Recent news coverage of the ravages of coronavirus in residential aged care has highlighted significant issues and risks in the aged care sector. While questions have been raised about systems, responses, funding and qualifications of staff, the underlying issue is the human rights of older people.
The focus of much of the messaging around coronavirus and older people is upon the increased vulnerability to the disease which comes with age. While our public health response most definitely needs to take this vulnerability into account, we must be careful not to paint a picture of older people as merely passive victims. We must respect the autonomy, decisions, and self-determination of older people as for other groups in society. We must consult with, and act upon the views of, older people when preparing and responding to coronavirus outbreaks. The Four Corners investigation into the coronavirus outbreak at Newmarch House highlighted the denial of residents’ rights to exercise choice and control over their own lives, with resident Alice Bacon telling her daughter repeatedly, “Get me out of here!”, while a public health order effectively kept her locked inside.
Human rights do not diminish with age, and decisions about access to medical care and the allocation of medical resources must not be made on age alone. Again, the Four Corners investigation highlighted the denial of access to critical medical resources on an equal basis with others, through the imposition of the “Hospital in the Home” program which lacked access to essential medical equipment and a delay in accessing IV fluids.
Taking a human rights approach to our coronavirus response also means considering the impacts of policy decisions upon different groups in society, including older people. Coronavirus has had far-reaching impacts on older people beyond their medical vulnerabilities, including impacts on mental health and social connection. Older people are more likely to live alone and face barriers to using the online communications technologies others take for granted. Changes to the ways in which businesses operate, as well advice to stay at home during outbreaks, may have significant impacts for people who rely on regular medication, pre-prepared food, or access to therapy providers. Restrictions on religious gatherings may also have a significant impact on the spiritual and social wellbeing of older people for whom these gatherings were an important weekly habit. Some of these issues may be further heightened for older people from Culturally and Linguistically Diverse backgrounds, many of whom face additional barriers to accessing information and supports and building social connections.
It is also important that aged care workers from CALD backgrounds are not vilified in investigations into failures of the aged care system in responding to coronavirus. In mentioning an increasing proportion of “migrant workers” in the aged care workforce, this ABC news article implies (without providing any data) that these workers are likely to be “unqualified” and only taking on work in the sector because it is undesirable to “locals”. In contrast, recent research from the UNSW Social Policy Research Centre found that overseas-born care workers have higher levels of formal education than their Australian-born counterparts. Furthermore, while there are clearly significant issues with pay, conditions and supervision in the aged care sector, the cultural and linguistic skills of workers from CALD backgrounds are an asset, not a liability. With 1 in 5 of Australia’s older people having been born in a non-English speaking country, having workers who can speak additional languages and understand cultural norms is invaluable. Our blog post back in March highlighted the significant difference that ECSC’s multicultural Senior’s Support Groups have made in the lives of older Australians from CALD backgrounds. Australia needs a multicultural aged care workforce to meet the needs of our multicultural older population.
The coronavirus pandemic has changed life for all of us over the past few months. While “older persons have become highly visible during the COVID-19 outbreak… their voices, opinions and concerns have not been heard” (Ms Rosa Kornfeld-Matte, Office of the United Nations High Commissioner on Human Rights). It is critical that we take a human rights approach to consultation, planning, decision-making, and access to resources as we continue to respond to the pandemic. We must also value the skills and knowledge of the diverse workforce which supports Australia’s older people; and ensure that our aged care workers are well supported to continue their vital work.
Ingrid Boland, Social Work Consultant for ECSC