying to help us. And yes, of course, there has been instances of abuse from carers to clients. And this is what makes the news normally, but the other side doesn’t. And I’m an older person, but I’ve also worked in aged care. And I can see both sides. Yeah.
Andrea Petriwskyj 05:01
And I think that’s why it’s so good having your perspective moaner because you have experienced both sides as well with hearing so much from your community as well. What have been some of the best things from your perspective in having care staff from different backgrounds and who speak different languages? Can you talk a little bit to those experiences that you’ve had?
05:20
And well, there’s no doubt whatsoever that Effective Communication is paramount. But so is tolerance, patience, empathy, understanding, appreciation and respect. But I find it very interesting when somebody from a different background, cultural or whatever comes to me, and support me. And if I find that they speak a language that I know, I’d like to speak in their language, and that encouraged them to speak to me in their language. So I enjoy learning from other cultures, it’s the willingness to, to want to communicate, instead of looking at it as a hindrance. So to me, it’s an it’s an opportunity for new experience, it’s a bit of a challenge, it makes me understand better, and use my brain a little bit more. It’s a challenge that shouldn’t be shunned. It’s a challenge that should be taken and embraced, it’s going to be good for the person who provides us with a sport and tells them that they’re welcome. In our community.
Andrea Petriwskyj 06:44
Yep. So really having just an openness to the opportunity to learn and to know something different to experience something different and connect.
06:55
The connection is very important. And the rapport between the worker and the client is also very important. And this does not only come with language, it comes with a way that person provides a service to ceiling inside the client, that the person really cares. And that goes over any language, it goes over any cultural diversity is something that they feel about each other.
Andrea Petriwskyj 07:35
Of course, there’s a range of aspects of diversity, or particular groups of people using care services that anyone working in the care sector needs to be aware of. In our conversation with Rene from Ada, Australia, she flagged some important points about how people might be triggered, or might experience harm, from different things that can happen in care and support because of their past experiences. So we asked her, What are some of the common traps professional carers can fall into when they might think they’re providing a safe environment, but don’t realise they might be causing harm? I
08:12
say I’ll speak to this from the LGBTI specific space, because I’ve got the most experienced in that lens. And I think it’s really, really critical that we are remembering that although the world has been safer place for, say, the LGBTI community, myself included, that these are things that the people that were working with have been persecuted or prosecuted for, or it was against the law in their lifetime. So for some of these people, we could wrongly and incorrectly assume that it’s as safe for them as it was for us. And so they might not actually feel comfortable disclosing because of those fears that linger. And also it’s vital in terms of providing that trauma informed care, say that I disclose to you something about my sexuality, or my gender diversity, or whatever it is that someone discloses, and then you wrongly assume that that’s common knowledge. Or so we might have a family meeting, and you might just say, Oh, look, well, you know, since her partner, you know, A, B, or C passed away and they go hang on a second, like, Mom, did you have a female partner or something like that, and it can really lead to like break down in family relationships. We often see as well, where people aren’t necessarily saying that they’re experiencing discrimination, per se because of say their sexuality or gender identity, but they’re also not disclosing it, because they’ve had it indicated whether that’s through the organisation that they’re working with, or comments that they’ve overheard or they just haven’t really seen that there was a safe place for them to disclose their identity. Yeah, I’ve heard personal stories of people openly saying that they hide any evidence of, you know, same sex relationships. Before careworkers come around, I think a common trap and issue that I see is people going in thinking that they know best, but without actually considering what’s important to the people that we work with. And if you don’t have all the answers, or you don’t know how to best support that, you can brush up on the referrals that you can make. You don’t need to know everything about every single group, because that’s actually unrealistic and impossible. But what you can do is learn how to have really open non discriminatory conversations with people about what’s important to them, and how you can best support them. And I really genuinely feel that half the battle is won if people feel listened to heard and respected. So playing a role in terms of you know, keeping yourself accountable, getting comfortable saying, hey, you know, we’re saying he for this person, but they actually use they them pronouns and doing those corrections even if the person is not present, because that signals to the other people that you’re speaking with that you’re wanting people’s identity respected even when they’re not there.
Andrea Petriwskyj 11:16
We also caught up with Sue who’s responsible for Community Engagement working in an identified LGBTI QA plus role for well ways Karen gateway, and we asked her about what inclusion looks like in her work with family carers.
11:34
Carers in the rainbow community can sometimes shy away from discussing their family dynamic. So it’s important to allow the carer and the loved one to lead that sometimes sensitive conversation. It’s important for us to be respectful of the carer and their home environment that they actually allow us into. It’s their safe space, and must remain that way. As the carer how they would like to be identified, a partner, husband, wife, or friend. These small gestures can ensure carers within the rainbow community feel respected, safe, dignified, and accepted.
Andrea Petriwskyj 12:17
So what are some of the big issues that you see in your work supporting family carers, some of the big issues relating to inclusion that you see happening,
12:26
safety being judged? We all want to be respected and recognised and supported regardless of our gender or sexual orientation, not having the correct training for inclusive language for our rainbow community. Unconsciously stereotyping someone from the rainbow community, as someone younger or looking a certain way, and failing to acknowledge or wrongly assuming how an elderly person identifies.
Andrea Petriwskyj 12:56
So are there any examples that you are able to share a happy to share with our listeners about what that might look like? What it looks like to be respectful and inclusive and honour in a really practical sense? Sure.
13:11
I think a rainbow tick for all, all organisations is so important for our community. I understand it’s a long process, but it demonstrates the organization’s commitment to diversity and inclusion in our LGBTQ plus community. Good training for staff and community. And if you haven’t had any training, just ask. You can also listen to podcasts like this and add stories of lived experience for our rainbow community members. We’ve got some great stories to tell.
