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Australia has a diverse population of 407,000 using residential aged care services, home care or transition care in Australia (Australian Government Institute of Health and Welfare 2023). Older Australians, in particular those living in aged care residencies, represent one of the most vulnerable demographics, as they become increasingly reliant on others for support in basic daily activities, comprehension and decision-making, and experience decline in their physical and cognitive abilities (Sanchini, Sala & Gastmans 2022). 

There are a number of aged care services offered in Australia to suit older Australians with varying abilities, preferences and care needs, ranging from care in an individual’s own home through the Commonwealth Home Support Program (CHSP) or home care packages, to residential aged care in external facilities, and flexible or short-term care (Healthdirect 2023).

The challenges faced by older Australians are exacerbated for older Australians from culturally and linguistically diverse (CALD) backgrounds. 2016 Census data reveals that 20% of Australians aged 65 and over were born in non-English speaking countries, and 18% spoke a language other than English at home (Australian Government Australian Institute of Health and Welfare 2023). Barriers can include limited English proficiency (or none at all), digital literacy, limited social connections and community exposure, vulnerability to isolation and deficient access to reliable information and services (Gorgeou et al. 2023, p. 183).

Government and service providers must be mindful of accessible communications when providing reliable and inclusive services to older Australians, their carers and families, especially in the case of older Australians from CALD backgrounds. This article explores the value of accessible and inclusive communications for older Australians in aged care, and the crucial role that in-language translations and Easy Read and Plain English resources can play in this delivery.

Importance of reliable resources for decision-making

There are a number of important decisions that face older Australians, including determining aged care services and supports, end-of-life arrangements, advanced care planning, major legal or financial decisions, including regarding wills and estates and medical treatment. While the capacity to make decisions and comprehend information may be limited amongst older Australians, the ageing population is entitled to the right to make decisions for themselves regarding matters that impact them, and to access reliable information and resources that can support them in the decision-making process. This is especially important considering the weight of the outcomes involved in these decisions.

Resources made available in Easy Read and Plain English, as well as translated resources in a variety of community languages, can be of great benefit for older Australians with decision-making capacity to understand the options that are available to them, and the expected outcomes of each one.

Accessible information provides a sense of autonomy and dignity

Adequate resourcing for decision-making is essential to empower and enable older people to make decisions about their lives without being influenced by others around them, and preserve their right to autonomy and dignity. Older Australians may be more susceptible to abuse when not afforded the right to make independent decisions, or if their decisions are undermined by the people around them. 

Studies have linked autonomy and self-efficacy to increased quality of life and satisfaction among older persons (Moilanen, Kangasniemi & Suhonen 2021, p. 414). This demonstrates a clear necessity to develop more adequate resources for older Australians to govern their lives when they have the capacity to do so, and to promote self-governance through accessible communications as a core value of aged care services and healthcare for older Australians.

Value of social connectedness through accessible language

Social connectedness is an important value for all Australians and has direct outcomes on an individual’s health and wellbeing (Centers for Disease Control and Prevention 2023). However, barriers faced by older Australians, including age-related cognitive decline, hearing or vision loss, limited mobility and declining communicative abilities, may have negative impacts on an individual’s social wellbeing and may increase social isolation (Victorian Government Department of Health 2015). This is of particular concern for older people of CALD backgrounds who may have a limited social circle outside of their aged care support (if any), lack of integration within the community, and face language barriers.

Studies have demonstrated that poor mental health outcomes linked to practical, social and emotional loneliness are commonplace amongst older CALD migrants and refugees, and this was exacerbated through the COVID-19 pandemic, as movement and interaction, in particular in aged care facilities and medical institutions, were heavily restricted (Georgeou et al. 2023, p. 183).

There is an opportunity for innovation in this space to enhance social connectedness amongst older Australians through accessible means that go beyond language tools like Easy Read or Plain English, including through technological solutions.

Accessible communications encompass a range of English literacy levels and communication skills

While in-language translations of resources and information can be beneficial for older people from CALD backgrounds, the Australian Aged Care Quality Agency has identified that they are not the sole solution to ensuring accessibility and inclusion in communications and information delivery (2018, pg. 3).

Plain English is a helpful language tool that can cater for older people with a range of English proficiency levels, and can be used in both speech, and written resources (Australian Aged Care Quality Agency 2018, pg. 3). Easy Read may also be a useful tool to deliver written resources in a manner that is simplified and can take into account older Australians with declining cognitive functions and communication skills, as well as the CALD community who face difficulties in reading English materials, or do not have translated materials available to them (Federation of Ethnic Communities’ Councils of Australia 2022, p. 12).

