Language needs and service provision for older persons from culturally and linguistically diverse backgrounds in south‐east Melbourne residential care facilities

Objectives: To provide up‐to‐date figures on the language needs of older persons from culturally and linguistically diverse (CALD) backgrounds in local residential care facilities and to investigate the extent to which these needs are catered for by the provision of language‐relevant services. Methods: A postal questionnaire was sent to 189 registered aged care facilities in the south‐east region of Melbourne, Victoria. The questionnaire focused on three main issues: the number of residents who preferred or needed to speak non‐English languages; the staff available to speak to residents in non‐English languages; and the language‐specific services provided at their facility. Results: As many as 19% (1191/6409) of residents either preferred or needed to speak one of 40 different non‐English languages. While over half of the facilities had at least one staff member who conversed with residents in their preferred language, residents speaking nine non‐English languages were never spoken to in their original tongue. Almost one‐quarter of the facilities did not provide any language‐relevant services. Conclusion: The findings emphasise the need for widespread use of language‐appropriate services and, due to the growing ageing migrant population, have important policy implications.     

Overcoming barriers to physical activity among culturally and linguistically diverse older adults: A randomised controlled trial

Aim: To investigate by randomised trial, health professional facilitated sessions aiming to overcome barriers to physical activity (PA), improve readiness to undertake PA, increase PA participation and improve fitness among older Australian adults from Macedonian and Polish backgrounds. Method: One hundred and twenty‐one participants (mean age 70 years, 63% female) were block randomised to the intervention group (three one‐hour group education and goal setting sessions over 7 weeks) or control group (one‐hour health promotion talk) following baseline assessment, with reassessment approximately 9 weeks later. Results: No significant differences were found between experimental groups in primary (Stages of Change Questionnaire (SocQ), steps per day and Human Activity Profile) or secondary outcomes. Conclusion: This study has highlighted methodological considerations for PA health promotion and research with older adults from culturally and linguistically diverse (CALD) backgrounds in a community setting. Investigation of older CALD adults' perceptions of what are ‘adequate levels of PA’ and methods of increasing PA is warranted.     

Ethnic aged discrimination and disparities in health and social care: A question of social justice

Older overseas‐born Australians of diverse cultural and language backgrounds experience significant disparities in their health and social care needs and support systems. Despite being identified as a ‘special needs’ group, the ethnic aged in Australia are generally underserved by local health and social care services, experience unequal burdens of disease and encounter cultural and language barriers to accessing appropriate health and social care compared to the average Australian‐born population. While a range of causes have been suggested to explain these disparities, rarely has the possibility of cultural racism been considered. In this article, it is suggested that cultural racism be named as a possible cause of ethnic aged disparities and disadvantage in health and social care. It is further suggested that unless cultural racism is named as a structural mechanism by which ethnic aged disparities in health and social care have been created and maintained, redressing them will remain difficult.     

Building social capital among rural,older Australians through information and communication technologies: A review article

This paper undertakes a comprehensive review of the growing international literature on the adoption and use of information and communication technologies (ICTs) among older people. Issues associated with access and adoption of ICTs among older people living in rural communities will be explored, drawing on social capital as a theoretical lens through which to identify how these new technologies can build healthy ageing. ICTs as bridging social capital can address some of the challenges of service provision in rural Australia and provide access to more extensive information and resources. ICTs can also contribute to bonding social capital through access to other forms of communication to build on local connectedness. However, rural, older people face particular challenges of access, which may exacerbate the cycle of rural social exclusion. In the context of the Australian National Broadband rollout, it is timely to consider how some of these disparities can be addressed.     

Late HIV diagnosis of people from culturally and linguistically diverse backgrounds in Sydney: the role of culture and community

In Australia more than 85% of newly diagnosed HIV infections in 1999-2003 were homosexually acquired. In contrast, among people from culturally and linguistically diverse backgrounds, there is a much higher proportion of heterosexual exposure and many of the heterosexually acquired infections are diagnosed 'late', with people sometimes presenting with symptoms of AIDS. This paper reports on circumstances of late HIV diagnosis, meaning of an HIV-positive diagnosis and perceptions of risk among HIV-positive people from a variety of cultural and ethnic backgrounds in Sydney. The focus was on commonalities across cultures and ethnicities. Data were collected through semi-structured in-depth interviews with clients of the Multicultural HIV/AIDS and Hepatitis C Service and a sexual health clinic. Regular HIV tests were the exception in this group. Testing was usually motivated by a serious health crisis. Participants interpreted their diagnosis in the context of their knowledge and experiences with HIV/AIDS in their country of birth and the perceptions of HIV/AIDS in their ethnic communities in Australia. Many were not aware of the relationship between HIV and AIDS. Risk was perceived in terms of 'risk group' membership not in terms of practices and behaviours. Late diagnosis cannot be explained solely by association with country of birth, race or ethnicity. Rather, it is located within complex sets of social and cultural relations: the values attributed to HIV/AIDS and those infected and the social and cultural relations of ethnic communities in Australia and the dominant culture. These are enacted in healthcare seeking behaviour, perceptions of people with HIV and perceptions of being 'at risk'.     

