On his first day working in aged care, Pratik Sigdel was told by a resident to go back to where he came from.
He had arrived in the country less than a year earlier from Nepal — and entered a job where racism became a part of his everyday professional life.
"From the very first day … They used to tell us: 'You just go away, you just go back to the country where you're from. I don't like you, I don't like your skin'," he said.
Experiencing racism was so common, he accepted it as part of the job.
"I was there to support [the residents]," he said.
Experts say racism from aged care residents towards workers is a prevalent issue in the sector that is often overlooked.
"It's the elephant in the room that nobody talks about," the National Ageing Research Institute's Bianca Brijnath said.
"But it is there, and people do experience it on a daily basis.
"It really is very much specific to your skin colour, the way you speak, your accent and how you look."
The federal government's 2020 Aged Care Workforce Census Report showed 35 per cent of direct care workers in residential aged care identified as culturally and/or linguistically diverse, which is up 26 per cent from 2016.
As part of her work, Professor Brijnath runs seminars for aged care workers on dealing with racism.
While there is limited data on rates of racism experienced by staff, she said it was an issue raised at "again, and again and again".
"Every single workshop … And we've been in public forums and conferences and other places, and it is repeatedly raised as well," she said.
Government statistics show more than half of people living in permanent residential aged care have dementia, something Professor Brijnath said could make responding to racism even more difficult.
"With dementia, what can happen is people will lose their inhibitions. And they might behave in ways or see things that perhaps before they never did," she said.
It could be nearly impossible to change the patient's behaviours and foster respectful relationships, she said.
However, she said, it didn't mean staff shouldn't get support.
'Part of the job'
Flinders University researcher Temitope Olasunkanmi-Alimi said racism toward aged staff could often be overlooked because it was seen as "part of the job".
In 2022, Dr Olasunkanmi-Alimi conducted a study examining racism in aged care through the experiences of 30 African migrant women working in the sector.
She found workers stayed quiet about the racism they faced out of fear they would lose their visa or their jobs.
"They believe: 'I'm a professional, so I have to take it as being part of my job'," she said.
Dr Olasunkanmi-Alimi found the women faced racism, ranging from verbal abuse to rejecting care from black nurses.
"[Residents] say 'get off me, you animal. I don't want black people caring for me'," she said.
"For the women I talked to … they feel demoralised.
"They sort of lose their sense of identity and self-worth through acts of microaggressions displayed towards them."
Dr Olasunkanmi-Alimi's said she believed the racial discrimination plaguing the aged care sector was rooted in the racism that existed in wider Australia.
Structural issues found in industry
Executive director of the Multicultural Centre for Women's Health, Adele Murdolo, said culturally diverse aged care staff also faced structural racism.
Dr Murdolo said women from culturally diverse backgrounds working in the sector often struggled to advance in their careers, regardless of their overseas qualifications or accumulated experience.
A 2020 RMIT University study found home care workers who came from non-English speaking backgrounds were four times more likely to hold a degree than their Australian-born counterparts.
Personal care workers born overseas were almost nine times as likely to hold a degree than those born in Australia, according to the research.
Dr Murdolo described leadership in the aged care sector as "a very male group, and very white".
"As you come along and get down the hierarchy, you will see most of your personal care assistants and attendants are women from migrant and refugee backgrounds," she said.
"Within the sector, I think we really undervalue migrant women's potential for leadership."
More support needed as migrant worker reliance increases
Yesterday, the federal government conceded it would not meet its commitment to staff aged care homes with registered nurses by July 1, a self-imposed target that was born out of the aged care royal commission.
Vacancies in the sector, exacerbated by the pandemic, are increasing Australia's dependency on culturally diverse aged care workers.
In 2020, the government announced priority visa processing for migrant aged care workers to grow the workforce, as well as relaxing visa requirements.
Both Professor Brijnath and Dr Olasunkanmi-Alimi said Australia needed to find a way to support its diverse aged care workforce if the industry was going to survive the workforce crisis.
Supported by the federal government, the Partners in Culturally Appropriate Care (PICAC) Alliance is conducting a survey to understand the experience of culturally diverse aged care workers.
In a statement, the Department of Health and Aged Care said the findings from the survey would support the development of a toolbox to promote cultural safety for workers in the aged care industry, in recognition of diversity in the sectors workforce.
Professor Brijnath said the resources could not come soon enough.
"We need to start with a really frank conversation about the concerns that workers face, and there's real prejudices that they encounter on an everyday basis," she said.
She said the aged care sector should shift its focus to relationship-centred care, rather than patient-centred.
"In order to give care, someone's got to receive it, someone's got to give it and it is an interaction," she said.
Professor Brijnath said workplaces need to support staff, speak to residents and their families, and even resort to asking very racist clients to find care elsewhere.
However, she said, the best approaches still needed to be found.
"We certainly need more research in this space and more evidence … of what works to overcome racism," Professor Brijnath said.
After working in the sector for almost three years, Mr Sigdel said his overall experience was a positive one, despite the racism he faced.
However, he said, creating resources for management to better support staff experiencing racism would be a positive step in the right direction.
"I just want the management to step in … and work for the betterment of the workers who are facing racism," Mr Sigdel said.
"If you feel any racism at work, the management should always support you to improve your mental health.
"If you can't feel safe at work, how do you work properly in the workplace?"
