The report of the Victorian Legislative Assembly Legal and Social Issues Committee Inquiry into support for older Victorians from migrant and refugee backgrounds (featuring citation of my submission) features the following findings and recommendations
Findings
Improving services
F 1: The Victorian Government recognises the importance of providing culturally safe and inclusive care to culturally diverse communities by requiring departments to produce cultural diversity plans. However, departmental cultural diversity plans do not always outline how culturally safe services will be provided and the objectives of the plans are not always implemented in practice. Further, Victorian Government-funded service providers and the community services sector can be better supported to apply cultural safety principles.
F 2: The supply and use of interpreting and translation services in Victoria are not always sufficient and of adequate quality. Commonly reported issues include low awareness of available services, services that are inflexible or not extensive enough, and low-quality delivery of services.
F 3: Ethno-specific and multicultural organisations are trusted in the community and provide essential high-quality care and culturally relevant services to culturally diverse older Victorians. However, they are not currently resourced sufficiently and sustainably to deliver services effectively.
F 4: Community and place-based services are best able to meet the needs of culturally diverse older Victorians as they are more accessible and understand the needs of local communities. However, place-based community organisations and councils are often not sufficiently resourced to provide timely access to services and meet demand.
F 5: Regional and rural communities and councils face additional barriers when delivering culturally appropriate services due to factors such as geographical isolation, shortage of transport options and higher costs. They do not always receive the resources needed to address the needs of culturally diverse older Victorians living regionally.
F 6: Healthcare and social services systems can be confusing, complex and fragmented, affecting the quality of care provided to culturally diverse older people and leading to delays in them accessing services.
F 7: Digital service delivery and information can increase the accessibility of support and care. However, it can also prevent culturally diverse older people who do not have the means or skills to use digital devices from accessing services.
F 8: Providing translated service and health information on government websites is not an adequate means of ensuring culturally diverse older people are aware of services. Ethno-specific media and radio are particularly important media channels for communicating with culturally diverse older Victorians.
F 9: Culturally diverse older people may be unaware of services, mistrust services that are available, or may not access services due to stigma associated with seeking help.
F 10: Collaboration and partnerships between different levels of government, ethno-specific and multicultural organisations, service providers, peak bodies and the private and community sectors are essential to providing high-quality and comprehensive healthcare and social services systems.
F 11: Co-designing services and support with culturally diverse older people can help to ensure services are culturally safe, meet different needs and are accessible. Culturally diverse older communities should be consulted in the design and review of services that are relevant to them.
F 12: There is limited research on the experiences of culturally diverse older Victorians, particularly as it relates to intersectional factors such as gender, sexuality, mental health, regional location and disability, and specific challenges like elder abuse.
F 13: Data on cultural and linguistic diversity, age and other intersectional factors such as disability and sexuality in Victoria is not always systematically collected or consistently recorded.
F 14: There is an opportunity to collect more evidence on the experience of culturally diverse older Victorians when accessing services and programs and for this data to be used to improve service delivery.
F 15: The COVID-19 pandemic significantly affected Victoria’s culturally diverse older population in terms of increasing social isolation, digital exclusion and the risk of elder abuse, preventing access to essential physical and mental health services, and contributing to lower overall health and wellbeing.
Leveraging the value of bicultural workers
Strengthening mental and physical health
F 16: Ethno-specific seniors’ groups played an essential role in providing support for culturally diverse older people throughout the COVID-19 pandemic. They still have an important role to play in supporting culturally diverse older people to safely re-engage in the community as Victoria learns to live with COVID-19.
F 17: Culturally diverse older Victorians cannot always access the services they need when they need them. Greater attention should be paid to developing healthcare and social services systems that adequately respond to the challenges they face and enable access to a broad range of services.
F 18: Bilingual and bicultural workers are an integral element of healthcare and social services systems for culturally diverse older people as they contribute to the cultural safety of workplaces, facilitate better care outcomes and reduce barriers to accessing services. However, they need support to ensure they can work effectively and provide high-quality care.
F 19: Bilingual and bicultural workers in the aged care sector improve the quality and inclusiveness of aged care services by enabling greater interaction with clients and providing cultural understanding and safety.
