The Importance of Cultural Safety in Home Care
Published: 21 July 2022
Published: 21 July 2022
To read about cultural safety in aged care settings, see: The Importance of Cultural Safety in Aged Care.
The clients in your care will come from vastly different backgrounds and have varied life experiences. Having knowledge of and respecting an individual’s cultural background is crucial to being able to provide person-centred care.
The term culture refers to values, customs, languages, social structures, beliefs, patterns of human activity, and experiences shared with others - the symbolic structures that provide meaning and significance to human behaviour (Engebretson 2016; Rawson 2019).
Culture is fundamental to how we live our lives and informs the way in which we interact with the world (Rawson 2019).
Cultural safety involves being mindful of the similarities and differences between cultures, and using this knowledge to inform your communication with members of different cultural groups (HETI 2018).
In healthcare, this means you must act in a way that recognises, respects and nurtures your client’s identity while ensuring you meet their needs, expectations and rights. Instead of working from your own perspective, it’s important to consider the cultural perspective of the person you are caring for (HETI 2018).
You can make a difference in the lives of your clients by doing your own research (see SBS's Cultural Atlas) and by incorporating cultural awareness into your care.
Individual values and beliefs is a requirement of the NDIS Practice Standards under Core Module 1: Rights and Responsibilities.
This Practice Standard aims to ensure that NDIS participants receive supports that respect their culture, diversity, values and beliefs (NDIS 2020).
NDIS providers must meet the following quality indicators:
Statistics from the most recent national Census in 2021 reveal how culturally diverse Australia is, with just over one quarter (27.6%) of Australians being born overseas (ABS 2022).
In fact, over half (51.5%) of Australians were either born overseas themselves (first generation Australian) or had one or both parents born overseas (second generation Australian) (Khorana 2022).
As of 2016, there were over 300 separately identified languages spoken in Australia. More than one-fifth (21%) of Australians spoke a language other than English at home (ABS 2017).
As a healthcare worker, you should be able to appropriately and sensitively care for clients of all backgrounds, including:
Unfortunately, the perception of Australia’s healthcare system among people of culturally and linguistically diverse (CALD) backgrounds is far from positive.
People from diverse cultural backgrounds (including Aboriginal and Torres Strait Islander Peoples) are also known to have difficulty accessing and using healthcare services in Australia, leading to poorer health outcomes (Khatri & Assefa 2022; White et al. 2019; AIHW 2022).
The potential for error in the absence of culturally-aware healthcare is vast. Misunderstandings, miscommunication and culturally-unsafe care by healthcare professionals are often reported (Johnstone and Kanitisaki 2006). People of a non-Anglo-Saxon background have cited feelings of powerlessness, vulnerability, loneliness and fear (Garrett et al. 2008).
Failure to address cultural diversity can lead to a variety of adverse outcomes such as medication errors and interactions, misdiagnosis, inappropriate treatment and poor patient adherence to treatments (Brach et al. 2019).
Language barriers have been found to have significant adverse effects on care, including:
(Shamsi et al. 2020)
Culturally safe and sensitive practice is defined by the Medical Board of Australia (2020) as:
The following is crucial in providing effective care to clients from culturally and linguistically diverse backgrounds:
(Centre for Cultural Diversity in Ageing n.d.; Rawson 2019)
Culture-specific information allows us insight into the lives of people who share ethnicity, language, religion or other characteristics that individuals identify with, or groups that they belong to (Centre for Cultural Diversity in Ageing n.d.).
While culture-specific information will inform your work with individual clients, keep in mind that within any cultural group, peoples' values, behaviour and beliefs can vary greatly (Centre for Cultural Diversity in Ageing n.d.).
Learn and remember the ABCD Cultural Assessment Model developed by Kagawa-Singer & Backhall (2001). Make it part of your routine to take time to discuss the following with the clients in your care, as well as their families:
|A - Attitudes
|B - Beliefs
|C - Context
Also identify community resources that may be of assistance to healthcare professionals, clients and family members, such as translators, healthcare workers, community groups, religious leaders, and traditional healers.
|D - Decision-making style
|Identify the general decision-making style of the cultural group, and specifically, the client and their family. Explore whether individual or family decision-making processes are used. Ask questions such as:
|E - Environment
|Determine whether there are community resources available to the client and their family.
(Kagawa-Singer & Backhall 2001)
|A - Assessment
|Emphasis on the cultural aspects of a client's lifestyle, health beliefs and health practices.
|C - Communication
|Awareness in variations between verbal and non-verbal responses.
|C - Cultural negotiation and compromise
|Awareness of aspects of other people’s culture as well as understanding the client’s views and how they articulate their problems.
|E - Establishing respect and rapport
|Forster a therapeutic relationship that portrays genuine respect for the client’s cultural beliefs and values.
|S - Sensitivity
|Provide culturally-sensitive care to a culturally diverse group.
|S - Safety
|Create a space for clients to derive a sense of cultural safety, placing emphasis on the cultural aspects of a client’s lifestyle, health beliefs and health practices.
Remember respecting the dignity and human rights of each resident is fundamental to providing quality care.
Although we, as healthcare professionals, constantly strive to provide sensitive, compassionate care, there is no doubt we may find ourselves in situations that challenge us. Although we don’t need to have a comprehensive understanding of every cultural and ethnic norm of all those who live in our society, we do need to make an effort to communicate with our clients and understand their needs in order to provide culturally safe care.
Remember respecting the dignity and human rights of each client is fundamental to providing quality care.
Question 1 of 3
Roughly what percentage of Australians were born overseas?