Ageing and Cultural Diversity:
A Cross-Cultural Approach by Susan Judith Ship with the assistance of Reaghan Tarbell [Different Histories, Some Common Issues] [Seniors and Elders] [Some Demographic Trends] [Elders at Risk] [The Normal Process of Ageing] [Essential Elements of Ageing Well] [Barriers to Ageing Well: The Problem of Unwanted Isolation] [A Wholistic Approach to Unwanted Isolation] [Footnotes]
Elders from First Nations, Inuit and
Ethnocultural Minority Communities:
"Our Nations' Elders Speak" is an innovative joint project between the National Indian and Inuit Community Health Representatives Organization (NIICHRO) and the Canadian Ethnocultural Council (CEC) which addresses the multiple dimensions of unwanted isolation faced by elders in First Nations, Inuit and Ethnocultural Minority communities.1 Their particular needs as members of culturally marginalized groups, for historically very different reasons, are not addressed by the mainstream agencies and services (or literature on seniors needs) working with seniors.
This unusual partnership between cultural groups, who often have little contact but much in common, is rooted in a shared concern for promoting and encouraging ways of working with elders from First Nations, Inuit and Ethnocultural Minority communities which are culturally sensitive, relevant and responsive to their needs, values and experiences. Despite significant cultural differences and histories, elders from First Nations, Inuit and Ethnocultural Minority communities face common issues involving unwanted isolation which result from language barriers, cultural barriers, minority status and limited access to services, accentuating the problems of unwanted isolation.
Senior: A person over the age of 65. It is a relatively recent social and legal definition. As First Nations and Inuit people have low life expectancy of all groups in Canada, an Aboriginal senior is any person 55 years of age and older. Given the relative dependence and vulnerability of many immigrant seniors who never fully integrate into Canadian society, an Ethnocultural Minority senior is any person 55 years or older.2
Elder: There is no single definition of Elder. Traditionally in First Nations, Inuit and most Ethnocultural Minority cultures, Elders are those people, usually older, who are recognized by the community as possessing great wisdom and who are called upon as an authority to advise or act on important family and community matters. The term "Elder" in some cultures, referred to and may still refer to any older person to indicate respect, honor, and special status as ageing in many cultures is associated with experience, wisdom, the transmission of cultural heritage and language, leadership roles in the community, and in some cases, spiritual knowledge.3
The term Elder has come to mean many different things to Elders themselves. It may mean frail elderly or it may signify wisdom and experience and/or spiritual knowledge; it may define a state of being to achieve or it may just mean old. We have chosen to use the term Elder rather than senior to refer to all people age 55 and older from First Nations, Inuit and Ethnocultural Minority communities to celebrate the vitality, knowledge, experience and positive contribution of our nations' Elders to our common future.
People aged 65 and older are the fastest growing segment of Canadian society. These growth rates are lowest in the First Nations and Inuit communities and highest in the Jewish community.
Women outnumber men in the population 55 and older, particularly in the Caribbean communities but not in the Dutch, Italian and Inuit communities.
Fifty-five per cent of First Nations and Inuit Elders age 65 and older and 44 per cent of those over 55 claim an Aboriginal language as their mother tongue, with Cree, Inuktitut and Ojibwe the most widely used. Fifty-one per cent of Chinese elders, 29 per cent of South Asian elders and 21 per cent of Southern European elders speak neither English nor French. Far more women than men, age 65 and older, are unable to speak either official language.
The main sources of income for people aged 65 and older are government pensions, particularly among First Nations and Inuit elders. The average income for Aboriginal and Ethnocultural Minority elders is between $5,000 and $14,999 with women having substantially lower personal income levels than compared to men.4
Old age is "whenever health and functioning deteriorate to a level that results, as we age, in decreasing independence and mobility."5
Traditional cultural practices do not negatively affect the health and functioning of older individuals from First Nations, Inuit and Ethnocultural Minority communities. The social and political status of cultural groups in Canada, which results from our very different histories, poverty, cultural disruption, racism, sexism and ageism negatively affect elders' access to resources and to services which in turn affect their life chances, health, well-being, quality of life and ageing itself. In this respect, First Nations and Inuit elders are particularly at risk.
The majority of First Nations and Inuit elders have experienced unhealthy living conditions and poorer health than all other cultural groups in Canada for most of their lives - consequences of the "legacy of disadvantage" resulting from European colonization. Aboriginal elders have the lowest life expectancy of all groups in Canada, are more likely to suffer degenerative diseases normally associated with old age, as well as experience the social and psychological consequences of old age such as loss of friends, spouse or relatives earlier in their lives.6 Many elders have experienced a loss of self-esteem and independence resulting from the negative impact of Native residential schooling and the loss of traditional ways of life.
The health status of elders in Ethnocultural Minority communities is generally more favourable than is the case with First Nations and Inuit elders, although this may vary from community to community and by social class background. Migration, immigration and resettlement are associated with a wide range of physical and mental health problems, in particular, a complex array of stresses and anxieties related to culture shock, culture conflict, loss of social status and narrowing social networks, to which older immigrants are particularly vulnerable. Refugee women are particularly prone to post-traumatic stress, depression and suicidal feelings as well as infectious diseases such as TB, hepatitis B and reproductive health problems, as a direct result of trauma, including rape, torture and the loss of family members.7
"To Age Well is to Feel Whole."