F 20: Culturally diverse older people experience an increased risk of poor mental health due to factors such as migration journey, trauma, marginalisation, visa status, socioeconomic disadvantage and social isolation. Victoria’s mental health system is currently undergoing significant reform which may reduce barriers to accessing services and lead to better mental health outcomes.
F 21: Culturally diverse older people can experience an increased risk of poor physical health. Physical activity and health services such as physiotherapy are important contributors to overall health and wellbeing, but are not extensive and are not always culturally appropriate.
F 22: Culturally diverse older people experience long wait times to access public dental healthcare and often cannot afford private dental services.
F 23: The Victorian Government and Palliative Care Victoria have several initiatives that aim to increase awareness and uptake of palliative care services in culturally diverse communities. Despite this, awareness of palliative care services in culturally diverse communities can still be low, particularly in regional and rural areas.
F 24: Culturally diverse communities may have low awareness of dementia and risk reduction strategies. Consequently, they can experience poorer health outcomes, including late or inaccurate diagnosis.
F 25: The Victorian Government provides significant support for carers. However, access to culturally appropriate respite and peer support networks, and better awareness of available services, could be further improved in culturally diverse communities.
F 26: Culturally diverse older people often experience financial hardship, leading to poorer health and wellbeing outcomes, lower access to services and increased risk of social isolation and elder abuse.
F 27: Financial independence and literacy can enable culturally diverse older Victorians to age at home for longer and facilitate independence and improved quality of life. However, culturally diverse older people, particularly women, often experience poor financial literacy and understanding of financial and consumer rights.
F 28: Health literacy is an essential skill for understanding health information, navigating health services, making informed health decisions and managing overall health. However, culturally diverse older people often have inadequate health literacy which can be a barrier to accessing services and lead to poorer overall health and wellbeing.
F 29: Age-friendly cities and adequate transport can enable older people to move about in the community, maintain their independence, attend medical appointments and remain in their homes for longer. They also contribute to better overall mental health and wellbeing.
F 30: Age and culturally appropriate private and social housing is essential for maintaining the independence of culturally diverse older people. It allows them to sustain social connections, access services and experience better quality of life. Insufficient housing supply or housing that is not appropriate is a particular issue in regional communities, as well as for older people experiencing elder abuse.
Addressing social isolation and loneliness
F 31: A holistic approach to the mental and physical health and wellbeing of culturally diverse older Victorians can be facilitated through recognising intersectionality, providing person-centred care and addressing the social determinants of health. Providing services that address a range of mental and physical health needs in a timely manner is required to achieve this.
F 32: Culturally diverse older Victorians are more likely to experience social isolation and chronic loneliness than other older people due to language and cultural barriers, and this can have adverse effects on their mental and physical health.
F 33: Further opportunities for formal and informal social interaction will help culturally diverse older people remain socially connected.
F 34: There is a shortage of affordable, accessible and appropriate venues for culturally diverse older people to interact and participate in social activities.
F 35: There is a lack of transport options to enable culturally diverse older people to attend social activities and interact with other people in informal settings.
F 36: Some ethno-specific seniors’ groups lack funding, resources and capacity to operate sustainably and run programs and activities to address social isolation among their members.
Enabling greater participation
F 37: Some culturally diverse older Victorians may not fully participate in elections due to language barriers or poor awareness of the electoral process.
F 38: Co-design with culturally diverse older people will ensure government policies and programs for older Victorians are inclusive, culturally responsive and able to successfully meet the needs of culturally diverse older people.
F 39: Jobs Victoria’s employment programs could be better tailored and marketed to improve employment outcomes for older jobseekers from migrant and refugee backgrounds.
F 40: Culturally diverse older jobseekers may not be aware of the training opportunities and employment readiness programs available at neighbourhood houses and Learn Locals.
F 41: Culturally diverse older people face barriers to accessing the legal system and receiving appropriate legal advice in Victoria. They may not be aware of available services or understand different legal issues that affect them and potential solutions.
Fostering digital inclusion
F 42: Older people are more likely to experience digital exclusion, and this is exacerbated for culturally diverse older people whose first language is not English, resulting in them missing out on information and support services. It can also result in a loss of financial independence if they are unable to use banking technology.
F 43: Access to government services and information is increasingly through digital platforms, which may result in culturally diverse older people who are digitally excluded missing out on timely and appropriate information and services.
