Exploring Community-Based Aged Care with Aboriginal Elders in three Regional and Remote Australian Communities: A qualitative study

While a small body of literature focuses on various facets of aged care services delivered to Aboriginal and Torres Strait Islander Elders, very little is known about the support needs and preferences of Indigenous Elders who ‘return to country’. This article addresses this gap. It explores the support needs of Indigenous Elders who return to their communities after having lived elsewhere for prolonged periods of time. It provides an overview of the key themes emerging from group sessions and semi-structured interviews with 11 Aboriginal Elders and 12 representatives of regional health and social care providers conducted between 2012 and 2013. The article argues that the quest of Elders to strengthen traditional kinship systems should not be seen as a barrier but as an opportunity to develop aged care services that resonate with the needs of Indigenous Elders and with their kinship network. The findings presented in the article are structured around the themes of empowerment and choice; culturally appropriate care; enhancing program flexibility; case management; and systemic issues. The article recommends that (1) aged care services should work with and support Indigenous Elders in their efforts to strengthen traditional culture. (2) Aboriginal Elders eligible for home care packages should receive services that have the same flexibility and scope as those delivered under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NPFACP). (3) A relaxation of funding guidelines and particularly around the issue of income substitution should be considered for Indigenous Elders. (4) Agency staff should be up-skilled (i.e. cultural safety, culturally appropriate interventions, referral options) and given the authority to support Indigenous Elders to address grief and loss issues in a culturally appropriate fashion. (5) Elders and their communities should be central to the decision making process underpinning their support arrangements and have shared control over services