Engaging Arabic Speaking Elders

Arabic elders

People from Culturally and Linguistically Diverse (CALD) communities in Australia face a range of issues which have been well documented (Nimri; 2007; Orb, 2002; Radermacher, Feldman & Browning, 2008; Rao, Warburton & Bartlett, 2006). These issues include those shared by older people from all backgrounds, such as:

  • Physical health
  • Mental and psychological well being
  • Socio-economic welfare
  • Social isolation
  • Transport access
  • Safe and affordable housing

However, there is strong evidence to suggest that these issues and concerns are exacerbated by cultural and language barriers as well as the experience of migration, gender and geographic location (Bartlett, Rao & Warburton, 2006). In addition, the importance of maintaining cultural identity, values, practices and language has been found to be vital for people from CALD backgrounds as they age (Feldman et al., 2012).

For elders of Arabic speaking backgrounds there are specific migration and cultural factors which affect their lives as they age and affect their access to services. These are important considerations for service providers working with aged/ageing people of diverse Arabic speaking backgrounds. We provide you with an outline of issues to consider:

Issues to Consider

  • Migration factors Open or Close

    There are two groups of elders of Arabic speaking backgrounds: those who migrated at a younger age and have grown older in Australia and those who arrived more recently as elderly migrants (under family visas), or as elderly refugees. Both groups may face similar issues and challenges, including:

    • Grief and loss: This can be experienced at a time when the elderly person’s responsibilities for child rearing and for providing for the family have been fulfilled.  Many older migrants and refugees experience ‘postponed’ grief for the loss of their homeland, the loss of family members in their home country and, in some cases, post-traumatic symptoms may develop years after the trauma occurred.

    • Social isolation: This can be compounded for older women of Arabic speaking backgrounds, many of whom have spent their younger years fulfilling traditional family and child rearing responsibilities.  Consequently, they may have had limited education, employment and English language learning opportunities.

    • Disruptions to memory: Mental health changes, such as dementia, can trigger painful suppressed memories, especially for those who have experienced torture or trauma prior to migration. This is distressing for clients and can lead to challenging behaviours, which can become more evident in residential facilities where clients' memories of confinement may affect their behaviour.

      The onset of dementia can also affect English language skills that elders acquired during their working years.  It is common for bilingual elders with dementia to revert to their first language and lose proficiency in a language acquired at a later stage in life.
  • Language and communicating with elders Open or Close

    Language barriers at all levels can affect the elder person’s confidence to access support and to navigate the complex aged care service system. Apart from determining the elder’s level of English language proficiency, it is also important to remember that some elders of Arabic speaking backgrounds may not be literate in Arabic and face difficulty reading health information and promotional materials in Arabic.

    Given the cultural significance of family members in the care of Arabic speaking elders, your communication with elders may require you to liaise with their children, grandchildren and other family members. The communication process may therefore require you to extend Western notions of ‘person centred care’ to consider communication and involvement with family members significant to the elderly person and integral in the elder’s decision making.

  • Cultural factors Open or Close

    Amongst diverse Arabic speaking communities, elders are traditionally held in high regard and enjoy special status, as their opinions are respected and valued. However, many Arabic speaking elders in Australia experience a loss of this status. Cultural change in the family may not uphold the reverence traditionally bestowed on the elderly; their skills and opinions may not be valued in the family as they were in the home country, which could lead to depression, anxiety or conflict in the family.

    Grand-parenting and the provision of care to grandchildren is considered an extension of family support and obligation. Many elders of Arabic speaking backgrounds have had hands on involvement in raising their grandchildren and consider their grandchildren’s contribution as invaluable to their ageing and aged care needs – this contribution can vary from spending time together, to help with accessing services, to the provision of direct care support. The degree to which children and grandchildren are involved with elders, varies from family to family and you will need to consider family dynamics.

    The role of religion and fatalism play an important role in the lives of the elderly in diverse Arabic speaking communities, irrespective of whether they are Muslim, Christian or of another religion. Consideration of future needs and planning for aged care needs will almost always carry a description of an elder’s future as that being determined by God; the will of God or “Insha’Allah” will be expressed by elders as one of the key determinants of their health as they age. Adherence to religion and the observation of religious customs is a cultural consideration for you to determine with your client when undertaking your assessment.

  • Family dynamics and support for elders Open or Close

    Across all families of diverse Arabic speaking backgrounds, there is the cultural expectation that younger family members will provide all care needs to their elders. Seeking help outside the family for the care needs of an elderly person may be seen as a failure in family members’ responsibility and obligation to support and care for their elders.

    Changing values, beliefs and capacity about the role of the family to assist each other, and the associated stigma about seeking external support and residential aged care, increase the burden and stress on families. In many cases, families struggle to meet their own economic needs and this reality, coupled with their reluctance to use home-based and residential care, requires that service providers engage families with sensitivity. 

    Importantly, while family may play a key role in providing care, they need to be better supported in this role; they require your support to address practical care needs and to cope with any perceived sense of failure.

    For some elders, there may be other risks, especially for those who do not have family supports in Australia and for those who belong to a small community. Risks of social isolation and related problems of depression and anxiety challenge service providers in their efforts to link these elders with people of similar age and background.

  • Attitudes to health and ageing Open or Close

    Attitudes to disability and mental illness may carry strong cultural stigma, as many mental illnesses are not considered as such. Depression and dementia may not be understood with a medical or clinical perspective, which can lead to reluctance in accessing mental health, dementia specific and other specialist services. Community education programs have resulted in growing awareness amongst Arabic speaking communities, but you will need to explore your elder client’s knowledge further.

    Additionally, understandings of treatment options may be inclusive of various traditional healing practices. People of Arabic speaking backgrounds may use western medicine concurrently with herbal remedies or traditional healing practices.

    Although doctors and qualified medical people are well accepted and respected by Arabic speaking community members, some people of Arabic speaking backgrounds, especially those with poor formal education, might accept the advice of a friend about the type of medicine they should be taking. For this reason, it is important to review medication and determine sources of advice for treatment options with Arabic speaking elders.

  • Service system response Open or Close

    It is important for aged care service providers who work with elders of Arabic speaking backgrounds to be aware of key issues for effective and responsive service, including:

    • The diversity of beliefs and experiences both within and across Arabic speaking communities, which requires a thorough cultural assessment with elders

    • Person centred care which allows for optimal service delivery and the Arabic elder’s family - cultural and religious perspectives are an integral part of this

    • Arabic speaking elders and their families, by and large, will only seek help in a crisis and may not always understand early intervention

    • Access to bilingual workers across all stages and in all types of aged care service provision strengthens the engagement of Arabic speaking elders and their responsiveness to care and treatment options

Guide for Service Providers

Guide cover

As a service provider, you will provide effective and useful services with increased background knowledge of the clients’ language, history, religion, ethnicity, migration and settlement history, and their involvement in their community groups and networks.

By strengthening your cultural knowledge of the diverse groups of people of Arabic speaking backgrounds you will have a stronger understanding of the cultural factors which may be important in your clients' lives and in the way you and your clients will work together.

Arabic Welfare has created a guide that includes an outline of issues to consider, and useful hints and strategies as part of a best practice checklist, to ensure effective engagement with elders and appropriate service provision to support their needs.

Please contact us to obtain a copy of this guide.