F 44: Digital literacy training provided by bilingual mentors in community settings is the most effective way to reach culturally diverse older people and improve their digital skills and confidence.
F 45: Culturally diverse older people who do not have access to affordable and reliable internet connections and digital devices are unable to use the internet and build their digital skills and confidence. Reliable internet connectivity is a particular issue in regional communities.
Enhancing responses to elder abuse
F 46: Elder abuse is an emerging issue that will likely increase with Victoria’s ageing population. A Victorian elder abuse prevention and response strategy is needed to increase understanding of the issue and ensure older people can access services.
F 47: Short-term and insufficient funding hinders the ability of service providers and community organisations to undertake elder abuse awareness-raising and prevention initiatives.
F 48: There is a shortage of research on effective elder abuse prevention and response strategies, evaluation of current programs and data collection on elder abuse in culturally diverse communities.
F 49: Intergenerational programs are one of the most effective ways of combatting ageism as a key driver of elder abuse.
F 50: Awareness-raising campaigns and educational programs can combat ageism and increase understanding of elder abuse and available support. There is scope to expand these activities in culturally diverse communities to prevent elder abuse and facilitate better access to services.
F 51: Culturally diverse older people on temporary, contributory parent or parent visas can experience an increased risk of elder abuse and may be more reluctant to seek help.
F 52: The banking sector has made important changes to assist with the prevention and early identification of financial elder abuse. However, more can be done to ensure culturally diverse older people are not unduly influenced or coerced when making financial decisions.
F 53: Increasing financial literacy and providing financial counselling services can reduce the risk of elder abuse, particularly in migrant and refugee communities.
F 54: Culturally appropriate elder abuse responses should educate older people on their rights, and should respect the choices they make and place them at the centre of their own care. Non-legal interventions are often a more appropriate means of responding to elder abuse.
F 55: Specialist elder abuse responses, such as health justice partnerships, Seniors Rights Victoria and community legal centres, can effectively address elder abuse because they consider the needs of an older person holistically, provide culturally responsive and place-based services, build trust with clients and build effective partnerships with other service providers. However, they are not sufficiently funded to meet current demand.
F 56: Staff at community organisations and service providers in the healthcare and social services sectors should be trained on identifying and responding to elder abuse. Community leaders and family members in culturally diverse communities should also be able to identify the signs of elder abuse and refer people to appropriate support.
Meeting aged care support needs
F 57: Culturally diverse older Victorians may not access aged care services because of a shortage of culturally appropriate services, lack of awareness of available services, language barriers and the cultural stigma associated with placing older family members in residential aged care.
F 58: Community education campaigns to raise awareness among culturally diverse older people of available aged care services and how they work could help increase uptake and reduce misinformation and stigma associated with aged care.
F 59: Culturally diverse older people need bilingual and bicultural assistance to navigate the My Aged Care system and access appropriate aged care services.
F 60: Not all aged care service providers deliver culturally inclusive and safe services, which can negatively affect the health and wellbeing of culturally diverse older people.
F 61: There is a lack of ethno-specific residential aged care facilities to cater to the needs of culturally diverse older Victorians.
The Recommendations are
R 1: That the Victorian Government explore opportunities to support and encourage departments and funded service providers to develop and implement cultural safety plans and objectives, for example, by producing a guide on cultural safety for service providers, promoting existing resources or setting expectations for funded services to adopt cultural safety approaches. Adequate implementation of cultural safety plans should be regularly evaluated.
R 2: That the Victorian Government undertake a review of its language service policies, guidelines and practices and seek to increase investment in translation and interpreting services, including in regional Victoria.
R 3: That the Victorian Government increase ongoing funding for ethno-specific and multicultural organisations to provide essential services for culturally diverse older people.
R 4: That the Victorian Government review an increase in investment in councils’ and community-based service providers’ capacity to support older people from culturally diverse backgrounds. Particular attention should be directed to the needs of smaller ethnic and recently arrived communities to ensure equitable access to services.
R 5: That the Victorian Government ensure regional and rural councils, community groups and service providers are adequately supported to meet demand for culturally appropriate services and provide culturally safe care.
R 6: That the Victorian Government trial or implement a care finder or community connector initiative to help culturally diverse older people find and access support in their local areas.
R 7: That the Victorian Government and service providers continue to resource face-to-face service options and offer non-digital communication methods for people who cannot access online services.
