Culturally safe aged care for Aboriginal and Torres Strait Islander people – what is yours to do?

The new Aged Care Act enshrines the right for older people to receive aged care services that are culturally safe, culturally appropriate, trauma-aware and healing-informed; and for Aboriginal and Torres Strait Islander people a right to opportunities and assistance to stay connected to their community, Country and Island Home. 

What does that look like in practice, operation and implementation? What is yours to do? What resources and frameworks are there to guide change? How are changes within the aged care sector aligned with broader processes such as the National Agreement on Closing the Gap and Reconciliation?  

Cultural safety involves inner and outer change 

Let’s start with the definition of cultural safety developed by the National Aboriginal and Torres Strait Islander Ageing and Aged Care Council (NATSIACC) which highlights the importance of:  

• understanding one’s own culture and the impact that your culture, thinking, and actions may have on the culture of others through ongoing critical self-reflection 

• taking responsibility for building trust and relationships with Aboriginal and/or Torres Strait Islander service users, and their families 

• centering the living experience, cultural, and ageing needs, as determined by Aboriginal and/or Torres Strait Islander service users themselves 

• Only the Aboriginal and/or Torres Strait Islander person who is the recipient of a service or interaction can determine whether it is culturally safe. 

Does the cultural safety training undertaken by your organisation include a focus on critical self-reflection? Does your organisation support ongoing reflective practice for direct service staff, coordinators and managers? How well connected is your organisation with Aboriginal and Torres Strait Islander communities in the areas where you provide services? How might those relationships be strengthened? 

A path forward – Transforming Aged Care for Aboriginal and Torres Strait Islander people  

The Interim First Nations Aged Care Commissioner Andrea Kelly, during her extensive Australia-wide travels and consultations in 2024, heard consistently that the lack of cultural safety is the primary deterrent for older Aboriginal and Torres Strait Islander people not accessing aged care.  

Andrea Kelly’s report to government Transforming Aged Care for Aboriginal and Torres Strait Islander people is a must read, giving voice to Aboriginal and Torres Strait Islander older people, their families, communities, service providers and peak bodies. The report shares both the impact of inequities and lack of culturally safe aged care provision, case studies of positive examples that the sector can learn from and outlines a path forward.  

A key aspect of the path forward – one of the four recommendations from the report – is the government committing to a transformation plan, co-designed with Aboriginal and Torres Strait Islander people and informed by the Priority Reforms under the National Agreement on Closing the Gap. This is in addition to 27 urgent actions the Government should commit to as a priority. 

Imagining continuity of care within a culturally safe aged care system 

In the meantime, there is a role for governments to support and encourage partnerships between Aboriginal Community Controlled Organisations (ACCOs) and mainstream service providers and accelerate efforts to build the cultural safety within mainstream services, but not at the detriment of building the ACCO sector.  

How could your organisation strengthen relationships with local ACCO’s in a way that contributes to a viable regional service ecology and supports continuity of culturally safe care for Aboriginal and Torres Strait Islander older people and Elders? What connections and partnerships already exist in your region? What examples could you learn from? 

The Aboriginal and Torres Strait Islander Aged Care Framework 2025-35 offers important guidance to the sector and is a good step toward the deeper co-designed transformation plan that Andrea Kelly has called for. Importantly, it is a vehicle to drive government actions and the internal cohesion necessary to enshrine healthy ageing for older Aboriginal and Torres Strait Islander people at the heart of aged care reforms.  

Centering the knowledges and cultural strength of the world’s oldest continuous cultures 

As you reflect on what is yours to do and the next steps that your organisation can take on the ongoing journey building cultural safety, I invite you to sit with the words of the Inspector General of Aged Care Natalie Siegel-Brown, from her recent Statement of Commitment to the National Agreement on Closing the Gap: 

“I affirm that real improvement in aged care in Australia cannot occur without learning from Aboriginal and Torres Strait Islander peoples. For generations, they have modelled how to honour, protect and care for their Elders in ways that are rich in connection, respect and intergenerational responsibility. If we as a country are to collectively achieve the objects of the new Aged Care Act 2024 – particularly respect, dignity, and the right to live a life of meaning – we have a lot to learn from the knowledge and cultural strength of the world’s oldest continuous cultures.” 

Join a national community of CHSP providers committed to meaningful change 

The National CHSP Aboriginal and Torres Strait Islander Cultural Safety Community of Practice is an opportunity to: 

• Learn from other providers’ experience 

• Reflect on practice, progress and next steps for your service 

• Identify actionable improvements that evidence regulatory obligations while embedding meaningful change 

• Contribute to conversations about an aged care sector that not only meets requirements but strives for the right to cultural connection, safety and healing 

• Be inspired and encouraged by a national community of leaders and practitioners who are prioritizing cultural safety for older Aboriginal and Torres Strait Islander people 

This Community of Practice welcomes people across all organisational levels and stages on the ongoing journey building cultural safety. This is an activity of the National CHSP Sector Support and Development Aboriginal and Torres Strait Islander Working Group.

For more information and to register.