THE IMPACT OF A SPECIALIST ATSI HEALTH WORKER WITHIN DUBBO ACAT

1. THE IMPACT OF A SPECIALIST ATSI HEALTH WORKER WITHIN DUBBO ACAT Robin Payne and Helen Johnson

2. ABORIGINAL OR ATSI During this presentation Dubbo ACAT has used the term Aboriginal to maintain continuity.

3. DUBBO ACAT TEAM • Has 5.9 FTEs • All are from nursing backgrounds • not multi discipline (not through lack of trying) • Currently have a FTE position vacant

4. WHERE IS DUBBO AND WHAT AREA DO WE COVER? • Dubbo is in Central West NSW • Dubbo ACAT is one of 5 in Greater Western Area Health Services (GWAHS). • Covers approximately 120,000 square kilometres • 11 Local Government areas • In Australia 126 MPS (multipurpose services) 9 in Dubbo ACAT

5. TOWNS THAT ACAT VISIT Baradine, Balladoran, Binnaway, Birriwa, Brocklehurst, Bugaldie, Canbelego, Cobar, Coolah, Collie, Coonabarabran, Coonamble, Dubbo, Dunedoo, Elong Elong, Eumungerie, Frog Rock, Geurie, Gilgandra, Gin Gin, Gollan, Goolma, Gratti, Gulargambone, Gulgong, Hargraves, Hermidale, Lue, Mendooran, Merrygoen, Mianderla, Mudgee, Mumbil, Narromine, Neilrex, Nevertire, New Mollyan, Nymagee, Nyngan, Stuart Town, Teridgerie, Tooraweenah, Trangie, Ulan, Warkton, Warren, Wellington, Weetaliba to name most

6. LOCATION WITHIN NSW

7. ABORIGINAL TRIBES Wailwan Ngiyampaa Wangaaypuwan Kamilaroi Wongabon Wiradjuri Piambong

8. ABORIGINAL SPECIFIC DETAILS Dubbo ACAT: • Has 6 different tribes in our area • Different tribes in our local LGA • There is an aging population (both from Aboriginal and ACAT perspective)

9. OUR EXPERIENCE IN DUBBO ACAT • Aboriginal population is transient; census not true indication • The Aboriginal population is becoming better educated and it has been reported that the Aug 2010 Census should be truer indication. • In all population there is an expected increase in dementia in 20 years.

10. OUR EXPERIENCE IN DUBBO ACAT(cont) Cultural awareness tells us that: • Elders expect support will be given as needed, by extended family, but: • Family structures are breaking down/changing and therefore • More external support needed and • Service providers will and do consider family members to provide support

11. OUR EXPERIENCE IN DUBBO ACAT(cont) Shows that the Aboriginal population: • have an inherent mistrust of “white” medicine. • Have been and still are subjected to racism and are • Still subjected to lies • Still made to feel “inferior” when having any issue explained

12. ARE WE COMING OR GOING?

13. HOW DID ACAT GET ASTI HEALTH WORKER? Feedback from Round 2 of NSW ACAP Stakeholders Consultations Informed ACAT that; • There was a lack of information and understanding of ACAT’s core business and role with the Aboriginal community and services • Dubbo ACAT had limited access to the Aboriginal clients and

14. HOW DID ACAT GET ASTI HEALTH WORKER (cont) ? • Dubbo ACAT was not receiving adequate numbers of referrals from the Aboriginal population. • Dubbo ACAT did not have the cultural appropriateness or time to provide information and education to the Aboriginal population.

15. IN A 5 YEAR PERIOD According to ACE program, Dubbo ACAT: • Had seen 65 ASTI people • 4 were from other areas that Dubbo ACAT does not service but • In Dubbo ACAT’s areas, with Aboriginal populations, no referrals have been received

16. HOW DID IT HAPPEN? • Proposal put to Aboriginal Health Programs and financial support gained. • As this was an entirely new role in GWAHS, it needed clear defining as well as planning for the role • Robin was recruited for the role.

17. RESULT. • It was identified that an Aboriginal worker was needed to gain access to Aboriginal communities.

18. ACAT WAS VERY HAPPY

19. ROBIN PAYNE Robin is from Nyngan, which is in the Central west 230 klm from Dubbo Is well known and respected. Has worked in aged care facilities locally and interstate Was able to access the Elders in all the 6 tribal areas and local communities and Was prepared to travel

20. WHAT HAS BEEN THE IMPACT? • There has been a 200% increase in Aboriginal referrals in 5 months

21. STATISTICS FROM ACE DATA Number of clients seen in 2008/09 and 2009/10 for the equivalent time period

22. IMPACTS • Robin has been able to access the Elders and some of the other groups • Improved relationships between Aboriginal workers and ACAT

23. IMPACTS (CONT) • Robin being contacted re concerns which are not appropriate to ACAT • Lack of services in local area and are • Not Aboriginal specific • If Aboriginal Specific, not always accepted as not correct tribe.

24. OTHER IMPACTS • Sex of worker in this area has not been an issue for the education • Sex of worker could impact on holistic assessment • Maybe need a male Aboriginal Health Worker • Culture of men’s and women’s business

25. WHY HAS IT WORKED? Robin: • Speaks with the Aboriginal local Lands Council – • Who in turn contact the local Elders, asking them if they would like to meet with an Aboriginal health worker from Lourdes Hospital. • This is an open forum usually in the Lands Council

26. WHY HAS IT WORKED? • Lands Council venue is not always appropriate • As some people would prefer to meet one on one, by river or under gum tree • Also liaises with the local Aboriginal Health Workers (community, hospital and AMS) • Travel time and distance (plans needed to changed due to other circumstances e.g. funerals)

27. WHY HAS IT WORKED? • Dubbo ACAT has a ethos of good working relationship and • Open communication between all staff • Robin feels part of the team and • Is comfortable talking with all members of team

28. WAYS THAT WORK • Sitting and yarning • Support delivered by an Aboriginal worker • Relevant information is taken to meeting and also sent • Information easy to understand • Providing help for formal information that is difficult to read and comprehend • Robin is mature and well known

29. MAIN ROAD

30. ROBIN HAS • Meet with the Elders and Aboriginal services • Yarned with Elders on a 1 on 1 basis, • Provided education to care facility, diversional therapist , hospital, service providers and ACAT staff • Supported clients, carers, staff and family members

31. ROBIN HAS: • Attended assessments with co-workers • Promoted core business of ACAT • Increased Dubbo ACAT staff’s knowledge and understanding of cultural issues • Increased number of referrals • Spoken with areas (e.g. Cobar) where ACAT has not had referrals before.

32. THE FUTURE • Dubbo ACAT wishes to remain at the forefront of Aboriginal service provision • Still in early stage • No formal Proforma • Staff in rural areas want more information on being culturally aware. • Robin to keep her job

33. GREAT LEAPS HAVE BEEN MADE

34. THANK YOU Thank you for your attention • Finally this is what we all hope does not happen to us, • But the statistics indicate that this will be some of us in the not too distant future.