The Cultural Constraints on Australian Aged Care
- By Zoya Patel
It’s happening – as I inch closer to 30, I am noticing the creeping change in my relationship with my parents, where we begin to swap sides in the dynamic of carer vs dependent. This is the inevitable evolution of the parent-child relationship, the slow morphing of our mothers and fathers from being invincible custodians of our well-being, to becoming more vulnerable in their health and capacity, until eventually they rely on us, not the other way around.
My parents are still quite young (in their fifties), so the hints I am getting of this change are still quite minor. My mother may need me to help organise things for her that require a great deal of internet literacy. My father has started to watch his cholesterol more diligently. There are small signifiers of their age, or their reliance on myself and my siblings that weren’t there maybe five years ago, and that gently hint at the much larger changes to come.
Ageing remains a process that many of us are too afraid to confront. I still get a leap of anxiety in my chest when I think about how quickly life passes, and how soon each phase of our lives is upon us. It forces us to confront our mortality, and seeing it reflected in our parents as they grow older, feebler, and eventually die, is often too difficult for children to face. More and more elderly Australians will live out their final years in nursing homes and retirement facilities, away from the gaze of the average Australian, relegated to the corner of society that means they won’t be an unwelcome reminder of our inability to avoid time. In fact, in 2016, 15% of our population was aged 65 and over.
The system of aged care in Australia is in many ways a superior one – there is government support for the elderly, facilities that combine medical and social care, and an existing framework for children to slot their parents into when the time comes. Of course, the system is rife with issues – abuse of elderly residents in nursing homes, the increasing for-profit model of aged care, and the cost can mean that outcomes are varied or non-existent for some.
But even if the aged care options were world class and had no potential negative impacts, my siblings and I could never consider placing our parents into a facility when they are no longer able to care for themselves. As Fijian-Indians, our culture places a high regard on the elders in our family, and it is the duty and honour of the children to take care of their parents, in their homes, until their death.
Typically in our culture, parents live with their eldest son. It is one of the reasons why having a son is so important, and having only daughters can be considered a burden. In the patriarchal, traditional system of marriage in India, daughters are obliged to their husband’s families, while sons are obliged to their own parents.
Our family doesn’t adhere to these norms, but it is still without question that our parents will live with one of us when the time comes – it is likely to be whoever has the most stable home life, income, and ability to care for them, and all of us will support them financially. A combination of these values of family connectedness, respect for elders within the family unit, and a culture that doesn’t really support nursing homes means that our parents are our responsibility as they age, and are likely to live out their lives in one of our homes.
This cultural context makes the prospect of our parents ageing slightly different for us than for many of my white friends. In no way does this mean that those friends care any less for their parents, or will be any less present in their parents lives; but the logistical way in which this care will be demonstrated will vary more than what is likely to occur in my family.
Whilst traditions and cultural norms certainly play a huge role in our approach to ageing and the role of the elderly in society, in a multicultural community such as we have in Australia, this becomes more complex. In 2016, one in seven Australians aged 65 and over were from a non-english speaking background. As we know, there is a tendency for the elderly to revert to their first language, often as a result of dementia. In Australia, within a culture that relies on a nursing home and aged-care system to respond to the needs of the elderly, the need for cultural awareness and bilingual workers is pressing – something that has been acknowledged in pleas to the government to date.
Without this incorporation of multicultural factors into our aged care systems, Australians from culturally diverse backgrounds face a challenge when seeking to bring together our cultural traditions and the expectations of our adopted homes.
It’s challenging to live out traditions that come from a culture that is more focused on the collective within a capitalist society focused on the individual. In India, it is normal for parents to live with their children. Houses are built to accommodate more people, the roles that each family member plays in contributing to the broader organism of the family are more defined, and there is a continuity to this – the social lives of families are more connected to each other, for example, so that elder relatives are incorporated into gatherings, and are part of the beating heart of family life. The social isolation experienced by many elderly people in Australia is not as apparent, or at least is driven by different factors (such as physical location and mobility).
In Australia, however, we’re moving to increased density and smaller house sizes, and workplace culture is not as flexible to caring responsibilities as is needed to accommodate living with an elderly parent without some sort of external care provision.
It creates a challenging future scenario – how will my siblings and I care for my parents if they require translator support and don’t have access to assistance that can accommodate this, when we will all be working full-time jobs?
How will we ensure the connectedness of our parents to the community and reduce their isolation, without the bustling social framework of extended family that would exist in Fiji, but that we’re isolated from in Australia?
These are questions without clear answers for now, but the need to address diversity and inclusion within Australian aged care frameworks is ever-increasing in pressure.