How NATSIFACP supports quality of life for older First Nations people

Years ago, when I first heard a presentation on this topic, it really stuck with me. At the time, the Aged Care Quality Agency (now the Aged Care Quality and Safety Commission) had reported that over 95% of services were meeting the aged care standards. But when they asked care recipients themselves how they rated their quality of life, the picture was much less positive.

People said they felt safe and well cared for — but they didn’t feel happy. They didn’t feel connected. They didn’t feel like they had purpose.

What makes life meaningful

When we think about what makes life meaningful, it’s more than having meals cooked or medications given on time.

It’s about:

• Being surrounded by family and friends.
• Speaking your own language.
• Having choice over how you spend your time.
• Staying connected to culture, land and community.
• Feeling you still have something to contribute.

For many older Aboriginal and Torres Strait Islander people, leaving home or community to enter a mainstream aged care facility can mean losing all of that.

How NATSIFAC makes a difference

The National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) was designed to change this story.

As the name suggests, NATSIFACP offers flexible, culturally safe care to older First Nations people, particularly in rural and remote areas.

Unlike mainstream models, these services are:

• Community-led. Local communities design services based on what works for their people.
• Culturally grounded. Care recipients can stay on Country, speak their language, eat familiar foods, and continue cultural practices.
• Adaptable. Services can range from home care-style support including delivered meals, laundry, transport, and personal care, through to day respite or 24/7 residential-style care, depending on what the community and individual needs.

What does this look like on the ground?

Care recipients can stay involved with activities of interest, they can continue to visit the art centre, women’s centre, or participate in the Rangers program. They can go fishing or hunting with family.

They can live with or close to family, supported with meals, cleaning, transport, and personal care delivered in their own home or a culturally safe centre, or have the option to attend the centre for social connection and day respite.

In some communities where residential care is provided, care recipients may prefer shared rooms because it aligns with local cultural norms, they are not forced to live in separate rooms that are typically expected in mainstream care facilities.

Buildings are often designed with community input, including guidance from Elders on where buildings should sit on Country and how they should be laid out. Walls might display local artwork, and staff are often sourced from the local community, speaking the languages and understanding the cultural requirements of the people they care for.

This supports quality of life

Whether you’re part of a NATSIFACP service, or another aged care program, supporting quality of life for older Aboriginal and Torres Strait Islander people starts with understanding what matters most to them, and often, that’s deeply tied to culture, family, community, and Country.

It’s about more than providing good meals or clean homes. It’s about:

• Supporting connecting to family, kin, and community.
• Respecting cultural protocols and traditions.
• Ensuring people can speak their own language and be understood.
• Providing care in ways that are culturally safe and meaningful.
• Enabling people to continue cultural practices, from fishing and hunting to art, ceremony, and storytelling.

Ask care recipients:

• What food and activities make you happy?
• What makes you feel strong and connected, what gives your life meaning?
• What helps you feel at home here?
• Who do you want to be involved in your care, are there special family members we should be listening to?

Write care plans and provide information in a way that people understand, that makes sense to them.

By listening, respecting cultural knowledge, and working alongside communities, you can help ensure that aged care isn’t just about meeting physical needs you can help people to live with dignity, identity, and cultural strength.

NATSIFACP and Aged Care reforms

With the upcoming aged care reforms from November 2025, some things will change, but the heart of NATSIFACP remains the same.

Existing care recipients can continue receiving services, whether home care or residential without needing a formal aged care needs assessment. For new care recipients, whilst they will need to be assessed via the Single Assessment Workforce there will be an alternative entry pathway so urgent needs can be met without delay, even if accessing a culturally safe assessment takes time.

And speaking of culturally safe assessment, older Aboriginal and Torres Strait Islander people will be able to request an assessment by a First Nations Assessment organisation.

There will be a number of other changes that will impact on NATSIFACP operations however you are not alone. The NATSIFACP support program funded by the Commonwealth Department of Health, Disability and Ageing and facilitated by Ninti One with support from Culturally Directed Care Solutions (CDCS) can support providers to understand the impact of reforms and exactly what to do.

In short, providers can keep focusing on what matters most: supporting older First Nations people in ways that honour their choices, culture, and community.

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Want to explore more about culturally safe aged care or preparing your team for the upcoming reforms?

The CDCS team is here to help with practical resources, training, and support tailored to your service. Reach out to us today.