CALD Aged Care: Recording Language and Cultural Needs

CALD stands for culturally and linguistically diverse. In aged care it describes older people whose cultural background or language differs from the majority, and the Department of Health, Disability and Ageing lists it as one of the groups the Aged Care Diversity Framework considers (see its guidance on working with diverse groups). The CALD glossary entry gives the short definition.

What matters in CALD aged care is not the label. It is the specific facts you record about each person: preferred language, interpreter need, cultural and religious practices, and who they want involved. This article is general information, not legal advice.

Key Takeaways

CALD is a broad label, so record the individual facts (preferred language, interpreter need, practices, communication preferences) and never infer them from country of birth.
Outcome 1.1 of the Strengthened Quality Standards expects providers to identify each person's background, culture, beliefs and communication needs during assessment and planning, and use them to direct service delivery.
Record each item once in a structured place in the client or resident record, carry the practical points into the care plan and handover, and review them when health, cognition or circumstances change.
Assessor evidence is a short chain: what you asked, what you recorded, and what changed in care because of it.

What does the CALD label tell you, and what does it miss?

Not much about any one person. The AIHW describes cultural and linguistic diversity as a broad concept that can mask specific issues, and notes that cultural practices and family culture can shape what a person needs from aged care. Two people born in the same country can speak different languages and want different things from their care.

The measure matters too. Using country of birth outside the main English-speaking countries, around 28% of people using home care and 20% in permanent residential aged care at 30 June 2020 were counted as CALD. Preferred language other than English covered around 12% of aged care users. The AIHW says country of birth is only one marker and may underestimate the proportion. These are 2020 figures, so treat them as a reason to record both fields.

Why does recording language and culture matter?

Because the obligation is individual. The Department's guidance says providers must meet care recipients' needs on an individual basis, and the Statement of Rights in section 23 of the Aged Care Act 2024 includes the right to have identity, culture, spirituality and diversity valued and supported. See also provider obligations under the Statement of Rights.

The Commission's Outcome 1.1 on person-centred care turns that into action. Providers implement strategies to identify the individual's background, culture, diversity, beliefs and life experiences as part of assessment and planning, and to identify their particular communication needs and preferences. A record that says "CALD" and nothing else does neither.

What should you ask at entry or service start?

Ask only what changes how you deliver care, and say why you are asking. Adapt these fields to your service type.

Country of birth - What to record: Only if the person is happy to share it; What it changes: Reporting and context, never a substitute for the fields below
Preferred language - What to record: Spoken language, dialect if known, and the language they read; What it changes: Translated materials, rostering, interpreter requests
Interpreter need - What to record: The person's own answer, and which conversations it applies to; What it changes: Care plan reviews, consent, fees discussions
Communication preferences - What to record: Spoken or written, hearing, literacy, form of address, picture cards; What it changes: How workers explain and check understanding
Religion and cultural practices - What to record: Observances, prayer times, fasting, modesty and worker gender preferences; What it changes: Visit times, personal care, activities, end-of-life wishes
Dietary needs - What to record: Foods eaten and avoided, preparation requirements; What it changes: Menus, meal support, shopping and meal preparation
Who speaks for the person - What to record: Chosen supporters, their role, and consent to share information; What it changes: Who is contacted and present at reviews
Community connections - What to record: Groups, places of worship and people to stay connected with; What it changes: Social support and activity planning

Outcome 1.1 also requires providers to ask and record whether a person identifies as an Aboriginal or Torres Strait Islander person. Treat that as its own question, not a CALD field.

How should you ask?

Ask the older person first, in their preferred language where you can, and use an interpreter for the intake conversation if there is any doubt. The Department says TIS National can be used to discuss care needs, services and preferences, and to develop or review documents such as agreements and care plans. Check the page for eligible programs and the client code you need.

Use open questions ("What would help your days go well?") rather than a checklist read aloud, and let the person decline any item. Record "prefers not to say" as an answer so the next worker does not ask again. Do not ask a family member to answer for the person by default, and note who gave each answer and when.

