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Understanding individual experience key to care

New research on older people’s experience of diversity in aged care shows the best care for older clients involves them being treated as individuals.

“How would I like to be treated? Just as a normal person. I’d like people to treat me as I treat them,” one participant said.

The inter-relationship of diversity principles for the enhanced participation of older people in their care: a qualitative study, published in International Journal for Equity in Health, interviewed home care clients over 65 about their experience of diversity.

Bolton Clarke Research Institute Senior Research Fellow Dr Rajna Ogrin said older people interviewed identified human connection based on trust and rapport as a crucial first step to understanding their needs. They also highlighted the importance of care workers understanding the different intersecting aspects of each person’s identity and experience.

Participants were aware of unconscious bias and prejudice by health professionals and its impact on their care. They noted that promotion of inclusion through language was important for a positive relationship. The report also highlighted the importance of physical accessibility of services, with limited mobility and lack of transport acknowledged as barriers to equity of access.

Older people with complex needs said they would prefer not to accept a service if it would infringe on their ability to remain independent or participate in social life.

Dr Ogrin said all participants referred to their identity – their past experiences shaping them to be who they are as complex, layered individuals. Their experiences were integral to their identity and potentially relevant to participation in care.

“It is critical to human connection and participation in health care that older people are viewed as autonomous individuals with a unique set of needs and preferences, who can be supported by the health and aged care workforce in an inclusive and respectful manner,” she said.

“Participants recognised that the health and aged care worker was there to address a health issue but were adamant that they were more than the health issue – they were an individual seeking a more personal interaction with acknowledgement of them as a person.

“Older people do not want to feel like they are a task, with no human connection beyond that task.”

Participants understood they required assistance from the health and aged care worker but felt it important that their strengths were acknowledged.

Some felt health and aged care workers and the community more broadly were biased around aspects of older age.

“They were concerned, and in some instances angry, that they were seen as less than who they are because of their age, with aspects overlooked due to their older appearance,” researchers reported.

“I still think and work things out for myself,” one participant said. “I don’t want to be just treated like somebody who is stupid.”

Older people said language was important in shaping their relationship with their aged care worker.

The researchers said to promote a positive care experience there was a need for health and aged care workers to be aware of the unconscious biases and assumptions and promote inclusion through language.

“There was a complex interplay of experiences that made participants who they were and they wanted the health and aged care providers to acknowledge this complexity and treat them with respect.”

Dr Ogrin said the study supports the training already developed by Bolton Clarke for health and aged care workers, emphasising the need for human connection and a positive care experience.

Read the report:

Ogrin, R., Meyer, C., Appannah, A. et al. The inter-relationship of diversity principles for the enhanced participation of older people in their care: a qualitative study. Int J Equity Health 19, 16 (2020).