Indigenous peoples’ experiences and preferences in aged residential care: a systematic review

Abstract

Although the demand for aged residential care increases, low use of aged residential care by Indigenous people raises questions about unrecognised barriers to health care. The objectives of this systematic literature review are to (a) examine current scientific literature that reports older Indigenous people’s experiences in aged residential care and (b) describe critical factors that shape Indigenous people’s preferences in aged residential care settings. We conducted a systematic review of studies using an online search of the literature. A total of 6,233 citations were retrieved, and 45 studies examined in full-text. Eight studies met the study inclusion criteria. Indigenous older people were found to be younger, had higher prevalence of complex health conditions, and were less likely to receive dental and mental health services on admission to aged residential care. Their preferences for care were more likely to be evident in aged residential care facilities where the Indigenous composition of staff reflected the Indigenous makeup of its residents.

Who cares about Aboriginal Aged Care? Evidence of home care support needs and use in rural South Australia

“…15 Notably, the failure to properly value and engage with older Aboriginal and Torres Strait Islander Peoples and families has resulted in additional challenges and inequalities in accessing aged care services, with implications for workforce planning. 2,[26][27][28] Moreover, the collaboration between health services and aged care assessment should underpin streamlined evaluation, especially in regional and remote areas.…”

Exploring elderly Māori experiences of aged residential care using a kaupapa Māori research paradigm: methodological considerations

“…Our results from an earlier systematic literature review using Betancourt et al’s (2003) multi-level framework for addressing racial and ethnic disparities in health and health care suggest that the provision of culturally responsive care may influence the uptake of ARC services offered to elderly Indigenous people (Keelan et al, 2021). New Zealand’s current socio-cultural context privileges a dominant Western-focussed discourse that is reflected in training institutions and health services (Mikahere-Hall, 2017).…”

“…We conducted a systematic review of the literature to identify knowledge gaps and inform potential questions for the interview schedule (Keelan et al, 2021). Interview questions were devised using Betancourt et al’s (2003) multi-level framework to generate kaumātua and whānau systems perspectives of ARC.…”

It's not special treatment… That's part of the Treaty of Waitangi! Organisational barriers to enhancing the Aged Residential Care environment for older Māori and Whānau in New Zealand

“…We conducted a systematic literature review to identify and include additional organisational barriers and knowledge gaps used to inform the study interview schedule. 12 Interview questions were devised using Betancourt's et al 11 cultural competence framework in combination with the findings from our systematic literature to generate a comprehensive systems perspective of ARC. We considered issues related to the non-alignment of ARC provision with Māori cultural values and preferences for care, lack of cultural diversity in healthcare leadership and workforce, the absence of Māori health models in healthcare delivery and the inflexible nature of rating assessments when assessing the need of older Indigenous people for ARC.…”

“…11 We aimed to use these factors to identify and analyse barriers that may contribute to, and maintain racial disparities in ARC. 12 The authors note that the structural and clinical-level factors associated with older Māori and whānau healthcare access to ARC are reported elsewhere in separate papers.…”