Where should the information live in the record?

In one structured place, then reflected in three others. A free-text line buried in an assessment is the most common reason workers never see it.

Client or resident record: discrete fields for preferred language, interpreter need and communication preferences, with the date, source and the person's consent.
Care plan: the cultural needs care plan entries that change delivery, written as instructions a worker can act on.
Handover and rosters: a short line any worker can read before the first visit or shift, covering language, interpreter need and the practices that matter most.
Service agreement records: whether the document was translated or interpreted, and who supported the person.

Your cultural diversity and inclusion policy should say which record is the source of truth, so entries do not drift apart.

How do you keep it accurate over time?

Set review triggers, not just a calendar date. Review language and cultural information at each care plan review and after a hospital stay, a new diagnosis, a change in cognition, a bereavement, a move, or a change in who supports the person.

Dementia needs its own trigger. Australian research drawing on Royal Commission data found many older people from culturally and linguistically diverse backgrounds who were living with dementia reverted to their language of origin, and that care suffered when no language support was offered. A person who managed in English at entry may later need an interpreter. Pass any change in how someone communicates to the nurse or clinical lead.

How do you use the information in daily care?

Make each recorded item produce an action a worker can see.

Interpreters: book through TIS National for the conversations the Department describes. Our guide to interpreter and language access in home care covers booking, and your interpreter and language services policy should set when a professional interpreter is expected.
Translated materials: the Department funds a free aged care translation service for eligible materials such as service agreements, welcome brochures and facility signage.
Rostering: match workers by language and practice where you can, but do not assume. The AIHW notes workforce and consumer backgrounds often differ.
Food and personal care: put preferences into the meal plan and care plan, and keep texture or swallowing needs set by clinicians in the clinical record.

For the wider approach, see supporting CALD clients in aged care and culturally safe care. Worker confidence is where cultural safety and diversity training fits.

What about privacy and consent?

Language, religion and ethnic background are sensitive information. Tell the person what you are recording, who will see it and why, and record their agreement. Share with workers only what they need to deliver care, and keep anything the person asked to be private out of handover summaries.

What evidence will an assessor look for?

A chain they can follow for one person, from question to action.

A start-of-service record showing preferred language, interpreter need and communication preferences, with a date and a source.
A care plan that visibly reflects those answers in meals, visit timing or personal care.
Interpreter or translation use for care planning, agreements and reviews.
Reviews showing entries were updated after a change, and feedback that led to a change.

Where do providers most often fall short?

"CALD" ticked as a status, with no preferred language or interpreter need recorded.
Country of birth used as a stand-in for language, religion or diet.
Family members used as default interpreters for care decisions, without asking the person.
Preferences written in assessments but absent from the care plan and handover.

Related Resources

Common Questions About CALD Aged Care

1. What does CALD mean in aged care?

CALD means culturally and linguistically diverse. It describes people whose cultural background or language differs from the majority. It is a broad label, so use it as a prompt to ask about each person's actual language, practices and preferences.

2. Do we have to record a person's language and cultural needs?

Outcome 1.1 of the Strengthened Quality Standards expects providers to identify background, culture, beliefs and communication needs during assessment and planning. Recording them is how you show you did.

3. Can we use TIS National for these conversations?

The Department says providers can use TIS National to discuss care needs, services and preferences, and to develop or review documents such as care plans and agreements. Check the Department page for eligibility and client code requirements.

4. What if a person stops speaking English as their dementia progresses?

Update the record, tell the clinical lead, and arrange interpreter or language support. Research on CALD dementia care found many people reverted to their first language, and communication broke down when no support was offered.

Record it once, use it every shift

A person's language and cultural needs only count when the worker at the door can act on them. Record the facts the person chose to share, carry them into the care plan and handover, and review them when life changes. Start by auditing five current files for preferred language, interpreter need and a matching care plan entry.

CALD in Aged Care: Recording Language and Cultural Needs So Care Plans Match the Person