Gradual sensory loss Diminished hearing, sight, taste, touch and smell Decreased mobility (including access to public transportation or driving a vehicle) Increased health problems with less resilience Narrowing social network, including fragmented families and other social losses related to death, incapacity or institutionalization Growing dependence on others Isolation and loneliness
"Ageing Well has the same basic meaning regardless of
a person's cultural background."8
Physical, mental-emotional, social and spiritual well-being Empowerment (ability to make decisions about one's life) Awareness of and access to information about existing programs and services Easy access to medical, social and other support services Ageing in place, with respect and with dignity, for as long as possible (independent and interdependent living) A supportive social environment Continued community involvement and participation Financial security Adequate and affordable housing Accessible and affordable transportation
Unwanted isolation appears to be a common problem for many elders, irrespective of cultural background. However, language barriers, cultural differences, minority status and limited access to services accentuate the problems of unwanted isolation for elders from First Nations, Inuit and Ethnocultural Minority backgrounds.
Physical isolation can occur as a result of: Social isolation can occur as a result of: Spiritual isolation can occur as a result of: Mental-Emotional
isolation can occur as a
- Geographic isolation
- Lack of transportation
- Poor physical health
- Inadequate housing
- Poor diet
- Physical inactivity
- Mobility problems
- Limited access to health care
- Lack of information about programs and services
- Lack of home care and home supports
- Lack of support services, weak family, social and community networks
- Lack of participation in recreational, social and community activities
- Inability to observe religious and spiritual practices as a result of lack of access and opportunity
- Loss of meaning and purpose in life
- Loss of sense of connectedness and belonging to something larger than oneself
- Mental disabilities
- Low self-esteem
- The impact of cultural change on the status of elders
- Difficulties accepting ageing
- Communication problems with family or community health workers as a result of language and cultural barriers
- Ageist, sexist, racist attitudes
The way we think about health and disease is culturally shaped. As Stewart points out, "The bio-medical model one-culture system of North American health care service is based on the assumption that one can take a piece of a person and mend it, without reference to the whole person, much less the social environment."9
First Nations and Inuit cultures, as well as other "non-Western" cultures, take a different approach to health, well-being and disease, which is concerned with the whole person and not merely the part of the person that is injured or diseased. Good health means more than the absence of disease or illness but rather emphasizes the whole person and the harmonious functioning of body, mind, emotions and spirit. This view of health is only now coming to be accepted by the modern health care establishment.
A wholistic approach which takes into account and integrates all aspects of health - physical, mental-emotional, social and spiritual - is appropriate to understanding and addressing the multiple dimensions of unwanted isolation by elders from First Nations, Inuit and Ethnocultural Minority communities. This approach also views the individual in relation to the family, the family in relation to the community and the community in relation to the larger society.
1. First Nations refers to the original occupants of the lands we now call Canada, comprising many different cultural and linguistic groups, whereas the Inuit are the original occupants of the northernmost regions of what is called Canada. Aboriginal peoples refer collectively to status and non-status Indians, Métis, and Inuit people in Canada. Ethnocultural Minorities are Canadians whose origins are other than Aboriginal, Anglo-Celtic or French. This term refers to the lack of power exercised by these groups relative to ethnocultural majorities. Ethnocultural Minorities are not homogenous. Differences relate to whether members are born in Canada, are refugees, recent or less recent immigrants.
2. C. Armstrong-Esther and N. Buchignani (1987), Blood Tribe Health Care Utilization Study, University of Lethbridge and Betty Bergin (1995), Elder abuse in Ethnocultural Communities, Canadian Association of Social Workers, Health Canada and Department o Canadian Heritage.
3. Assembly of First Nations (1993), "Wisdom and Vision" The Teaching of Our Elders. Report of the National First Nations Elders Gathering, Manitoulin Island, June 21-25 and Alberta Multicultural Commission (1986), Understanding Seniors and Culture. Multicultural Activities Guide 3, Culture and Multiculturalism.
4. Canadian Heritage (1995), Characteristics of Canadians 55+ by Ethnic Origins - A Draft
5. C. Armstrong-Esther (1994). "Health and Social Needs of Native Seniors." Aboriginal Seniors' Issue: Writings in Gerontology, Ottawa, National Advisory Council on Ageing: 43.
7. Ontario Ministry of Health (1993), Immigrant, Refugee & Racial Minority Women and Health Care Needs: Report of Community Consultations, Toronto: 7-9.
8. National Advisory Council on Ageing (1988), A National Workshop on Ageing and Ethnicity, Ottawa, Health and Welfare Canada :17.
9. Malcolm Stewart (1986). "Partnership in Responding to a Multicultural Society - A Social Work Perspective." in Ralph Masi, ed. Partnerships in Health in a Multicultural Society. Toronto, Multicultural Health Coalition: 27.
copyright © 1997 NIICHRO 05/01/98