Providing culturally competent care to older people and people with disabilities who are from culturally and linguistically diverse backgrounds is of vital importance to their well being. And creating a home environment that is designed with their beliefs and culture in mind is also essential.
In this article we outline some strategies for providing culturally competent care through home modifications. We also cover the importance of involving family members and caregivers in the planning of home modifications within the broader social context of the home.
Cultural diversity in Australia
Australia has an extremely culturally diverse population. According to the Australian Bureau of Statistics, as at June 2023, more than 30% of our population was born overseas, and more than 20% speak a language other than English at home. Waves of immigration to Australia have resulted in large community and cultural groups from Europe, Asia, the Americas and Africa settling here. We have created a successful and harmonious society where we are each able to take pride in our cultural identity.
Celebrating cultural differences in disability and aged care
Ensuring that older people and people with disability can maintain and celebrate their cultural identity is paramount to their well being. Providing opportunities to participate in cultural activities and experiences can help a person maintain their identity and feel grounded, connected and safe.
Understanding how a person’s culture can impact their values and aspects of their day to day life can influence the type of care provided. Managing expectations regarding cultural preferences is also an important part of culturally competent care.
What are home modifications in the NDIS?
The National Disability Insurance Scheme (NDIS) is Australia’s primary support system for people with disabilities. NDIS participants can receive funding and access to services and supports that help them maintain their independence and meet their goals. An important part of the scheme is helping participants to be safe and comfortable at home. The NDIS will provide funding for home modifications, which are adaptations and changes made at home to promote independence and safety.
When considering home modifications, the NDIS not only consider if proposed modifications are safe and appropriate, they also consider a person’s preferences, culture and family situation. The NDIS recognise that culturally sensitive supports need to be provided.
What are home modifications in My Aged Care?
My Aged Care is a scheme for older people in Australia, supporting clients over the age of 65 to live healthy and independent lives. My Age Care participants can access a range of services designed to help them maintain their skills and independence. Under the scheme, an older person can receive service provision for cleaning and personal care, as well as modifications such as grab rails and ramps at home.
Why are individual preferences important in home care?
Several studies have also found that how a person considers and experiences home modifications and assistive technologies can impact how successful they may be. This means that if a person is not confident or comfortable with home modifications that have been made, they are unlikely to use these technologies to their full capacity.
It’s important that a person is happy with and confident to use the home modifications in their home. It is vital that a person’s preferences for the installation of modifications are respected. Clients should be able to participation in the creation of a home environment they enjoy and appreciate.
In a previous Nursed Care blog, we described the ways in which home modifications can increase a person’s confidence, social mobility and overall health.
Cultural knowledge in occupational therapy services
An occupational therapist is typically involved in the planning and design of home modifications for participants of the NDIS and My Aged Care schemes. Occupational therapists can watch how a person moves around the home and how they carry out the tasks of daily life. They can suggest home modifications that will assist a person and make it easier for them to be active at home. These adaptations can then enable them to more easily participate in the community and in the wider society.
Occupational therapists need to have knowledge of a a person’s cultural preferences and be aware of their preferences for modifications and adaptions at home. Cultural competence is an important skill for occupational therapists and a critical component of home modifications planning.
Cultural competence in home modifications
Before undertaking home modifications in a person’s home, it is important to understand the significance of cultural and social factors on a person’s understanding and perceptions of where they live.
In all modifications, reasonable accommodations should be made for the person’s preferences with regard to how the home and shared spaces should be modified or changed. Beliefs about privacy, shared spaces, common areas and even the design of the home should be explored and respected.
Culturally sensitive bathroom home modifications
Occupational therapists often provide advice about the safe use of the bathroom. Wet areas like the bathroom can be high risk areas for people with disabilities, due to the chances of slips and falls in wet areas.
Many people have deeply rooted cultural beliefs about tasks associated with personal care and toileting. Particular hygiene practices may also be deeply embedded in a person’s culture. It may be inappropriate for some caregivers to carry out personal care tasks, despite being a primary or key carer. The bathroom must be designed to suit caregivers as well as clients. Bathroom modifications must take into account a person’s beliefs and encourage cultural comfort and safety for families.
