This submission addresses the Royal Commission’s Terms of Reference in relation to the criteria of person-centred aged care; challenges and opportunities for delivering accessible, affordable and high quality aged care services; and how best to deliver aged care services in a sustainable way, including through innovative models of care and investment in the aged care workforce.

Older Aboriginal and Torres Strait Islander people are being let down by the aged care system. They are significantly underrepresented in residential aged care services, at under one per cent, and their uptake of dementia services is very poor. Yet older Aboriginal and Torres Strait Islander peoples experience at least 2.3 times the burden of disease as other Australians and are also 3-5 times more likely to experience dementia. It is a sad indictment of the system that the care needs of our ageing First Peoples are not being met.

The needs of older Aboriginal and Torres Strait Islander peoples require urgent attention by the Australian Government and the health and aged care systems. As the Commissioners will be aware, the population of First Peoples aged 65 and over is projected to grow by 200 per cent between 2011 -2031. This unprecedented population growth combined with the complex health issues that our people experience as they age presents major challenges for providers of both aged care and primary health care to respond to increased service needs from Aboriginal and Torres Strait Islander elders. We believe it is imperative that the Australian Government commits to resourcing more innovative, efficient and effective solutions that address the barriers to accessing aged care solutions for older Aboriginal and Torres Strait Islander peoples.

Key points:

• NACCHO believes the next step forward in addressing the needs of older Aboriginal and Torres Strait Islander peoples as outlined in this submission, is a genuine commitment from the Australian Government to work in partnership with Aboriginal and Torres Strait Islander peoples and their representatives to develop solutions and oversee their implementation in services on the ground.
• Lack of cultural safety is the main reason why Aboriginal and Torres Strait Islander peoples are underrepresented in residential aged care statistics. More must be done to improve the representation of our people in residential aged care.
• The Royal Commission hearings have illustrated how an accumulation of risk factors arising out of First Peoples’ experiences of poverty, poor housing, education and employment prospects, intersect with their health, ageing and life expectancy outcomes. As a result, Aboriginal and Torres Strait Islander people are more likely to require aged care supports at a much lower rate than other Australians.
• NACCHO believes it is imperative that trauma-informed care be embedded in aged care services as a priority, given the evidence which suggests that members of the Stolen Generations and their descendants experience a significant higher burden of trauma, chronic disease, and other markers of disadvantage, and are more likely to develop dementia as they age.
• NACCHO believes that the Australian Government has a moral responsibility to rise to the challenges, and to ensure ageing Aboriginal and Torres Strait Islander peoples, many of who are victims of past government policies, have access to culturally safe, affordable and high quality aged care services, regardless of where they live.

It is imperative that, given the population projections of older Aboriginal and Torres Strait Islander peoples, the burden of disease they carry, and their underrepresentation in the aged care system, that their needs and preferences are given urgent priority. NACCHO believes the next step forward is for the Australian Government and providers to deliver on 15 what works, in genuine consultation with Aboriginal and Torres Strait Islander peoples and their representatives.