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