Merepeka Raukawa-Tait: Cultural safety an issue

How would you feel if, as a rest home resident, your care was provided by staff who have nothing in common with you?

They don't look like you and the other residents, rarely converse with you in your language and know little of your country and way of life. That's something we'll have to get used to in New Zealand.

In the past three years 5000 work permits have been granted to overseas aged-care workers, mostly from Southeast Asia, but particularly the Philippines.

My friend's mother lived in a rest home in Christchurch, until the earthquake 12 months ago. She said her mother received excellent care, provided by staff, all of whom were from the Philippines.

I was surprised at the "all" and asked "what about New Zealanders?" "In administration only," she said. The overseas rest home owners recruited exclusively from the Philippines. My friend liked the workers and was happy with her mother's care. I asked if her mother agreed and had she ever voiced concerns about being cared for and surrounded by a workforce of foreigners? My friend was a little put out by my question. Why would her mother care about who did the work in the rest home? Quality care for her mother was all she cared about.

It's her definition of "quality care" that I have problems with. Older people aren't all the same, although we might like to think so. It is wrong to assume they will not want a say in who's caring for, and supporting them.

We may have to ensure cultural safety for Pakeha residents becomes a reality in rest homes in the future.

In the 1990s Irihapeti Ramsden was vilified when, as a nurse educator, she suggested cultural safety for Maori should be taught to health professionals in the New Zealand Health Services. The uninformed were against it as they believed when you're sick you don't care about cultural safety, you just need looking after.

She has been proven right and because the principles of cultural safety have been recognised as relevant to all cultures its application has been broadened accordingly.

But asking rest home residents to take "cultural classes" is going about it the wrong way. This is currently happening in a number of New Zealand rest homes. Some residents are being accused of racism towards foreign workers. By taking classes they can familiarise themselves with their cultures and won't do or say anything to offend workers through their lack of cultural awareness.

In my view older Pakeha in rest home care should be insisting on cultural safety practices relevant to their needs first and not the other way around. At the same time support needs to be provided to overseas aged-care workers so they have the sensitivity and self-awareness to provide safe care.

Rest home residents' care should be a stress-free experience. Being surrounded by workers who are there for the money only, admittedly prepared to work hard at it, won't provide the "added value" that comes from being cared for by someone who knows you; your background and culture.

Older people aren't invisible. They like company and can talk about all manner of things if we take the time to talk to them. Having efficient staff is desirable but we should never confuse efficiency with quality aged care.

One meets standards of hygiene and quality audits while the other centres on the person - including taking the time to talk to and show an interest in them. To do the latter you need staff who are culturally aware, have good communication skills and the time to put down their cleaning gear.

At present there are around 80,000 young New Zealanders under the age of 24 who are work ready but unemployed. Thousands of them turned out this week to honour Anzac Day. They already show understanding and goodwill towards older people.

Why not harness 10 per cent of the unemployed youth, those desperate to find work, and steer them towards jobs in the aged care health sector? We will then have a young workforce where they get trained, qualified and are valued.