Address to the CALD Cultural Diversity in Ageing 2014 Conference with Senator the Hon Fierravanti-Wells
Convention Centre, Melbourne.
Melbourne, 12 June 2014
FIFIELD:
It’s a real thrill for me to be here with my colleague Senator the Honourable Concetta Fierravanti-Well. I’ve always thought there is something truly lyrical about Connie’s name. Connie is a great friend and we are two thirds of the social policy ministerial team along with Kevin Andrews. You should see us very much a team in this portfolio area.
I’m extremely fortunate to have, as was mentioned, not only responsibility for disabilities, but also for ageing and aged care. One of the great delighted about the portfolio is that ageing and our ageing population is truly one of the untapped national resources that we have. You probably know the statistics well but there are over 3.7 million Australians and 16% of the population are over the age of 65 years. More than 420,000 people or 2% who are over the age of 85. And by 2050 around 23% of the population will be 65 and over. But the figure that really absolutely stunned me when I came into this portfolio was that in Australia today there are three and a half thousand Centenarians, three and a half thousand people over the age of 100. But, by the year 2050 there will be more than 50,000 Australians over the age of 100. What a fantastic national resource. What a fantastic opportunity for our country. We know, given the traditional working age population is shrinking as a proportion of the economy, we know the value of Australians who are older, who are living longer and living better. To be working, and we need that great resource for our community.
Now you will hear sometimes people talk about our ageing population as though it’s a tsunami, as though it’s something negative. You will never hear me talk about our ageing population as a tsunami. An ageing population living longer, living better, living healthier, living well is something that we have been striving for, for generations. So if you’re going to have challenge it is a great one to have.
Friends, we can’t really talk about this great ageing population without acknowledging and understanding that we do have a culturally diverse and wonderful community. And again that is another great national asset that we have. The diversity of the nation. And Connie, I hate to say it, but the capital of multiculturalism in Australia as a Victorian Senator, I have to say, is Melbourne. It is something that is a great resource for Victoria. That is a great national asset overall. I know that one in four of Australia’s 23 million people were born outside of Australia. Now I wasn’t, I was born in Australia, my parents were born in Australia and their parents were born in Australia. But my partner was born outside of Australia. So even if you yourself are not born outside of Australia, chances are another member of your family was. I think it’s fair to say that to be CALD is Australian. And to be Australian is to be CALD. That is the fantastic nature of our society today.
We know that when you get older, aged care and finding the right aged care is a challenge for an individual and their family. When you put that together, with a CALD background, it can be doubly challenging. I have many friends whose parents were born outside Australia who’ve found through their lives they’ve had to serve as guides and interpreters for their parents who may not speak English. And even if that role passes for a time, when their parents get older they can again find that they’re in that situation. So when you’ve got a CALD background, which can be a challenge, put it together with navigating the aged care system which is a challenge at the best of times for anyone, it’s something that will be in our focus.
Connie knows this area extremely well. Not just through personal experience but also professionally. She has had involvement in the aged care sector herself. She has also served as shadow in this area. And she also has very intimate personal knowledge of the extra challenges that people from a CALD background face. To share some of that insight and some of that wealth of experience, would you please welcome Connie.
FIERRAVANTI-WELLS:
Well thank you very very much Mitch.
It is my great pleasure to be here this morning to commence today’s gathering with some personal reflections. I would like to especially thank the Minister for affording me the opportunity to work with him on CALD ageing issues.
Following World War Two, we embarked upon one of the most ambitious programmes of nation building the world has seen.
This meant bringing more than 7 million new arrivals to Australia, including some 750,000 refugees, and successfully incorporating each wave of newcomers and their diverse cultures into our society.
Our current prosperity and stability as one of the world’s most diverse societies is evidence of this success.
I am proud and privileged to be able to say that my own story as the child of migrants is a part of this greater story. My father arrived in this country in 1953 with his belongings in an old suitcase, having left his fiancé, my mother, behind in Italy.
He worked as a cane cutter in North Queensland and then moved to Wollongong to work in the steelworks.
After having saved every penny he earned he bought a small cottage in Port Kembla the home which I grew up in and which my parents still own today. My mother joined him in 1959.
My parents’ hard work and sacrifices ensured that my brother and I had a good education and were afforded opportunities which, had my parents remained in Southern Italy, would probably not have been possible.
My parents’ journey is but a snapshot of millions of similar journeys, all of which have added to the rich tapestry of multicultural Australia.
I think we can all agree that, as a nation, we have achieved enormous strength and unity from our cultural diversity, that has brought with it creativity, prosperity and overall, a uniquely Australian sense of community.
The statistics indicate that the cohort of post-war migrants is now the generation of our CALD older Australians in need of residential and home care.
The top two groups are the Italians and the Greeks. Hence, the lessons learnt in these communities will provide valuable insight into future demands from other CALD communities.
Over many years, I have seen first-hand so much of what it means to be part of the whole ageing spectrum in Australia, including visiting numerous aged care facilities all over Australia, some of which also deliver services to CALD communities.
