1. 16th International Metropolis Conference Ponta Delgada, S. Miguel Açores Caring for the Elderly in the USA and Canada Catarina Guimarães Nuno Pavão Nunes

2. Why the Portuguese and Luso-descendant Elderly in the U.S. and Canada?  The issues of aging have known a strong increase in research, social and political organization of modern societies.  This is due to the fact that, year after year, the presence and relevance of the elderly population is increasingly visible.

3. Why the Portuguese and Luso-descendant Elderly in the U.S. and Canada?  Portuguese families are rooted in geographic areas with a high concentration of Portuguese communities in North America.  In communities, the number of older men and women continues to increase, following the global trend of longevity.

4. Research Questions 1 – Where do Portuguese and Luso-descendent elderly live? 2 – With whom do they live with? 3 – How they occupy themselves? 4 – What are the main challenges faced by elderly during the aging process?

5. Research Questions 5 – What are the main difficulties experienced by elderly as it relates to Daily Living Activities? 6 - What type of illnesses affect this population the most? 7 – Who cares for the Portuguese and Luso-descendent elderly? 8 – What are the main difficulties experienced by caregivers?

6. Research Questions 9 – What types of supports do these families receive? 10 – What needs to be changed to guarantee a better quality of life?

7. Methodology  This is a descriptive study based on qualitative and quantitative methods. SAMPLE:  573 elderly & 1363 relatives/caregivers in the U.S.  471 elderly & 738 relatives/caregivers in Canada. To collect data we used: - Surveys and Interviews.

8. Results/Discussions

9. Elders with autonomy live mostly:  Own place.  Rented apartment.  With a daughter and her family.

10. Elders without autonomy live  With daughters and her family.  In nursing homes.

11. Main challenges experienced by elders 1) Loneliness 1) Isolation 2) Dependence on other people 3) Poor family support 4) Problems in communicating in English

12. Main challenges experienced by elders 6) Financial problemas 6) Illness 6) Dificulties with transportation 6) Also, the elder individuals born in Portugal misses the homeland and relatives left in their countries.

13. Caregiver/relatives difficulties 1) Become physically and psychologically tired 2) Lack of time 3) Lack of support from other family members 4) Financial difficulties

14. Caregiver/relatives difficulties Some caregivers are extremely tired because there are elderly who do not receive home care or do not attend a senior home. Sometimes this happens because people do not want someone who does not speak Portuguese to provide services or because the family feels the need to demonstrate that they can take care of their elderly without any help.

15. Quote…  Portuguese community "does not like to leave their elderly in nursing homes (…) We can be proud to keep our parents in the family. The Portuguese have a great love for the elderly and, somehow, we feel shame and guilt if we even make them go into a nursing home”.

16. How they occupy themselves?  Men: Regularly go to social clubs and associations linked to the Portuguese communities where they play cards, watch TV and socialize with friends. They also go to church. There are social clubs and associations linked to the Portuguese communities, and religious festivals that allow socializing with friends / and are important in the reduction of isolation, and feelings of worthlessness.  Women: Watch TV and listen to the radio, cook, go to the doctor, go to the church, take care of the house, spouses and grandchildren.

17. The main difficulties experienced by elderly as it relates to daily living activities.  Inability to take responsibility for taking the medicine (drugs) correctly and timely.  Managing money.  Shopping.  Difficulties in using the means of transportation (problems with transportation and long distances limits elderly daily rountine activities, like going to the doctor, shoping, visiting friends, family, etc.).

18. What type of Illnesses affect this population the most?  Heart problems  Cholesterol and Hypertension  Obesity and Diabetes  Anxiety and Depression

19. What type of support do they receive?  Health insurance  Retirement benefits  Financial support that happens through the federal and state programs Elder and their families use little and have little knowledge about governmental programs that provide financial and social support.

20. What is necessary to change in order to guarantee a better quality of life?

21. Changes: Luso communities in the U.S. and Canada should focus more on the quality of life and value more the elderly people residing in communities. Offer more information, assistance and training in seeking government support.

22. Create more support for families who caregive for elderly people. Create more day centers and day activities that serve the linguistic and cultural needs of the elderly Portuguese and Luso-descendant. Changes:

23. Since Community programs and day care centers do not meet the needs of elderly Portuguese or Luso- descendant, it is important to have caregivers who speak Portuguese because they establish a better relationship with the Portuguese speaking elder. When this happens it leads to better compliance with treatment on a regular basis and better results, improving quality of life.

24. Conclusion In profiling the Luso elderly population, we expect to contribute to the application of policies to ensure better living conditions for elderly people who left their country, their families, worked and fought hard to ensure a better life and future for the following generations.