1. Culturally Sensitive Care for Seniors Queenie Choo Chief Executive Officer

2. About S.U.C.C.E.S.S. Founded in 1973 30 service locations in BC, Ontario, and Overseas (China, Taiwan, and South Korea) 300+ multi-lingual staff Settlement, Language Training, Employment, Family and Youth Services, Business & Economic Development, Health Care, Housing, and Community Development S.U.C.C.E.S.S. Multi-Level Care Society: Adult Day Centre, Assisted Living, and Long-Term Care Home

3. Immigrants Seniors in Metro Vancouver Population Age 65 & Up: 57% are immigrants Top 5 Places of Birth: China, UK, India, Hong Kong & Germany Senior Immigrant Arrivals: Increased from 1,318 arrivals in 2009 to 3,182 in 2013 Lack of Official Language Proficiency: 26% of immigrant seniors do not have knowledge of English or French National Household Survey 2011 Welcome BC, 2013

4. Context Increasing Immigrant Senior PopulationChallenges Adjusting to New Environment Unaddressed Challenges  Isolation, Inability to Communicate Needs, Feelings of Mistreatment, Negative Health Impacts Culturally Competent Care Needed to Respond to Changing Needs of Seniors

5. Challenges of Immigrant Seniors Preference for First Language Language Barriers Food Recreational Activities Holidays/Celebrations TV/Radio Missing Cultural Norms Ties to Cultural/Ethnic Community Loss of Community E.g. Care providers of opposite sex E.g. Exposure of body while bathing Unfamiliar Cultural Practices E.g. Rooted in Historical Conflicts Cultural Conflicts with Other Residents and Care Providers

6. Understanding of Health Conceptualization and Understanding of Health Issues Stigma/taboo (e.g. mental health, end of life practices) Deference to Authority Reluctant to ask questions or express needs Compounded by language barriers Family- Based Decision Making

7. Cultural Competency Care Cultural Sensitivity Understand there are cultural differences as well as similarities Value not assigned to differences (there is no right or wrong) Cultural Awareness Sensitivity and understanding of other cultural groups Internal changes in attitudes and values Cultural Knowledge Understanding of cultural characteristics, values, belief systems, and norms Evans, 2001 National Maternal and Child Health Centre on Cultural Competency, 1997 Adams, 1995

8. Culturally Competent Care Barrass, 2012 Tayab & Narushima, 2015 Cultural, spiritual, and personal needs Person- Centred Care (Build Relationships & Understand Needs) Provide Sense of Community

9. Best Practices Use appropriate and trained translators who are bi-lingual and bi-cultural Improve Language Capacity Listen to Seniors Share Perspectives and Acknowledge Similarities and Differences Develop Mutually-Agreed Upon Plan Culturally Competent Communication Familiar Foods Recreational Activities Celebrate Cultural Holidays Practice Cultural Norms More training for staff on needs of immigrant seniors, cultural traditions and practices, and culturally sensitive practices Training on how culture impacts quality of life Open communication and sharing Enhance Cultural Sensitivity and AwarenessLeverage Cultural-Specific Community Resources

10. Contact Queenie Choo Chief Executive Officer 604-408-7272 queenie.choo@success.bc.ca www.success.bc.ca