At age 23, I was a founding board director of an aged care facility in Wollongong. At that time, the Italian-Australian community got together with the Uniting Church to establish a home to cater for older Italian migrants.
Getting started was the hard part. And as I have spoken to many different communities, this still remains the challenge.
As Parliamentary Secretary to the Minister for Social Services, I am privileged to have been given special responsibility for multicultural affairs and settlement services. This is role that I enjoy and a space I know well.
Since the early 1980s, I have been involved in a wide range of community activities, especially in the CALD area. I have watched issues develop in the CALD communities and today, there is little doubt that ageing and aged care is one of the most important concerns in our CALD communities.
Over the years, the aged care sector has seen many changes, but the industry remains a challenging one.
I wanted to share this with you given what I am about to say in the context of my own family experience. Despite all my years of interest in this area, it did not prepare me for the reality of dealing with the aged care system, especially for a loved one with dementia.
We all know the statistics. There are about 320,000 people living with dementia. If no cure is found, by 2050, we will have almost 1 million people in Australia with dementia.
Based on 2011 statistics, about one in four of our over 85 year olds with dementia come from CALD backgrounds and the challenges are even more acute.
My father has not only lost the English he knew, but he has reverted not to Italian, but to the dialect of his birth.
Dad, like many other migrants, learnt English on the job. Over the years, his knowledge of English increased and he was quite proficient.
We first noticed a change in dad about three years ago. He became forgetful. He would repeat himself. Our family doctor referred him to a geriatrician which we eventually saw a few months later. This is definitely a profession in demand!
My mother was his carer. As dad deteriorated, so too her condition worsened. Dad’s illness took its toll on her health. But being from an Italian background, it was imperative that dad be cared for at home.
Caring for our CALD elderly is a complex issue. It is not just the physical day to day needs, but the cultural overlays. In Italy, old people are cared for at home.
They have a profession called a badante – a person who lives in, is given board and keep and gets a small stipend. Often, it is a relative or someone that is known to the family.
Also, there is a lack of understanding about dementia. Regrettably, illnesses of the mind still carry a stigma.
This is an area where greater work needs to be done to better educate CALD communities about dementia, its causes, effects and early diagnosis.
But in Australia, it is more difficult to meet these cultural imperatives. Distances, work commitments and a myriad of other matters makes it hard for the children of migrants, usually the women, to live up to the expectations of caring for their ageing parents.
I know I share these experiences with many women my age from different cultural backgrounds. They find themselves caught between generations, sometimes caring for young grandchildren and elderly parents at the same time.
But back to dad. His forgetfulness meant he couldn’t even go to the shops to buy bread. He began to wander and the busy street where my parents lived in Wollongong became a real challenge.
I had dad ACAT assessed in anticipation of what was to come. I was fortunate. I knew who to call, where to go and who to connect with. But for many like my parents, it would not have been as easy.
Perhaps they could have relied on a connection with one of the welfare bodies or a friend who had been through the experience.
With dad having problems with day to day needs, we eventually were able to get a home care package. This was fine for a few months, but eventually, dad’s wandering was such that my mum was no longer sleeping at night.
We were able to get some respite at one of the aged care facilities in the Illawarra. Again, I knew where to go, who to ask and where to fish out the requisite information. Had my mum been on her own, it would have been a lot harder.
My mum like many migrant women stayed home and looked after us. She did not go to work but looked after the home. My father looked after everything, including the finances.
My mother’s English was passable, having been acquired in her own day to day interactions at the local shopping centre.
When my father got dementia, suddenly, my mother was left to sort out finances and do things she had never been required to do before.
Eventually, my mum had to face the hardest decision of all – that dad needed to go into full time care.
Like many migrants to Australia, my parents left all behind to come to Australia. My father worked so hard to provide for us, to educate us, to buy a home and yet, now he didn’t know what day of the week it was.
How could this all happen? My mother’s sadness has been heart wrenching to watch.
You see my parents come from the same town in Southern Italy. They went to kindergarten together. They were engaged for thirteen years before my mother took the journey to Australia in 1959 to marry my father. They have known each other for almost eighty years.
In my parents’ case, they live in a very culturally diverse area with many people of Italian background and hence, the local aged care facility is very multicultural.
We were very fortunate to find a low care dementia unit in our local aged care facility. The paperwork for entry is considerable and is yet another challenge, especially to someone who does not know English well.
Dad went into full time care in February and is doing well. The man in his neighbouring unit used to work with him at the steelworks. The thirteen or so residents in the dementia unit come from different backgrounds.
The professional staff anticipate their needs, even though communicating with them in their dialects of birth is definitely a challenge.
Mum is now preparing herself for the next hardest decision, to go into care herself. Luckily, the aged care facility where dad is has new units available and mum will shortly be moving in so she can be close to him.
I have seen the system at its best and at its worst over the last three years.
Many of you in this room have done very good work in the CALD ageing space. Can I take the opportunity to commend you for your efforts, your dedication and your passion.
