aboriginal families

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We would like to acknowledge the traditional custodians of this land and pay our respects to the Elders both past, present and future, for they hold the memories, the traditions, the culture and hopes of Indigenous Australians. Acknowledgement

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Page 1: Aboriginal families

We would like to acknowledge the traditional custodians of this land and

pay our respects to the Elders both past, present and future, for they hold the memories, the traditions, the culture and hopes of Indigenous Australians.

Acknowledgement

Page 2: Aboriginal families

“What do you need to keep in mind

when working with Aboriginal families?”

Page 3: Aboriginal families

A family is a group of two or more people that are related by blood, marriage, adoption, step or fostering, and who usually live together in the same household.

(Australian Bureau of Statistics , 2011)

Page 4: Aboriginal families

It is important for Workers to have an understanding of the concepts of ‘family’ and ‘kinship’ as they exist for Aboriginal and Torres Strait Islander people and their family structure is significantly different to the Western view of a family unit.

(Australian Institute of Family Studies, 2011)

Page 5: Aboriginal families

Know more about the Aboriginal families and tradition

Page 6: Aboriginal families

The Elders

Story-telling

Stolen Generation(Shaoli, Finn and Thomson. 2009)

Page 7: Aboriginal families

“What do you need to keep in mind when working with Aboriginal families?”

Page 8: Aboriginal families

CULTUREHealth professionals’ lack of understandingImportance of extended family and of country

Considerations

- Putting Aboriginal men and women together

- Mixing family groups inappropriately

- Male doctors attending female patients and vice versa

- Younger providers advising older Aboriginal patients

(Shaouli, Finn and Thompson, 2009)

Page 9: Aboriginal families

SOCIAL GRADIENT

WHO description: “The poorest of the poor, around the world, have the worst health.”

Factors

High level of stress in daily life

Loss of cultural continuity

Geographic dispersion Racism

(Sheperd, et. al., 2012)

Page 10: Aboriginal families

Not always the language of choice

No readily available interpreter services in Perth

Ability to feel lack of compassion in interpersonal interactions from healthcare providers

Silence: part of culture

Dissimilarities between Aboriginal beliefs and cultural consideration and the approach of the Western medical system

(Shaoli, Finn and Thomson. 2009)

COMMUNICATION

English

Non- verbal communication

Importance of effective communication

Page 11: Aboriginal families

Invasion of privacy leads to shame and embarrassment

(Shaoli, Finn and Thomson. 2009)

PRIVACY

Page 12: Aboriginal families

PREVIOUS EXPERIENCES

Resulted to loss of trust

(Shaoli, Finn and Thomson. 2009)

Page 13: Aboriginal families

EnvironmentWhen working with Aboriginal families, it is important to consider the

family’s environment they find themselves in.

Home, School, Community, Friends and Family.

Can vary between families and also the locations they reside in.

In 2011 the average family in Australia consisted of 2.6 persons, compared to Indigenous Australian families, consisting of 3.3 persons (DPMC, 2011).

Modern houses in Australia built to accommodate “Typical” nuclear family of two parents and 2 children, 3 bedroom, 2 bathrooms.

Does not accommodate the majority of Indigenous family sizes, 3-4 persons per household, with often visiting persons also residing for periods of time (ABS,

2008).

Indigenous families tend to be larger, with 39% being one parent families compared to 9% of Non-Indigenous families (Bailie and Runcie, 2001).

Page 14: Aboriginal families

Overcrowding is an important factor to consider, has been addressed by EnviroHealth Workers across Australia during in field promotion,

inspections and assessments (ABS and AIHW, 2003).

In 2008, 25% of Indigenous Australian population over 15 years of age, were living in overcrowded living conditions (ABS, 2011).

13% in major cities, 20% in regional areas and 48% in remote areas.

Statistics had not changed in 6 years between 2002 and 2008 (ABS, 2011).

Resulting in fewer resources, higher levels of stress, higher rate of infectious and parasitic disease (Thomson, 2003).

Inadequate water quality and supply, electricity and gas.

“Poverty poor housing conditions” despite first world country (Pholeros, Rainow and Torzillo, 1993).

Indigenous households 2.5 times more likely to be in the lowest income bracket in Australia (ABS, 2004).

Nearly half of all Indigenous children living in jobless families in 2006 (ABS and AIHW, 2008).

45% of dependent children in Australia from Indigenous communities (ABS and AIHW, 2008).

Page 15: Aboriginal families

Influences from the environment can have detrimental impacts on family health.

40% of community housing efforts of accommodation

still resulting in overcrowding.

Properties managed by Indigenous Housing

Organisations (IHOs), 23% required major repairs, 7%

required replacement in 2006 (ABS, 2007).

