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 persons 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