Key considerations

CALD Older People Resource

Trinh and Ahmed (2009) highlight the following as useful practices when working with older CALD clients.

Use the following cultural assessment tools (see “Tools and Guidelines” section) to guide clinical assessment.

Invite family members to assist with:

Physical needs, negotiating a new environment.
Confirmation or clarification of information.
Interpretation in the event that a qualified interpreter is not available, or to clarify expressions for the client in the event of poor English and/or poor hearing.
Providing an accurate family history.

It is important to assess chronic health conditions (cancer, heart disease, stroke, etc.) as these are known to affect the mental health of older people . Rates of depression can be two to three times higher in older clients with chronic health issues (Black et al.1992).
Encourage clients to bring all medication to the interview to avoid confusion and difficulty recalling names and the dosages of medication (combinations of medications can cause confusion). Check what the older person is actually taking not just what they were prescribed.

The level of functioning of older people is often understated by their children. It may be necessary to refer for an over 65 assessment for HBSS or mental health day stay as the pressure on families of a dependent older person is considerable.

It is important to assess for elder abuse (see Mehta, 2012). Apart from assessing for physical, sexual and psychological abuse, it is also important to be aware of possible improper use of funds and other resources, and/or exploitation.
Older people often experience neglect and CALD clients can be more vulnerable because of acculturation issues, as well as isolation if no family is available.

This must be assessed prior to making treatment plans and arranging for further assessment. Be aware that literacy influences test outcomes.
Employment history will also be an important indicator of pre-morbid functioning.