R 8: That the Victorian Government undertake a review of the content on its websites to ensure information for older people is current, accessible and accurate.
R 9: That the Victorian Government expand the translation of health and service information, resources and websites into a broad range of community languages using simple language and accessible formats. The Victorian Government should actively promote its translated resources in the community and encourage service providers to better utilise them.
R 10: That the Victorian Government fund ethno-specific and multicultural organisations to provide culturally appropriate and community-led education programs to expand older people’s and their families’ knowledge of government services and resources, and to overcome the stigma associated with accessing support.
R 11: That the Victorian Government continue to promote its services and work collaboratively with peak bodies, service providers, multicultural and multifaith organisations and communities to disseminate culturally appropriate and accessible information promptly. This should involve multiple modes of communication using culturally appropriate communication and engagement methods—for example, Easy English, translated resources, ethnic community media, online engagement methods and social media—as well as leveraging the trusted position of community leaders, community organisations and bicultural workers to convey information.
R 12: That the Victorian Government ensure programs for culturally diverse older people and service providers have adequate resourcing to develop tailored advertising and promotional materials that can be translated and distributed through different communication pathways.
R 13: That the Victorian Government enhance partnerships between different levels of government, ethno-specific and multicultural groups, service providers, peak bodies and the private and community sectors by creating a network or partnership program focusing on the needs of culturally diverse older Victorians. Particular attention should be paid to partnerships in regional and rural areas.
R 14: That the Victorian Government more actively engage culturally diverse older people and their carers in the co-design of services through outreach and consultation.
R 15: That the Department of Families, Fairness and Housing establish an older persons’ advisory group under the multicultural affairs portfolio to advise on government service design.
R 16: That the Victorian Government commence a research program on the experiences of older people from migrant and refugee backgrounds, particularly about their perspectives on ageing and the impact of intersectional factors.
R 17: That the Victorian Government improve data collection on different personal attributes to enhance the provision of services to culturally diverse older people. The Victorian Government should review the Federation of Ethnic Communities’ Councils of Australia’s 2020 report, Towards consistent national data collection and reporting on cultural, ethnic and linguistic diversity when considering how to collect the data.
R 18: That the Victorian Government develop culturally inclusive feedback mechanisms for the continuous improvement of services.
R 19: That the Victorian Government’s Pandemic Repair Plan more specifically address the concerns and challenges experienced by culturally diverse older people during the COVID-19 pandemic. The Plan should include ways to encourage older people to re-engage in physical, social and community activities and strategies to address adverse health and social impacts of the pandemic.
R 20: That the Victorian Government continue to invest in providing information and education about COVID-safe practices and social connection opportunities through funding for ethno-specific seniors’ groups and community organisations.
R 21: That the Department of Families, Fairness and Housing’s and the Department of Health’s cultural diversity plans include a section on addressing the specific needs of older people and new and emerging communities given the complexity of the challenges they face and the expected increase in the population size and needs.
Leveraging the value of bicultural workers
R 22: That the Victorian Government consult with peak multicultural bodies, service providers, community leaders and culturally diverse communities when developing its bicultural worker strategy.
R 23: That the Victorian Government’s bicultural worker strategy consider consistent remuneration, core competencies, training, professional development and support for bicultural and bilingual workers.
R 24: That the Victorian Government’s bicultural worker strategy consider how to support people from migrant and refugee backgrounds to apply for bilingual and bicultural roles, and how to embed workers in service delivery, particularly in regional areas.
R 25: That the Victorian Government continue supporting and expand Jobs Victoria programs that target and support newly arrived migrants, refugees and culturally diverse people to gain qualifications and employment in the aged care sector.
Strengthening mental and physical health
R 26: That the Victorian Government increase the promotion of existing physical health initiatives and programs in culturally diverse communities and seek to ensure programs offered can be tailored to different cohorts.
R 27: That the Victorian Government invest in state public dental services to deliver more procedures for culturally diverse older patients needing dental care.
R 28: That the Victorian Government raise awareness of available free or low-cost dental services in culturally diverse communities.
R 29: That the Victorian Government’s 2022–23 State Budget funding for palliative care services in regional and rural communities be accompanied by a campaign to raise awareness of services in culturally diverse communities.