Consider influences of possible drug, alcohol,

violence, neglect, support, networks, safety house, police, which could be

close to the family home which could indirectly

impact.

Education in the home, in 2008, Indigenous

Australians aged 25-38 years 78% had completed

year 10 or above, compared to 27% of those

aged 55 years or older (ABS, 2011).

Page 16: Aboriginal families

Slowly as generations are gaining and retaining their education, their households are attaining

educated persons in their home. With better education, comes better health knowledge and employment opportunities.

However, Government funding needs to be improved to

accommodate larger than average families amongst our Indigenous

communities.

Page 17: Aboriginal families

Considerations in the practical setting:

• Naturally shy- encourage other family members for support.• In some circumstances, may be lack of transport, income, medicare

card.• Different concepts of time- when informing medication. Instead of

“take medicine with food every 4 hours”, “have with lunch or dinner”.• Social approach rather than biomedical questioning.• Allow extra time, give time to talk, build rapport.• Learn about person’s background prior to addressing clinical issues.• Family or community events may take priority over personal

appointments.• Tend to identify with one health worker and may expect to associate

with only this person for health related issues.• Self referrals- serious. Accessing Non-Indigenous organisations for help

indicates the person is likely to be in desperate need of help. If asked to come back later, they usually won’t return.

Page 18: Aboriginal families

Considerations in the practical setting:

• Never assume, find out as much information as you can.• Alternative communication methods, pictures, interpreter.• Acknowledge embarrassing questions from the beginning, make them feel more

comfortable• Avoid intrusive questions, use more open ended questions.• Avoiding eye contact is polite in particular indigenous communities. Particularly cross

gender.• Be mindful of own body language.• Avoid finishing sentences for them, they may be searching for the right English word,

don’t rush them.• Exchange and share cultural basis, build rapport.• Artworks and posters create more friendly environment• Avoid discussing scars and wounds if possible, can symbolise initiation, conflict or

grief.• Consult whole family, not just the individual, often all or most will influence decision

making for the individual.• Aboriginal Health Workers (AHWs) active assistance and support when necessary.

(UDRH, 2012).

Page 19: Aboriginal families

http://www.youtube.com/watch?v=MYuCvesBszQ

Page 20: Aboriginal families

Conclusion

Page 21: Aboriginal families

References:Australian Bureau of Statistics (2004) National Aboriginal and Torres Strait Islander Social Survey, 2002. Canberra: Australian Bureau of

Statistics Australian Bureau of Statistics. (2011) Characteristics of Families (No. 6224.0.55.001). Retrieved from: http://www.abs.gov.au

Australian Bureau of Statistics (2007) Housing and infrastructure in Aboriginal and Torres Strait Islander communities, Australia, 2006. Canberra: Australian Bureau of Statistics

Australian Bureau of Statistics, Australian Institute of Health and Welfare (2003). The health and welfare of Australia's Aboriginal and Torres

Strait Islander peoples 2003. Canberra: Australian Institute of Health and Welfare and the Australian Bureau of Statistics Australian Bureau of Statistics, Australian Institute of Health and Welfare (2008) The health and welfare of Australia's Aboriginal and Torres

Strait Islander Peoples (2008). Canberra: Australian Bureau of Statistics and Australian Institute of Health and WelfareAustralian Institute of Family Studies (2001) Working with Indigenous children, families, and communities. People. Retrieved from:

http://www.aifs.gov.au/cafca/pubs/sheets/ps/ps6.html

Australian Institute of Health and Welfare (2011). The Health and welfare of Australia’s Aboriginal and Torres Strait Islander People. Retrieved from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737418955

Bailie RS, Runcie MJ (2001) Household infrastructure in Aboriginal communities and the implications for health improvement. Medical Journal

of Australia; 175: 363-366 Department of the Prime Minister and Cabinet (2008). 2. Profile of Australian Families; Families in Australia. P9. Retrieved from:

http://www.pmc.gov.au/publications/families

Pholeros P, Rainow S, Torzillo P (1993) Housing for health: towards a healthy living environment for Aboriginal Australia. Newport Beach, NSW: HealthHabitat

ReconciliationAus.( 2013, January 31).Family and Kinship [Video file]. Retrieved from http://www.youtube.com/watch?v=mNtPcW4t1PY

Shahid, S., Finn, L. & Thompson, S. (2009) Barriers to participation of Aboriginal people in cancer care: communication in the hospital setting. Med J Aust 2009; 190 (10): 574-579.

University Department of Rural Health. (2012). Practical Considerations for Health Professionals Working with Aboriginal Clients. Greater Green. Retrieved from: http://www.greaterhealth.org/education-training/indigenoushealth/practicaladvice/

Thomson N, ed. (2003) The health of Indigenous Australians. South Melbourne: Oxford University Press