I know that you will continue to work with the Australian Government to ensure that all Australians, irrespective of background, get the care they need, when they need it and how they need it.
FIFIELD:
Connie thank you so much for sharing with us your family story. You can talk at a theoretical level at conferences such as this, but nothing really brings it quite home like the experiences of an individual. So thank you so much Connie.
I think Connie also points to something really important and that is that the aged care sector more generally can learn a lot from people of different heritage and how they care for their older people, and the models of care that they employ. I think that’s a very rich source of advice for us in government. And that’s part of the reason why as a still newish government we have affirmed our support for the national ageing and aged care strategy for people from a CALD background. The strategy for those who might not be aware is intended to look at capacity of the aged care sector to deliver culturally and linguistically appropriate care. Both in the mainstream and generalist services as well as on a cultural and ethno-specific settings.
Partners in Culturally Appropriate Care, PICAC, which we heard a little about before, those organisations do play an important role in equipping aged care providers with the necessary skills that they need. Just as we do strive to equip generalist providers to deliver culturally appropriate care we seek to build the capacity of CALD specific organisations.
I am very pleased to announce today, with Connie, that there will be a new project to assist CALD organisations to be more competitive in the contestable process known as the ACAR. We will be allocating one and a half million dollars to help develop tools and resources that will help make organisations competitive in the applications for community and residential aged care processes. So that’s $1.5 million to help CALD organisations to be more competitive.
Can I say, on that note, one of the debates that I’ve found particularly arid in the other part of my portfolio, which is disabilities, is the debate about whether you should have supports on a mainstream basis or a more specialised basis. For me, whether it’s disability or aged care it’s got to be about choice. You need to have mainstream services, you also need to have more specialist services so people can have more choice to what is appropriate for them and their family member. And that’s what this programme seeks to reinforce along with the CALD strategy in aged care.
As you are probably aware, we are currently delivering a change program in aged care. It was legislated in the last Parliament by the previous Government. And that seeks to create a more consumer directed and transparent aged care system. If I had been the Minister at the time when those things were legislated, some things may have been different. But in the broad, we think those changes are a step in the right direction. And part of that change is ensuring that we have a balance between people making a contribution to their care and accommodation, who have the capacity to do so. Making sure that there is sustainability in terms of taxpayer dollars. But also making sure there is a safety net for people who aren’t in a position, who don’t have the means to afford and fund their car or their accommodation.
And through this process of change I’m very aware, and Connie is very aware, of the need to be mindful of culturally diverse communities. And what would be the first point of contact for all Australians through this change process will be the My Aged Care gateway. A lot of people have an understandable concern with a web based access gateway. I understand you can’t just have an online contact point. People need human contact and particularly people who are culturally and linguistically diverse. So there is also a call centre that is part of the My Aged Care gateway. What this service will provide is information on aged care, support for consumers to find services in their areas. Callers to the gateway will also be able to use the Translation and Interpretation Services. Initially web content is in 7 languages, this is going to be expanded to a further 18 languages this year. And an Access Strategy for People with Diverse Needs has been developed to help make the service more accessible.
Increasing care for people in their own homes in line with the consumer preference is also something that I think fits better for many people from a CALD background. The introduction of consumer directed care, as we know, gives people more choice about the supports that they receive. We really are just beginning to scratch the surface of what the new consumer directed world will look like. But again I think particularly for people from a CALD background, it provides a greater opportunity for them to choose services that will meet their cultural needs.
But can I say just in reflecting on Connie’s experiences and also from listening to many passionate advocates from a range of communities, I know that more needs to be done. And in this regard, you should very much see me and Connie as your CALD team when it comes to aged care issues.
A question. What ultimately will drive reform in the sector for people from CALD backgrounds in relation to the services that they need? Is it going to be Government policy? Is it going to be demographics? Is it going to be fiscal pressures? The answer to that question, I think the key driver is going to be consumer choice. The old retail maxim ‘the customer is always right’ is something governments are increasingly discovering. It is something that is increasingly going to be the driver of aged care policy. That is going to be a key driver of the shape of aged care and the shape of aged care support for people from culturally and linguistically diverse backgrounds.
Friends, customer choice ultimately will mean competition which we hope and we want to drive innovation in services and new models and new ways of thinking. Whenever you’ve got the individual in the centre and in control and in the driving seat, it’s the best way to drive outcomes that meet what individuals need. And I think that tendency is only going to be pushed further given that we now have the National Disability Insurance Scheme cheek by jowl in the same portfolio as aged care. As you may know, consumer choice, the individual at the centre, is at the heart of the NDIS. And having disability and aged care together is only going to push that charge for greater consumer control in this portfolio.
Friends, thank you so much for having Connie and myself here today. We know that there is a lot of work here to do. We very much see the stuff that is at the heart of the social services portfolio as the core business of government. Connie and I look forward to working with you on these issues over the years ahead. It gives me great pleasure to be here with you, with Connie, at the official opening of the conference. Thanks very much.