Clients have the right to speak up about the care they are receiving.
Providers must ensure that every client has the ability to raise concerns about their care regardless of culture, language, impairment or other factors. If these barriers impede the client’s ability to access the complaint system, the provider is expected to give the client extra support that enables them to do so (ACQSC 2019).
Furthermore, providers should readily inform clients about the complaint process, as well as access or advocacy services available to them (ACQSC 2019).
It is essential that each client is given equal access to the complaints system (ACQSC 2019).
Clients may encounter barriers to accessing the complaint system such as sensory impairment or language and may require additional support due to their background or situation (ACQSC 2019).
Clients who may want extra assistance include:
First Nations people;
Clients from culturally and linguistically diverse (CALD) backgrounds;
Clients living in remote or regional areas;
Clients living with disabilities;
Clients who have vision or hearing impairments;
Clients in the LGBT community;
Care leavers (Forgotten Australians, Former Child Migrants and Stolen Generations);
Veterans, war widows and widowers;
Clients who are financially disadvantaged;
Clients who are homeless or facing homelessness.
(My Aged Care n.d.)
What are Advocacy Services?
An unwell client being integrated into an unfamiliar and fast-paced healthcare environment is often vulnerable and may require extra support to help them navigate and find their voice (Crocker & Crocker 2019).
An advocacy service will provide the client with an advocate to stand alongside them and assist in the complaint resolution process and other discussions (ACQSC 2020).
The advocate is an impartial party who works on behalf of the client, helping them to achieve the best possible outcome. They represent the wishes of the client and ensure the client understands their rights and is able to have a say in decisions (ACQSC 2020; My Aged Care 2019).
One of the main goals of advocacy is to empower the client to find their voice and speak up about their healthcare, enabling the client to feel more confident and autonomous. This, in turn, relieves the stress put onto healthcare staff and resources, who are constantly being stretched to meet demands (Crocker & Crocker 2019).
The three main roles of an advocate are:
Negotiating to reach an outcome in a harmonious and effective way. This may involve:
Making phone calls on behalf of the client;
Establishing a collaborative network of health professionals to support the client.
Mediating to create common ground between the client and the provider (or another party).
Interceding to ensure the client is satisfied with the support they are receiving and is able to have their say.
(Crocker & Crocker 2019)
Any client receiving Australian Government-funded aged care services (either residential or at home) is entitled to free, independent and confidential advocacy, delivered by the Older Persons Advocacy Network (OPAN) (ACQSC 2020).
What Can Advocates do?
Inform the client about their rights and responsibilities;
Empower the client to uphold their rights and responsibilities;
Support the client in decision-making;
Listen to the client’s concerns;
Discuss the client’s options;
Support the client in making a complaint;
Support the client throughout the complaint process;
Help the client resolve complaints;
Help the client interact with the aged care system;
Help the client transition between services;
Speak to providers on behalf of the client, at their direction; and
Help the client increase their skills and knowledge so that they can advocate for themselves.
(ACQSC 2020; My Aged Care 2019; Seniors Rights Service 2016)
Advocates must not:
Make treatment or medication decisions on the client’s behalf;
Tell the client what decisions to make;
Act as the client’s substitute decision-maker;
Diagnose the client;
Treat the client;
Provide treatment to the client;
Offer legal advice;
Adopt the role of a counsellor or social worker; or
Take any other actions that extend beyond their brief.
(Crocker & Crocker 2019)
What are Language Services?
Being able to effectively communicate with clients is integral to positive health outcomes and delivering safe, high-quality care (NSW DoH 2017).
Language services support clients from culturally and linguistically diverse backgrounds to communicate with providers and actively participate in their care (DoH 2020).
Clients who have difficulty speaking or understanding English are able to access interpreters who will help them communicate with their provider (My Aged Care n.d.).
Interpreters can help clients participate in a variety of conversations, including:
Discussions about care needs, services and preferences;
Do not assume the client is linguistically competent without assessing their English ability. The patient must be able to fully understand and communicate; being able to talk about everyday topics does not necessarily mean they can cope with medical situations and terminology (NSW DoH 2017).
Working with Interpreters
The following is some practical advice for working with interpreters.
Confirm the client’s preferred language or dialect, gender preference and other preferences when finding an interpreter.
Do not allow the client’s friends or relatives to act as an interpreter - this is not appropriate.
Book interpreters as far in advance as possible to ensure they will be available.
Brief the interpreter before the session. The briefing should include:
Context of the discussion;
Outline of the provider’s objectives;
Parameters (e.g. mode of interpreting, seating arrangement);
Cultural background information, if required;
Any forms or assessment tools that are to be used;
Any potential risks (e.g. client behavioural issues); and
Whether the matter is sensitive (e.g. traumatic situations).
Remember that interpreters speak in first person (i.e. as the patient).
Speak to the patient rather than the interpreter.
Ensure seating arrangements are appropriate (this is the provider’s responsibility).
Ask the interpreter for cultural information during the session, if required.
Debrief the interpreter after the session and clarify any issues. You may seek feedback from the interpreter.
(NSW DoH 2017)
It is also important to note that the client may refuse the assistance of an interpreter. In this case, you should discuss this with the client and explain how an interpreter may be helpful. However, the client has a right to decline assistance if they wish to do so (NSW DoH 2017).
Effective communication between client and provider is an essential component of delivering safe and high-quality healthcare.
Therefore, it is crucial to recognise clients who may require extra assistance, ensure they are able to access this assistance and provide this assistance if required.