In my joint appointment between Northern Adelaide Local Health Network and the Research Centre for Palliative Care Death and Dying, I sit alongside the community geriatrics team serving older people and their carers of the Northern Suburbs of Adelaide.  Compared to the rest of South Australia, the Northern suburbs are particularly diverse. The catchment is also made up of some the lowest socioeconomic areas of SA. What does the term wellbeing, contested in the literature and across fields, mean for the older aged carers who make up a growing NALHN population? 

Recently, I have been struck by how structural inequities coalesce with the ageism that seems to penetrate our health and social care systems, as well as society more broadly. Social Worker Louise tells me about Te Han, a man in his late 80s with heart and kidney failure. Te Hans level of function has worsened, and he is becoming increasingly breathless. His wife Binh is his main caregiver but Binh has dementia and Te Han sees himself as carer for Binh. Binh is still able to do some cooking. Te Han is very worried about what will happen to Binh if anything happens to him. They have no family to support them but do have some friends in the Vietnamese association who deliver groceries occasionally. Their home has no insulation and gets very cold in winter.

The community nursing team say the couple are no longer safe to be at home, especially as their house is so small and cluttered. They have stopped visiting. Louise tells me, the couple can manage at home with frequent visits to assist Te Han with showering and dressing and to support Binh. The couple avoid picking up the phone because their English is not good. Louise is tenacious in her attempts to find a care provider that will understand and respond to the couples needs. She patiently conveys the situation to multiple agencies over and over again. By the end of the day, she at last seems to get somewhere, but there are still multiple hoops to jump through. Louise’s work is for the most part, invisible. It is not accounted for ‘in her stats”. But what if there is no Louise? No community team? No advocacy?  Surely it is difficult enough to negotiate the systems and multiple online forms to complete when English is a first language? 

Older carers and people who speak in languages other than English, like Te Han and Binh, should have access to the same support as other Australian carers and communities. CarerHelp’s recently launched resources for Australia’s diverse communities and resources in languages other than English, is an important step in the right direction for older Australians and those who care for them. We need to continue to produce resources like these, together with carers themselves, to support the wellbeing of all older people, whatever their language or circumstances 

*Please note Te Hanh and Binh are pseudonyms and their story has been adapted to protect confidentiality. 

Author: Dr. Aileen Collier, Associate Professor Palliative Care & Aged Care Nursing Division of Aged Care, Rehabilitation and Palliative Care Northern Adelaide Local Health Network & Research Centre for Palliative Care, Death and Dying Flinders University