Aboriginal and Torres Strait Islander people become eligible for aged care from 50 years of age, in recognition of significantly higher rates of chronic disease and lower life expectancy compared with the non-Indigenous population. They make up an estimated 3.6% of the population eligible for aged care in Australia. Yet they represent just 1.3% of people in residential aged care, 2.9% of Commonwealth Home Support Program recipients, and around 3.3–3.4% of Home Care Package recipients across each package level.
The gap isn't explained by lower need. Instead, it reflects challenges around access, trust, and whether the aged care system feels culturally safe enough to engage with. That's not a policy abstraction. It's something every facility manager and learning and development lead can influence through the way their workforce is trained and supported.
Why trust is the real barrier, not distance or eligibility
The 2025–2035 Aboriginal and Torres Strait Islander Aged Care Framework, developed with the First Nations Aged Care Governance Group, outlines the systemic barriers driving low uptake. Trust in, and understanding of, mainstream aged care services is generally low among older Aboriginal and Torres Strait Islander people, reflecting the legacy of previous negative and culturally unsafe experiences with mainstream institutions. That mistrust means Aboriginal and Torres Strait Islander aged care providers often spend significant time providing informal guidance to help people navigate a system that was not designed with their communities in mind.
The Royal Commission into Aged Care Quality and Safety identified this directly: despite greater and earlier need, older Aboriginal and Torres Strait Islander people generally experience poorer outcomes within the aged care system than the broader Australian population.
What's changed under the new Act, and what hasn't
Since 1 November 2025, the Strengthened Aged Care Quality Standards and the new Aged Care Act have made cultural safety an explicit, rights-based expectation rather than a desirable extra. The Act's Statement of Rights guarantees every person's right to have their culture, language and traditions respected. Three Aboriginal and Torres Strait Islander assessment organisations are now operating, empowering individuals to work with services that truly understand their community and context, rather than relying solely on mainstream assessment pathways.
The National Aboriginal and Torres Strait Islander Ageing and Aged Care Council (NATSIAACC), defines cultural safety in aged care for older Aboriginal and Torres Strait Islander people as "understanding one's own culture and the impact that your culture, thinking, and actions may have on the culture of others through ongoing critical self-reflection." This understanding is "critical for ensuring access to a culturally safe, respectful, responsive and racism free aged care system providing for the optimal safety, autonomy, dignity, and absolute wellbeing of Aboriginal and/or Torres Strait Islander Elders and older people, and their families." Importantly, "only the Aboriginal and/or Torres Strait Islander person who is the recipient of a service or interaction can determine whether it is culturally safe."
That represents a fundamentally different standard from simply completing cultural awareness training. Cultural safety has to be reflected in everyday practice: how a support worker greets someone, how a care plan supports connection to Country or Island Home, and how family and community involvement is recognised as an essential part of quality care rather than an inconvenience.
What this means for your training approach
A single cultural awareness module completed during induction is unlikely to meet this expectation. The Framework calls for trauma-aware, healing-informed practice, recognising that for many older Aboriginal and Torres Strait Islander people, the impacts of past government and institutional policies are lived experience rather than distant history. Those experiences shape how people engage with aged care services from their very first interaction.
Practical starting points for facility managers and learning and development leaders include:
Audit who is delivering the training. Learning developed with Aboriginal and Torres Strait Islander input, including Elders, community-controlled organisations and people with lived experience, carries a level of authenticity and credibility that generic diversity training cannot replicate.
Make it ongoing, not annual. One NAIDOC Week session each year signals compliance rather than sustained commitment. Cultural safety should be embedded into onboarding and ongoing professional development.
Connect it to Standards 1 and 5. Under the Strengthened Quality Standards, assessors will expect to see cultural safety reflected in individual care planning and clinical care delivery, not isolated as a standalone HR initiative.
Ask the uncomfortable question. If an Aboriginal or Torres Strait Islander person walked into your facility today, would they feel safe enough to stay? If you're not sure, that uncertainty is valuable information. It highlights an opportunity to listen, reflect and strengthen your organisation's approach before someone else's experience exposes the gap.
NAIDOC Week provides a valuable opportunity to run a learning session, share stories and visibly recognise the contribution and achievements of Aboriginal and Torres Strait Islander peoples. But as NAIDOC marks its 50th year, it's also an opportunity to ask a more enduring question: what is your organisation doing differently beyond 13 July to create culturally safe care every day?
Supporting that change requires more than awareness. It requires ongoing education that helps teams build the confidence, knowledge and practical skills to deliver genuinely person-centred, culturally responsive care under the Strengthened Aged Care Quality Standards.
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