A concern raised by a number of remote Aged Care Coordinators, is how to provide effective support to their clients, who often find the new process for accessing aged care support overwhelming.
The Cultural Communication Challenge
The official intake process, once a referral has been lodged, commences with an assessor from My Aged Care contacting the individual seeking support, by phone. This can pose a communication challenge, as many older people living on very remote Aboriginal communities speak English as a second, third or even fourth language.
The communication barriers are no-one’s fault. However, a common, and often unconscious, misconception is that people who have lived all of their life in Australia, will speak and understand English.
I know this, because I have been guilty of making that same assumption. Many years ago, when I travelled through Tennant Creek, I was surprised to find that many of the locals, spoke the indigenous language of that area, and maintained strong and distinct accents.
Additionally, the assessor living in an urban setting, can find it difficult to fully comprehend the distances, and challenges faced by those living in very remote locations.
Of course it’s not just Indigenous Australians living in remote communities who face difficulty interacting with My Aged Care. Many other older people find the process confusing, or difficult such as people with dementia, from culturally and linguistically diverse backgrounds (CALD) or those who are hard of hearing.
Despite the amount of advertising that identifies My Aged Care as the pathway into aged care support, many people across Australia continue to contact their local aged care organisation when they are seeking care and support services.
So how can Aged Care Coordinators support those they help?
A few months ago the Commonwealth Government, in response to feedback from a number of sources, introduced some changes that may make it easier for you to assist your clients.
Option One – Identify that the person does not want a phone screening.
People who are unable to talk with My Aged Care over the phone, may be directly referred for an assessment without the need to speak to the call centre. This includes people who are of Aboriginal and Torres Strait Islander (ATSI) backgrounds, who are uncomfortable with speaking on the phone, or people who live in a remote community and do not have a phone.
The easiest way to effectively utilise this option, is to complete the on-line My Aged Care referral with the person, or on their behalf, if you have their consent. On page three of the on-line referral there is an option to add additional notes and comments, it is here that the person completing the referral can highlight that the person is of ATSI background, does not wish to speak over the phone, does not have access to a personal phone, and/or lives on a remote community.
Option Two – Become their Regular Representative.
There has always been the option for someone to speak to My Aged Care on behalf of an older person who is seeking aged care support.
The usual process, is that the individual seeking support first speaks to the My Aged Care assessor, and after identifying themselves, gives verbal permission for another person to speak on their behalf. The problem with this process, in a remote context, is that sometimes the older person is unable to adequately identify themselves. They may currently be using a different name than that on their Medicare card, or they may not remember their birth date.
How does this happen? It is not uncommon for an older indigenous person to use a variety of names, due to cultural or historical reasons. They may have an indigenous first name plus a name that was given to them during their time on a mission or station. They may use their ‘skin’ name or an alternative first name, due to cultural reasons; they may have taken, or have been assumed to take on their partner’s last name. They can be known in local health records by one name, Centrelink by another and have yet another on their Medicare card; it can all get very complicated!
In the past, the client also has had to give verbal permission each time they interact with My Aged Care, and for those of us who have lived and worked on community, we know how hard it can be to find the client at the time the My Aged Care assessor calls back.
How do you address this?
To overcome this problem, where an older person prefers, they can now sign an Appointment of Representative form. This document allows them to nominate someone to represent them and speak on their behalf. Their nominee may be a family member, neighbour or the aged care coordinator or a staff member.
Regular or Authorised Representative?
If the individual has capacity to give permission for you to act on their behalf, you can become their Regular Representative.
Alternatively, for individuals who lack the capacity to give permission, an Authorised Representative would be established. Legal documentation is needed to support the application and more than likely the Authorised Representative would be a family member or the Adult Guardian.
Clients can also give permission for someone to become their Regular Representative, over the phone when speaking with the My Aged Care call centre, or when speaking to a face-to-face assessor e.g. Regional Assessment Service (RAS) or Aged Care Assessment Team (ACAT).
What are the benefits of setting up a Regular Representative for the client?
When the aged care coordinator becomes a client’s regular representative, the benefits to the client can be:
- Faster response time for the referral (the person doesn’t miss out because they weren’t around to take a call when the My Aged Care call centre contacted them).
- The coordinator is able to clearly describe the background and needs of the client to a phone assessor, often resulting in improved screening and care plan.
- The coordinator will receive information relating to the referral and can monitor the progress of a referral on behalf of the client.
- Where the individual is on the National Waitlist for a Home Care Package, the coordinator will be alerted once a package is assigned, allowing them to support the person in taking up their package in a timely manner.
The world of My Aged Care can be difficult to navigate, and as mentioned earlier, language barriers can unnecessarily complicate the process. This can unnecessarily prolong the time it may take for a frail or vulnerable person to receive support. When the coordinator is actively involved in the process from the beginning, they are better able to help the individual understand and participate in the My Aged Care assessment process.