Overview

This culturally and linguistically diverse (CALD) older people resource is the first of its kind in New Zealand. It has been written because Asian groups now comprise 22% of the Auckland region population and Middle Eastern and African peoples are increasing in number (Statistics New Zealand (SNZ), 2013).

Many CALD families experience confusion and stress when trying to navigate care and support services for their older relatives. As just one example, the Ministry of Health (2013) New Zealand Framework for Dementia Care, together with the health and social support sector, recognises that dementia care needs to be improved nationwide in a way that is inclusive of Asian and other ethnic minority groups. In 2011, 1838 (3.7 percent) of the estimated 48,182 people with dementia were Asian. By 2026, of the estimated 78,267 people with dementia in New Zealand, 6568 (8.4 percent) are expected to be Asian (Alzheimers New Zealand, 2012).

There are many cultural reasons that may prevent families from seeking support for older family members. In Asian, Middle Eastern and African cultures, it is important for elders to be looked after by their own family. Cultural factors may delay families from seeking support, leading to increased stress for both the carers and the older person. Language barriers are significant for non-English speaking older people (Ministry of Health, 2013). The CALD Older People Resource for Health Providers is intended to support the health and disability workforce to provide culturally competent care for older peoples from Asian, Middle Eastern and African backgrounds and their families.

Who this resource is for

The purpose of this resource is to enable health providers to gain understanding around what is required to provide culturally appropriate care to CALD older people.
This resource is for health practitioners working with CALD older people and their families in primary, community, mental health, secondary care, home-based support services (HBSS) and residential aged care (RAC) settings. The resource serves as a reference for the online CALD older people resource and complements the CALD Cultural Competency Training Programme.

It is expected that viewers of this resource will:

• Have completed CALD 1: Culture and Cultural Competency.
• Be familiar with Ministry of Health and DHB protocols on interventions in suspected cases of Elder Abuse and Neglect.

Additionally it is highly recommended that the viewers of this resource will:

• Have completed CALD 2: Working with Migrants (Asian) clients course.
• Have completed CALD 3: Working with Refugee clients course.
• Have completed CALD 4: Working with Interpreters courses.

Additional valuable information on working in a culturally competent way with migrants, refugees and interpreters can be found in the following courses and supplementary resources:

• CALD 5: Working with Asian mental health clients.
• CALD 7: Working with religious diversity.
• CALD 9: Working in a mental health context with CALD clients.
• Supplementary resources:
  • Working with Asian clients in mental health.
  • Working with Middle Eastern and African clients in mental health.

Please enrol for courses through the eCALD® Services, CALD Resources site www.eCALD.com.

The resource is aligned to relevant competency standards and professional development frameworks, such as the Ministry of Health (2008) National professional development framework for palliative care nursing in Aotearoa New Zealand; and the New Zealand Framework for Dementia Care (MoH, 2013); and the Age Concern New Zealand (2012) protocols for elder abuse screening and intervention.

The University of Auckland (2016) CALD Guidelines for Dementia Patients in Aged Residential Care is also recommended to be read in conjunction with this resource for working with Dementia patients.

What this resource aims to do

The purpose of this resource is to provide:

• Information about Asian, Middle Eastern and African older adult populations.
• General cultural perspectives for CALD communities including working with families, decision-making, religious and cultural practices and its implication for practice.
• Cultural perspectives, cultural approaches and case scenarios for health practitioners in the following areas and services:Assessment, Treatment and
  • Rehabilitation.
  • Dementia.
  • Stroke.
  • Mental Health.
  • Needs Assessment and Coordination (NASC).
  • Residential Aged Care (RAC).
  • Elder Abuse and Neglect.
  • Advance Care Plan and Advance Directive.
  • End-of-life Care.
• Resources.

What this resource does not include

This resource assumes that health practitioners are familiar with Health of Older People Health Service Providers and agencies, for example: Needs Assessment and Co-ordination Service (NASC), Assessment, Treatment and Rehabilitation services (AT&R), and Age Concern; older people’s entitlements (e.g., Age Concern taxi chits, meals on wheels, free shuttle transport, etc.); and when and how to refer older people to such entitlements and agencies and services appropriately. Information about support services for older people is available on the Ministry of Health website.

How this resource is organised

Welcome: This provides an overview of what this resource is designed to achieve and its scope.

Background: This section provides an introduction to the topic, including a summary of definitions and terms, and some broad considerations for service providers working with older CALD clients. It includes an overview of Asian, Middle Eastern and African (Asian/MEA) populations the health status of Asian/MEA older people.

Assessment Treatment and Rehabilitation (AT&R): This section provides cultural information and tips for working with CALD clients.

Dementia: This section looks at cultural viewpoints on dementia and caring for older people with dementia. It also provides recommended tools for assessing CALD clients.

Stroke: This section looks at cultural perspectives about care giving and the impact of stroke on clients and their families with recommended approaches for service providers.

Mental Health: This section provides information about service barriers and the utilisation of services by CALD older people; and includes assessment tools and key considerations.

Needs Assessment and Co-ordination (NASC): This section provides an overview of the responses of CALD clients and their families towards home-based support services (HBSS) and Residential Aged Care (RAC) and recommends approaches for NASC services.

Residential Aged Care: This section gives an overview of what is required for culturally competent care.

Elder Abuse and Neglect: This section provides cultural contexts for the neglect and abuse of older people and offers culturally appropriate approaches.

Advance Care Planning: This section provides information about the impact of a client’s cultural background on their willingness to participate in Advance Care Plans and Advance Directives; and culturally appropriate approaches to addressing these issues with CALD clients.

End-of-life care: Cultural perspectives ont end-of-life care and the role of the family are provided. Considerations around culturally appropriate end-of-life care and guidelines are also included.

Resources for CALD people over 65: This contains information about services available for this group.

Tools and guidelines: This contains tools and guidelines for your use.

Terms Used and Glossary: This section contains commonly used terms.

A hard copy reference of this HTML online resource can be printed here.

How to use this resource

To be rewritten

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