R 30: That the Victorian Government increase awareness of dementia in culturally diverse communities, in partnership with ethno-specific and multicultural groups and organisations, to encourage preventative and early help-seeking behaviours.
R 31: That the Victorian Government, through the next iteration of the Victorian carer strategy 2018–22, focus on improving awareness of available carer supports in culturally diverse communities and providing culturally appropriate respite and peer support.
R 32: That the Victorian Government seek to alleviate the financial hardship of culturally diverse older Victorians and provide more affordable access to services by advocating that the Australian Government raise the Age Pension, providing additional subsidised care options or providing additional income support.
R 33: That the Victorian Government collaborate with ethno-specific organisations and financial counselling providers to develop tailored and culturally appropriate financial counselling services, financial literacy training and capacity-building workshops.
R 34: That the Victorian Government increase awareness of existing financial counselling services in culturally diverse communities.
R 35: That the Victorian Government fund culturally appropriate and place-based capacity-building programs and projects to improve the health literacy of culturally diverse older populations.
R 36: That the Victorian Government’s investment in social and affordable housing include housing that adequately addresses the needs of culturally diverse older Victorians and enables them to stay at home for longer.
R 37: That the Department of Health create a plan for improving the mental and physical health and wellbeing of older people, with a particular focus on culturally diverse communities. It should adopt the guiding principles identified in Chapter 2 of this report.
R 38: That the Victorian Government’s ageing well action plan, Ageing well in Victoria: an action plan for strengthening wellbeing for senior Victorians 2022–2026, and the Department of Health’s ageing plan (as identified in Recommendation 37), emphasise locating culturally diverse older people at the centre of their own care, recognising intersectionality and the needs of new and emerging communities, addressing the social determinants of health, providing wrap-around holistic support, and providing timely access to services.
Addressing social isolation and loneliness
R 39: That the Victorian Government expand social prescribing trials to meet the needs of culturally diverse older people and include multicultural and ethno-specific organisations as accredited providers.
R 40: That the Victorian Government support the expansion of the Chatty Café Scheme and similar programs across Victoria to create informal opportunities for culturally diverse older people to interact with their peers and with other generations.
R 41: That the Victorian Government expand the Age-Friendly Victoria initiative to assist all councils to provide multicultural community groups with low-cost, accessible spaces to run social activities and programs.
R 42: That the Victorian Government expand the Age-Friendly Victoria initiative to assist all councils to improve community transport options for culturally diverse older people to attend social activities and programs.
R 43: That the Department of Families, Fairness and Housing simplify grant applications and reporting requirements for ethno-specific seniors’ groups and ensure funding processes are accessible regardless of English language and/or digital literacy levels.
R 44: That the Victorian Government expand the role of positive ageing officers in local government to provide governance support and build the leadership capacity of ethno-specific seniors’ groups.
Enabling greater participation
R 45: That the Victorian Government support the Victorian Electoral Commission to expand its Democracy Ambassador program to educate more culturally diverse older people about elections and how to vote correctly.
R 46: That the Victorian Government set a target for representation of culturally diverse older people on advisory and decision-making bodies responsible for designing policies and programs relating to older Victorians.
R 47: That the Department of Jobs, Precincts and Regions develop a Jobs Victoria employment program specifically for culturally diverse older people and collaborate with ethno-specific organisations to link older jobseekers to the program.
R 48: That the Victorian Government collaborate with settlement agencies and ethno-specific organisations to raise awareness among culturally diverse older people of the training and employment readiness programs available at neighbourhood houses and Learn Locals.
R 49: That the Victorian Government facilitate better access to legal services for culturally diverse older people by funding culturally appropriate community legal education programs and community legal centres.
Fostering digital inclusion
R 50: That the Department of Families, Fairness and Housing examine the barriers to digital inclusion for culturally diverse older people and how to address them in its upcoming review into digital connectedness for senior Victorians.
R 51: That each Victorian Government department develop a communications strategy that outlines how it will provide equitable access to services and information for people who are digitally excluded, including older people and people for whom English is not their preferred language.
R 52: That the Victorian Government advocate to the Australian Government to fund the Be Connected network to create tailored digital mentoring programs and digital literacy resources for culturally diverse older people.
R 53: That the Victorian Government further support neighbourhood houses to offer digital literacy training specifically for culturally diverse older people.