Overall, the availability of resources in a number of forms is a proactive approach that considers the diverse needs of older Australians, in a diverse Australia.

Being informed together creates positive outcomes for all

It is important to consider that not all older Australians, especially those from CALD backgrounds, may seek aged care services. For example, many CALD older people and their families may choose to see family-centred care when available, rather than external aged care services (Australian Government Australian Institute for Health and Welfare 2016, pg. 1). This is why it is important that carers and families of older Australians are informed about best practices in accessible communications, and how they can support the older person(s) in their lives to access information and resources, develop ways of communication that are effective, and assist them in decision-making without infringing on their rights and choices. 

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Accessible and inclusive communications are integral to providing comprehensive care for older Australians, particularly those from CALD backgrounds. In a diverse, multicultural Australia, it is essential to build a system where every older Australian, regardless of cultural or linguistic background, and regardless of the aged care services they choose to seek or not seek, can age with dignity and autonomy, and are empowered to govern their lives through the decisions they make.

Get in touch with the dedicated team at easyread.tech to find out how Easy Read and Plain English can fit into your organisation’s information delivery.

References

Australian Aged Care Quality Agency 2018, New single quality standards: consumer information resource, viewed 12 December 2023, <https://www.agedcarequality.gov.au/sites/default/files/media/consumer_resources_standards_-_phase_1_report_6_july_18_pdf.pdf>.

Australian Government Australian Institute for Health and Welfare 2016, Exploring the aged care use of older people from culturally and linguistically diverse backgrounds: a feasibility study, viewed 12 December 2023, < https://www.aihw.gov.au/getmedia/55509a73-450d-42e4-9841-b7ed6f58c3ee/20342.pdf.aspx?inline=true>.

Australian Government Australian Institute of Health and Welfare 2023, Older Australians, AIHW, viewed 13 December 2023, <https://www.aihw.gov.au/reports/older-people/older-australians/contents/population-groups-of-interest/culturally-linguistically-diverse-people>.

Australian Government Institute of Health and Welfare 2023, People using aged care, Gen Aged Care Data, viewed 13 December 2023, <https://www.gen-agedcaredata.gov.au/topics/people-using-aged-care>.

Centers for Disease Control and Prevention 2023, How Does Social Connectedness Affect Health?, Centers for Disease Control and Prevention, viewed 12 December 2023, <https://www.cdc.gov/emotional-wellbeing/social-connectedness/affect-health.htm>.

Federation of Ethnic Communities’ Councils of Australia 2022, Recommended Protocols for the Translation of Community Communications, viewed 12 December 2023, <https://ausit.org/wp-content/uploads/2022/12/AUSIT-FECCA-RECOMMENDED-PROTOCOLS-FOR-THE-TRANSLATION-OF-COMMUNITY-COMMUNICATIONS-.pdf>. 

Georgeou, N, Schismenos, S, Wali, N, Mackay, K & Moraitakis, E 2023, ‘A Scoping Review of Aging Experiences Among Culturally and Linguistically Diverse People in Australia: Toward Better Aging Policy and Cultural Well-Being for Migrant and Refugee Adults’, Gerontologist, vol. 63, no. 1, pp. 182-199, viewed 13 December 2023, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9872767/>.

Healthdirect 2023, Aged care services, Healthdirect, viewed 13 December 2023, <https://www.healthdirect.gov.au/aged-care-services>.

Moilanen, T, Kangasniemi, M & Suhonen, R 2021, ‘Older people’s perceived autonomy in residential care: An integrative review’, Nursing Ethics, vol. 28, no. 3, pp. 414-434, viewed 13 December 2023, <https://journals.sagepub.com/doi/full/10.1177/0969733020948115>.

Sanchini, V, Sala, R & Gastmans, C 2022, ‘The concept of vulnerability in aged care: a systematic review of argument-based ethics literature’, BMC Med Ethics, vol. 23, no 1, viewed 12 December 2023, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379886/>.

Victorian Government Department of Health 2015, Communicating with older people who have diverse needs, health.vic, viewed 13 December 2023, <https://www.health.vic.gov.au/patient-care/communicating-with-older-people-who-have-diverse-needs>.