Social support and health of older people in Middle Eastern countries: A systematic review

The aim of this study is to systematically review quantitative studies exploring the association between social support (SS) and the health of older people in Middle Eastern countries. Sixteen electronic databases and other resources were searched to identify studies that met the inclusion criteria of the review. Abstracts of identified papers were screened for relevancy, following which the authors determined eligibility, applied quality criteria and extracted the data. Twenty‐two studies met the inclusion criteria. Even allowing for the diversity of the studies included, this review offered strong and consistent evidence for a positive relation between SS and mental health, while there was inconsistent evidence of an association between SS and other health outcomes. The limited evidence for the Middle Eastern region confirms findings from other settings on the importance of SS for mental health in later life. Current evidence is inadequate to assess whether SS is associated with physical health.     

Subjective memory impairment,objective cognitive functioning and social activity in French older people: Findings from the Three Cities study

Aim: To investigate the association between subjective memory impairment (SMI) and objective cognitive impairment in later life, and to ascertain whether this is modified by level of social activity, education or living alone. Methods: Data were analyzed from three French community surveys carried out in Bordeaux, Dijon and Montpellier. Representative samples of 9294 residents aged 65 years and over were included in the study. SMI was ascertained and investigated in relation to performance on the Benton Visual Retention Test (BVRT), the Isaac Set Test (IST) and Trail Making Test B (TMT). Adjustments were made for age, sex, education, depressive symptoms (Centre for Epidemiological Depression scale), site where study was carried out and living alone. Stratified analyses investigated modification by high or low social activity, education or living arrangement. Results: SMI was reported by 21.9% of the sample, and was significantly associated with lower scores on BVRT and TMT after adjustment for age, sex, education, depressive symptoms, site and living alone. These associations were not significantly modified by social activity, education or living alone. Conclusion: Worse subjective memory was associated independently with worse performance on two tests of cognitive function; however, in these cohorts, no evidence was found for modification of associations by social activity/support or education. Geriatr Gerontol Int 2013; 13: 139–145 .     

Medicines and disease information needs of older Arabic‐speaking Australians

Aim: To explore access, satisfaction, awareness and needs for medicines and disease information (MADI) sources for older Arabic‐speaking Australians. Method: Five focus groups were conducted (in Arabic) with 29 participants with a chronic disease, aged over 65 years, and unable to speak or read English fluently. Discussions were audiotape recorded, simultaneously interpreted into English, transcribed verbatim and content analysed. Results: Arabic‐speaking general practitioners were identified as the main source of MADI, despite dissatisfaction with their counselling. Written Arabic MADI was not accessed by participants, who revealed low English and Arabic literacy levels and a reliance on family members to act as interpreters. Male participants were more concerned and active about their health and medicine information than female participants. Conclusions: This study highlighted limited availability and access to Arabic MADI for older Arabic‐speaking Australians, with reliance on Arabic‐speaking health‐care professionals for information and family members as interpreters. An accessible and sustainable system for MADI is required.     

Health concerns and expectations of Anglo and ethnic older Australians: A comparative approach

Australia is a multicultural society in which the most rapidly ageing groups are immigrants, many of whom cannot speak English well. Minimal research has been conducted to identify ethnic variation in health concerns and expectations of older Australians from non-English-speaking backgrounds, necessary to facilitate culturally appropriate services. This paper presents findings from 12 focus group sessions (4 Anglo, 3 Italian, 2 Chinese, 2 Arabic, 1 Greek) with older (60+) Australians. Common areas of concern were inadequate medication information, labelling and instructions. Anglo participants differed from ethnic participants in their use of herbal remedies, language, relationship with pharmacist and doctor and awareness of health rights. Other concerns and expectations were specific to a particular ethnic group. The findings should increase health professionals' awareness of the similarities and differences which exist between mainstream Anglo and ethnic Australians, and also between ethnic groups, thereby avoiding the use of a blanket approach when communicating with, or planning policies for, ethnic older Australians.     

Spirituality,religion, social support and health among older Australian adults

Aim: To examine the impact of perceived importance of spirituality or religion (ISR) and religious service attendance (RSA) on health and well‐being in older Australians. Methods: A cross‐sectional survey of 752 community‐dwelling men and women aged 55–85 years from the Hunter Region, New South Wales. Results: Overall, 51% of participants felt spirituality or religion was important in their lives and 24% attended religious services at least 2–3 times a month. In univariate regression analyses, ISR and RSA were associated with increased levels of social support (P < 0.001). However, ISR was also associated with more comorbidities (incidence–rate ratio= 1.2, 95% confidence interval 1.08–1.33). There were no statistically significant associations between ISR or RSA and other measures such as mental and physical health. Conclusion: Spirituality and religious involvement have a beneficial impact on older Australians' perceptions of social support, and may enable individuals to better cope with the presence of multiple comorbidities later in life.