Home modifications to suit the family
One recent piece of peer reviewed research has identified some interesting findings about the impact of home modifications on other members of the family. When a home is extensively modified to accommodate the needs of a person with significant disability, these changes can actually impact the other members of the family. The study focused particularly on the experiences of the siblings of people with disability.
The needs and preferences of siblings may often not be considered during home modification and renovation processes. Siblings reported that they often do not feel involved or understood during home modifications. Yet these siblings must also be able to feel safe and comfortable at home. Larges pieces of disability equipment and aids can occupy a lot of space in shared spaces.
The study closed with a strong recommendation that siblings and other members of a household should be consulted during home modification planning.
Examples of culturally appropriate assessment tools
Tailoring assessments for each client is essential. In cases where an assessor will be meeting a client of a culturally diverse background, it can help to contact the client or their interpreter in advance to ensure they are prepared for the assessment and have clear expectations of what will happen on the day. Other tips for providing culturally competent care at assessment include:
involving and discussing modifications and services with family members and caregivers
arranging home visits at a suitable time and understanding the social context of entering another person’s home
being aware of and responding to language barriers by providing language services or translation services
attentiveness to non verbal communication such as through body language, posture and mood
using assistive communication technologies and devices
preparing for and being responsive to aspects of a person’s cultural identity
Assessors should also consider their own cultural biases, be willing to explore new values and life preferences. In some cases it is necessary to access training to extend their knowledge about working with people from other cultures.
Nursed Care for culturally sensitive care
Nursed Care provide quality personal care, domestic, community and social support services for clients around New South Wales.
Our staff come from a range of cultures and cultural backgrounds themselves, and we provide cultural awareness training, cultural competence activities and knowledge sharing opportunities for the entire Nursed Care team. We provide culturally competent care to clients from linguistically diverse backgrounds.
Our staff have professional experiences in health, education and social services and understand the importance of incorporating a person’s beliefs and culture into their care. We can arrange translation services for initial meetings, assessment and during service delivery. We want to help you get the most out of life and will do what we can to deliver services your way and in line with your preferences.
Cultural diversity and quality service provision
We employ to ensure we are providing culturally competent to our clients and residents. For example, we do this by:
respecting dietary restrictions
making time for the observation of faith practices and cultural beliefs
providing gender sensitive services when required, for example, providing female support workers for female clients requiring help with personal care tasks
involving families and caregivers where appropriate
celebrating cultural diversity and days of significance
creating opportunity for clients to share their beliefs with families and the community
sharing cultural experiences together in a community setting
accommodating requests for workers from particular cultures or cultural backgrounds
Nursed Care for culturally appropriate home modifications
Nursed Care have a complete home modifications team who work out in the community to make comfortable, safe and quality home and accommodation options for people with disabilities. When you chose Nursed Care for your home modifications, assistive technology installations and new home builds, we will involve you every step of the way.
We are aware that including your preferences, and the wishes of your caregivers and family members is vital. Staff will ensure they provide culturally competent care during assessment, planning and installation stages.
Contact Nursed Care to discuss our home modification, assistive technology and accommodation services today.
Related questions
Within the NDIS, there are clear guidelines on the importance of understanding and respecting the influence of a person’s culture on their experience of disability. The NDIS is aware of the need for quality, culturally sensitive service delivery for participants from linguistically diverse backgrounds. The care provided to people with disabilities must promote good health, and respect cultural practices, values and beliefs.
Within My Aged Care, older people have the right to access services and supports that are in line with their culture and encourage the expression of their identity.
Providing culturally competent care in a nursing home or residential facility can help address health disparities noted and observed in older people from diverse backgrounds and with language barriers. Residents who are given the chance to express their culture, their diversity and beliefs report greater satisfaction and well being in their lives.
Residents of aged care facilities will feel their values are supported when:
there are reasonable accommodations for faith and cultural expression for residents
the care provided is flexible and responsive to their culture and cultural needs
staff are respecting dietary restrictions in meal services for residents
there is an opportunity for residents to celebrate cultural days of significance
well being is promoted with a cultural and social context of residents’ cultural backgrounds
