Ageing in a foreign land

Advocating for ageing migrants and culturally appropriate care.

Lead researcher: Professor Michael Tsianikas | College of Humanities, Arts and Social Sciences

An elderly man is given sliced bread and ham. An elderly woman is given a cereal box and a carton of milk. They are told to make themselves breakfast. It’s a test. Can they look after themselves? Or do they need to go into residential care? For many people from different cultures, this test is unfair and confusing—they’ve never made a sandwich or poured a bowl of cereal. The type of food they eat is vastly different.

The way we care for the elderly is not designed for people with culturally and linguistically diverse (CALD) backgrounds. Our system was designed through an ‘Anglo-Celtic’ lens and has a large workforce from CALD backgrounds themselves—meaning that both the elderly and their carers are communicating through a second language. Professor Michael Tsianikas, who is seeing his Greek community age firsthand, is working to promote and normalise diversity in aged care. He speaks directly with ageing CALD people to find what challenges they face and how ageing services, funding and public policy can be improved.

When I began this journey ten years ago, ageing from CALD perspectives was almost inexistent. When I realised that migrant communities were silent, I decided to engage with the space.

I think we Greeks have very big expectations of our children, that when we get older they will look after us. Australians don’t have that. That’s what makes us drown and makes us feel like old age is worse. Because of this expectation of our children, it makes us feel worse. Everyone feels burned because their child brought them there [to a nursing home]...

Australia is a multicultural nation; in fact, it’s one of the most culturally diverse in the world. We also have an ageing population. Fast forward 50 or more years since the mass migrations after World War II and Australia now has large cultural groups from Greece, Italy, Germany, Poland and other countries needing access to aged care.

Michael’s research shows that people with CALD backgrounds face added difficulties and barriers in accessing aged care, including language regression (which is surprisingly common, particularly for people with dementia), different cultural practices and norms, socio-economic disadvantage, and lower access to formal services. In many of these cultural groups, it has traditionally been the role of families to care for their elderly; but that social structure is rapidly deteriorating with social change. Many CALD Australians still rely family to provide support and access formal services for them (‘My daughter, she’s the one who fills [the forms] in. Who else?’ a 71-year-old woman explains), even as their families have less time to give.

CALD people don’t tend to blame their children for providing a different degree of care than traditionally expected. They acknowledge the factors making it difficult: having fewer children per family, increased rates of divorce, greater geographical distance as children move away, more women in the workforce, and families raising their own children later in life. There is a sense of resignation (‘Of course we prefer [receiving help] from our children, but they can’t... When our children didn’t have their own families, they helped us,’ one 88-year-old man says).

Increasingly, elderly CALD people must rely on formal services that they don’t believe are tailored to them and their specific needs. It goes beyond language. Will they understand my customs? The kinds of foods I eat? How I grieve? Because formal aged care aren’t necessarily trusted to provide culturally sensitive services, many CALD people turn to health and social clubs and people with the same background—like community centres, cultural clubs, and MPs and GPs who speak their language.

It is through these organisations and people—as well as his own connections to the community—that Michael finds his interview subjects. Michael grew up in the mountainous remote village of Anatoli in mainland Greece—which is why the ageing Greek community who immigrated after World War II are his focus. He has experienced the difficulties of speaking a foreign language in an unfamiliar country, having moved to France to find work in early life. Since then, he has gone on to study classic literature and Modern and Ancient Greek in Greece, complete his post graduate studies in France, and pursue an academic career in the humanities in Australia. Being multilingual means Michael is able to connect with people in their native tongues. It’s a good thing he loves to chat.

Many of his conversations take place at Multicultural Aged Care Inc. (MAC)—one of the few centres to face the challenges of CALD people head-on and where he met CEO Rosa Colanero.

Italian-born Rosa Colanero has been involved in migrant communities since she came to Australia as a toddler. Years later, her lifelong commitment to helping others would be recognised with an Order of Australia. Rosa’s office is full of books, photos, awards, and an enormous painted portrait of the philosopher Aristotle. But when you speak to her, she’ll show you her latest card from a Flinders University student—someone she’ll be sad to see leave after their placement finishes (“You have taught me so much. I will always miss you” is the scrawled message from her latest departure). It is here, across the large wooden desk, where Michael and Rosa spend hours talking.

Under Rosa’s leadership, MAC is a place where diverse elderly people can find companionship and support that embraces their differences. The library is the perfect representation of MAC. It’s an eclectic collection of ‘things’: costumes, books, souvenirs, knick-knacks from a set of Swedish gnomes to a range of tradition Greek clothes.

The people at MAC are always happy to talk to Michael, whose research takes a holistic approach and respects the importance of aged people articulating their voices. He listens to their frustrations and places them in a broader social context.

Michael and Rosa both want to ease their experiences. Sometimes, this can be quite simple. When one aged care village asked Rosa how to engage a solitary Greek man, her answer was simple: buy a Greek newspaper subscription. The results were immediate; the man began reading voraciously and speaking to other residents about current affairs. Other times it’s more difficult, so Michael is working towards large-scale solutions such as translating essential documents, educating aged care providers and working with groups that lobby for policy change.

Over the years, Michael’s research has highlighted the importance of understanding spiritual and religious beliefs, the need to challenge cultural stereotypes, and the language barriers heightened by language regression. He found a way to share that knowledge by establishing the Ageing in a Foreign Land conference to educate others and give a voice to the voiceless. The conference brings together researchers, policy makers, aged care services, government and multicultural communities—challenging the whole community to support eldering CALD people in ageing well. It is the only CALD-focused aged care conference in Australia and it spurned a number of aged care conferences to incorporate CALD issues into their programs.

Aged care should not be a ‘one-size fits all’ service. Michael is working towards a future in which all people have access to high quality care that’s responsive to individual needs.

Ultimately, I would like to make sure that CALD communities are able to age proudly and feel like free individuals.

Lead researcher profile

Professor Michael Tsianikas is a philosopher and literary expert, with a focus on Modern Greek literature. Most notably, Michael is a leading researcher in culturally and linguistically diverse (CALD) ageing communities. His work aims to profile, advocate and address the specific needs of ageing CALD people. Michael established the unique-to-Australia biannual Ageing in a Foreign Land conference. He also collaborates with, and develops programs for, peak bodies within Australia’s CALD communities, including St Basil Homes and the Multicultural Aged Care.