R 54: That the Victorian Government work with libraries, neighbourhood houses, local government and community organisations to loan digital devices and dongles to culturally diverse older Victorians in need.
R 55: That the Victorian Government further advocate to the Australian Government for greater investment in improving internet connectivity in regional and rural Victoria.
Enhancing responses to elder abuse
RECOMMENDATION 56: That the Victorian Government develop a strategy to prevent and respond to elder abuse in Victoria. It should include specific actions for culturally diverse communities, build on past research and reviews, and consider the guiding principles discussed in Chapter 2 of this report.
R 57: That the Victorian Government, through an elder abuse strategy, provide long-term and sustainable funding for elder abuse prevention and response.
R 58: That the Victorian Government prioritise research, evaluation and data collection on elder abuse in culturally diverse communities when developing a Victorian elder abuse strategy.
R 59: That the Victorian Government support the expansion of intergenerational programs in Victoria targeted to culturally diverse communities to reduce ageism. They should be co-designed with and tailored to different communities.
R 60: That the Victorian Government fund a long-term and culturally appropriate elder abuse awareness-raising campaign and education program that aims to reduce ageism, increase awareness of elder abuse and direct people to available support. It should include funding to individual organisations and community groups to implement place-based, accessible and culturally specific awareness initiatives.
R 61: That the Victorian Government provide additional funding to Elder Abuse Prevention Networks to undertake place-based and culturally appropriate prevention initiatives.
R 62: That the Victorian Government advocate to the Australian Government to implement measures that support older people on temporary, contributory parent or parent visas experiencing elder abuse, such as health, housing and employment support as well as pathways to other visas.
R 63: That the Victorian Government provide additional health, housing and employment support for older people on temporary, contributory parent or parent visas experiencing elder abuse and conduct further research on the extent of the issue.
R 64: That the Victorian Government support elder abuse prevention initiatives that facilitate partnerships and collaboration between the banking and community services sectors, and Victoria Police. This should include encouraging the banking sector to use independent and qualified interpreters and provide culturally diverse older people with independent financial advice.
R 65: That the Victorian Government fund culturally appropriate financial counselling services in more community health settings as an elder abuse prevention and response initiative.
R 66: That the Victorian Government’s elder abuse strategy focus on non-legal responses and ensuring older people can make informed decisions about elder abuse interventions.
R 67: That the Victorian Government increase funding for Seniors Rights Victoria, elder abuse health justice partnerships and community legal centres in Melbourne and regional Victoria to ensure culturally diverse older people can access elder abuse services close to where they live.
R 68: That the Victorian Government expand training initiatives for healthcare and social services workers to identify and respond to elder abuse.
R 69: That the Victorian Government provide funding for bicultural and bilingual community educators to deliver training to community leaders, older people and their family members on elder abuse and appropriate responses.
Meeting aged care support needs
R 70: That the Victorian Government work with the Ethnic Communities’ Council of Victoria to develop and implement in-language community education programs about aged care to increase awareness and reduce stigma and misinformation about aged care services among culturally diverse communities. These programs should incorporate advertisements in ethnic media, in-person information sessions, and community engagement through religious and cultural leaders.
R 71: That the Victorian Government support multicultural and ethno-specific community organisations across the state to improve their capacity to provide bilingual and bicultural support to culturally diverse older people so they can effectively navigate the My Aged Care system and access relevant aged care services.
R 72: That the Victorian Government establish a multilingual phone line for culturally diverse older people to seek information about aged care services in their preferred language that is modelled on the Centre for Cultural Diversity in Ageing’s Multilingual Older Persons COVID-19 Support Line trial.
R 73: That the Victorian Government require its funded aged care service providers to use the Centre for Cultural Diversity in Ageing’s Inclusive Service Standards to self-assess and improve their cultural inclusion practices.
R 74: That the Victorian Government advocate to the Australian Government to mandate ongoing cultural awareness training for aged care staff and adoption of the Aged Care Diversity Framework by all aged care service providers.
R 75: That the Victorian Government continue to invest in the establishment of ethno-specific residential aged care facilities in Melbourne and where viable in regional areas.
R 76: That the Victorian Government encourage mainstream aged care providers to partner with ethno-specific organisations to improve their capacity to deliver culturally inclusive services.
