Challenges of growing older in Australia: Experiences of Chinese immigrants

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1 Challenges of growing older in Australia: Experiences of Chinese immigrants Associate Professor Briony Dow Funded by JO & JR Wicking Trust Department of Social Services

2 National Ageing Research Institute Mission: To improve the wellbeing of older people through research and research translation

3 Background Chinese immigrants are one of the largest and fastest growing groups in the older immigrant population Older Chinese people access health and aged care services less than Australian born, often in crisis Huge diversity within Chinese diaspora country of birth, language

4 Background NARI has conducted several studies to explore experiences of older Chinese growing older in Australia ( 200 interviews) Dementia - memory Clinics Depression and anxiety Intergenerational relationships Healthy ageing

5 What we have learnt Poor match between needs and perceptions of older Chinese and service responsiveness Experience of family life complex Diversity within diaspora Public housing and group programs beneficial

6 Why don t older Chinese people seek help for memory problems? Lack of knowledge and poor quality information Dementia sometimes seen as madness ; source of shame; just normal in older age Doctors reluctant to diagnose due to own lack of knowledge or belief that nothing can be done No Chinese speaking workers in memory clinics, Alzheimer s services Family want to protect older person from bad news so don t want diagnosis confirmed Lack of expertise/understanding of dementia amongst interpreters Inappropriate screening tools

7 Mini Mental State Examination (MMSE) Commonly used screening tool for cognitive decline No ifs, and or buts is not easily translated into Chinese and loses its articulatory complexity Spelling WORLD backwards more problematic when first language is not English Stating current street name and suburb Recall address 42 West Street

8 Depression and anxiety study Stigma, lack of knowledge, lack of or inappropriate service provision Beliefs that depression and anxiety were personal weakness, source of shame present as physical you can deal with this as long as you have a strong mind. Depression is not an illness. It s up to you to make yourself happy or how you see things differently. a lot of people think it s your personality. they would say that I am not interested in anything, I don t want to eat. I just think about the home countries all the time.

9 Lack of or inappropriate services Geriatric Depression Scale yes/no Do you feel happy most of the time Do you think it is wonderful to be alive now Responses of just so so ( 马马虎虎 ), average ( 一般 ), or it is ok ( 还可以 ) Chinese people not used to expressing strong feelings Preferable to stay in a calm/stable state and avoid extreme emotions If detected, limited options for Chinese speaking mental health services

10 Complexity of family Anxiety and depression study Mr L

11 Housing Study of intergenerational relationships 98% (61/62) lived with family on first arriving in Australia 42 moved out within 2-15 years To have own life Avoid conflict with daughter-in-law Maintain family harmony Can t afford to own or rent house need for public housing 100% 80% 60% 40% 20% 0% 98% Australians Chinese 53% 39% 3% 5% 0 2% 0 own property Children's property Private renting Public housing

12 Preferences re future care Study of intergenerational relationships

13 Diversity within diaspora Depression and anxiety study Cantonese speaking (44) Mandarin speaking (43) Years in Australia Age at immigration (years) University or higher education (%) Proficient in English (%) 39 9 Daily contact with friends (%) Very satisfied with life in Oz (%) Depressed (%) 10 30

14 Refugee experience Anxiety and depression study Mrs Y

15 Group programs Healthy Ageing Study

16 Growing older in Australia Can be very isolated due to lack of English proficiency and family complexity Older Chinese and policy makers cannot rely on traditional family norms also changing in China Lack of knowledge about some conditions associated with ageing Willingness to adopt preventive strategies

17 Recommendations for policy & practice Recognition of diversity & changing family expectations Education for service providers, older people and families about conditions associated with ageing Culturally appropriate services Tailored English language programs suit educational level and information needs on ageing, aged care sector, access to income support and housing Income support, housing & group programs beneficial

18 Resources Rowland Universal Dementia Assessment Scale (RUDAS) Culturally validated tools and guidelines for depression and anxiety Education resources, such as DVD for interpreters for cognitive assessment Tips for ACAS workers working with older CALD people

19 Questions/Discussion

20 Acknowledgements Project team/advisors Team Associate Professor Briony Dow Dr Anita Goh Ms Betty Haralambous Dr Xiaoping Lin Dr Caroline Yuen Ms Freda Vrantsidis Dr Irene Blackberry Dr Jean Tinney Dr Elizabeth Cyarto Advisors Dr Christina Bryant Clinical Associate Professor Dina LoGiudice Prof Nancy Pachana Prof Nicola Lautenschlager Funding sources JO & JR Wicking Trust Department of Social Services Advisory Group Emeritus Professor Ed Chiu Ms Sue Gherdovich, beyondblue Ms Marie-Anne Schull, beyondblue Ms Marion Lau Ms Junxi Su Dr. Lawrence Wu Ms Ada Wong Ms Caroline Yuen Research Participants

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