Andrea Petriwskyj 13:47
One of those key groups that all care professionals need to be aware of is of course, people living with dementia or cognitive impairment. Maureen shared with us her experience supporting her husband who was living with dementia. And she told us how medical specialists would talk to her and ignore her husband because of his dementia, and spoke about how upsetting and disrespectful that experience was. So we spoke with Lindsey Beck and Shareen who all work with Blue Care and I’m particularly involved in supporting people living with dementia to get their perspective on inclusive practice. First
Lyndsey 14:23
of all, the first thing that we teach our carers is they see the person that’s an avid individual and not the diagnosis, that they are the primary person in their od in the room despite their diagnosis and what stage they’re at, in our staff to speak to a person with dementia with respect and dignity and always asking them if they can help don’t assume that you can take over because they’re maybe not very good at communicating or the can’t hear very well. It’s always absolutely imperative that the staff are communicating with the person with dementia like they’re just a person I Another client that doesn’t have dementia, you know, each time they arrive at a client’s home a different client, they need to reset their thinking, their behaviour, their communication style, to match that and adopt that to the needs of the client. Because you know, they are all very different. And again, it goes back to the beginning, it’s about building the rapport, the trust, and how we get to know the client. Would you agree back? Yeah,
Bec 15:24
I think the only thing I would add to that is that there are a lot of misconceptions and stereotypes surrounding dementia, and what person living with dementia looks like how they can interact in society, etc. So I think as an organisation, it’s important that we ensure that we’re offering our staff those professional development opportunities to ensure that those stereotypes are challenged, and that they have a better understanding and skills to provide those care for our clients in a respectful, inclusive way, really.
Andrea Petriwskyj 16:01
And I guess the message then for care staff is to be aware of, you know, not assume that they actually do understand what dementia looks like and what its impact can be. Exactly.
Bec 16:14
And sometimes you’re right, Andrew, sometimes, we don’t even know that we have that idea until it’s challenged, or we have that misconception.
Andrea Petriwskyj 16:23
Yeah. So some of that, you know, presumably also comes from continually being open to, to upskilling and training and re educating yourself
Lyndsey 16:31
100%.
Andrea Petriwskyj 16:35
from a professional perspective, sharing what are the key things you think care staff need to know about respectful and inclusive ways of working with people with dementia,
Shareen 16:43
so dementia really is just a small part of who that person is. And I still continue to have so much more to give. Sometimes, I’ve got one personal carer that said she always makes it a goal every visit to find out a little bit more about who that person is that she’s providing care for. But also just to when you’re working with that person, understanding what their reactions are to different to different things in the community. Do they get really upset when there’s a lot of loud noise around? You know, are they better in the mornings and the afternoons do they need do they need more time when you come like to just talk to you before you say we need to, you know, I’m going to help you with a shower, like understanding what’s important for that individual person. So to make sure that you’re always introducing yourself, saying why you’re there and and what you will be doing, and so that you’re getting consent to go into their into their home. And when you’re thinking about doing activities, or even just when you’re talking to them to really think about, you know, who they are like, what are they interested in because there’s so much more than just that dementia. And they, they don’t want that to be what no one who’s living with dementia wants the dementia to define who they are.
Andrea Petriwskyj 18:20
We know there can be times when the person receiving care isn’t included. But also sometimes family carers can be excluded or not heard. So we spoke with Sam from well, ways care gateway about what being inclusive means when you’re working with family carers.
18:37
I think it’s about being consistent. And I think it’s about being present in the homes that you’re in, it can become quite process oriented in the way that we work with people. And there can be a lot of time constraints. And I think it’s just taking that little moment to say hi to the carer or to remember the carers name, or to touch base with them at the end of the shift about what you’ve done. I think it’s about just including them in the process and making sure that they feel comfortable with the way that services are being delivered in the home. Quite often they’re being guided by NDIS plans or service coordination or aged care plans. And that doesn’t necessarily take into account those little bits of detail that family carers could suggest or provide in terms of best care for the recipient. Yeah. And it’s really important that those little details and those little points of difference that the family carer knows about the person is is, you know, advocated for in the care planning and that if support workers or professional carers are coming across family carers that is seeming quite stressed or seeming quite particular about certain things. It’s usually for a reason, you know, they’ve supported their loved one for a long time. If a shift doesn’t go well there there to support their loved one after the professional worker leaves and carers are very engaged, very motivated, very resilient people, you know, by nature and they carry a lot for their loved ones. And I think when we do have professional carers in the home, use them as an asset. Use them as an ally in terms of the services that you deliver to the care recipient because they can help you a lot, actually.
Andrea Petriwskyj 20:32
We’ve heard some really important things today from our guests about what it means to be inclusive. Some of the key things to take away are, it’s important once again, to leave your assumptions about people at the door, and understand who they are as individuals what they need and want from you, and how you can be a safe source of support. It’s also important to educate yourself about what people’s experiences and backgrounds and identities might mean for how they see care and support, how they access it, how they might respond to you as the person providing it to them. There are a lot of aspects of diversity to be aware of. And of course, we’ve only touched on a couple in this episode, but we’ll share links to some resources for you. That’s today’s snack. Thank you so much for joining us and a big thank you to our guests for sharing their insights and ideas. If you want to find out more, you’ll find some great resources and other good stuff on our website Kota QL de.org.au. You’ll find links in the show notes. And please don’t forget to subscribe wherever you get your podcasts to make sure you get the next episode as soon as it’s out. Until next time, thanks again and goodbye from the coda Queensland team.
Andrea Petriwskyj 21:53
This podcast is part of the homecare workforce support programme, which receives grant funding from the Australian Government
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