The challenges of multicultural healthcare
Statistics
Categories of elderly / old ethnic people
• Migrants – people from the colonies– migrant workers– retired
• Refugees – own initiative– UN-camps
Characteristics of elderly /old ethnic people
• NOT a homogeneous group! How a person arranges its live in the ”new” country is individually defined.
• Factors which can influence a person’s way of arranging its life:– number of years in the new country
– social and cultural background from the homeland
– life situation in the new land
– age, gender, individual lifestyle + resources
Tendencies
• Shift of society: stranger socially, culturally and linguistically
• A dream of repatriation
Tendencies
• Status in the family:– Existing competences and experiences: not relevant
/fit for use
– Knowledge about the new society: insufficient
– Linguistic knowledge: insufficient or not-existing
– The young generation: growing more individual and independent
Tendencies
• Network– Network : the family
Men: foreign affairs / women: the interior
• Uncertainty about own identity: “who am I now?”– New status and new network?
• Uncertainty and fear for the old age
View on getting old and being old
• Exile: old earlier (refugees: 7 years) – psychical and mental strain
• Migrant workers: hard work has strained the body
• Different view on getting old and weak
View on getting old and being old
• Different view on health and illness – How to explain illness: physical or mental causes?
Does it hurt more in Arabic? (Amneh Hawwa)
• Knowledge about health and illness
• Knowledge about the health-care system in the new country: Specialist. Medicine,
• Lack of trust….but they visit the doctor often
Diseases
• Diseases: diabetes 2, high blood pressure, overweight, asthma, rheumatism, heart disease, kidney disease, cancer, problems with teeth
• Psycho-somatic: headache, stomach-ache, pains in the
back, depression….
• Webside:diabetes.dk
Management of the second language?
• Life long learning?
– ”I am too old to learn a new language!”– “I have too many problems – I can not concentrate “
– Illiteracy
– Motivation for learning the second language?– What is the carrot?
• Losing 2. language
Body language
• Different from culture to culture
= Risk for misunderstandings and fail of care.
Knowledge about the system
• Lack of knowledge, lack of trust – feeling: not treated equally
• How to get more knowledge/information about the system? (Language, Illiteracy )
• Projects: info in groups • same cultural background or mixed• men/women separated or together• info folders in mother tongue
Preventive efforts
– Info: info in own language: folders, film, sound based materials
– Visit in the home: status about health, wishes regarding activities, about future living. Info about the system and what it offers.
– Activities:• Ethnic club• International club• Activities that people find relevant• Activities together with local people and Danes
• Barriers: language, uncertainty, hostility
Curative efforts
• Nursing in private home– Cooperation with the family
– Info• Rights & duties• Health & illness
– Tools (“Pegebogen”)
Residental home
• Info – What is a residental home? – Religion and culture (pray, food, body)– Can the family take part?
• Fear for isolation (family, language)
Experiences regarding residental homes
• Language communities
• ”Language bank” / enterpreters / ethnic staff
• Interior arrangement
• Activities (dance, music, TV)
• Food
• Rinkeby Servicecenter, Stockholm. Rosengården, Malmø. Transwell, Amsterdam
How to prepare the system?
• Statistic: How many in the different age groups? Which cultures?
• What do elderly/old ethnic citizens want?
• Political ambitions?
How to prepare the system?
• Preparing the staff – incl. the leader
• Knowledge about other cultures, awareness of how you
act
• Interpreters?
• Preparing more ethnic staff?
Challenges for the society / the system
• How many + which cultural groups?• What do they want?• Communication between the system and the citizen • Information about the system generally• + specifically about the health care system• + specifically about the old-age-system• Information about health and illness• Preventive offers to the ethnic elderly people• Arrange the system • Education of staff
Challenges for the staff
• Ensure that every citizen are met individually and respectfully
• Ensure that every citizen receive the support it needs and have the right to receive