Food for thought with elderly migrants' care

The Bhartiya Samaj Trust activity hall is a lively place on a Wednesday morning. Indian senior citizens trickle into the room where they await a computer education class. Tea cups tinkle in the kitchen and a man plays a slightly clunky tune on a tiny keyboard built into a small box with a wheezing accordion attached to the back.

Jyotindra Shah is there. He's 70 and he and his wife are looking for a new home. He expects it will be the last home he buys before eventually entering a rest home. It's a prospect he is dreading, not as an elderly person but as an Indian.

When asked why, his face becomes sombre. "Food," he says.

Sharing a cup of tea with Mr Shah is Jeet Suchdev. Mr Suchdev is the co-founder and president of the Bhartiya Samaj Charitable Trust, which holds regular events and meetings attended by hundreds of Indian senior citizens, language and culture classes for children and social services for families. He says the trust has identified an issue for elderly South Asians - people from India, Sri Lanka, Pakistan and Bangladesh - in rest homes and hopes to establish a "culturally appropriate" rest home for those people.

"We visited a lot of older people in rest homes and we found they are miserable," says Mr Suchdev. "Rest homes are designed for Kiwi culture, there's nothing to cater to people in an Indian way."

The problems these elderly face come down to culturally appropriate care - including changes in food, language barriers, limited companionship, and difficulty in getting to their places of worship.

"Imagine if you had been eating a certain food your entire life and then I put something else in front of you for breakfast, lunch and dinner," says Mr Suchdev. Mr Shah nods solemnly beside him.

Many South Asians are vegetarian, for example, and then there is the issue of Muslims who don't eat pork.

Mr Suchdev says while traditionally an Indian family would not wish to send their elderly parent to a rest home, modern family dynamics have made it a more common choice.

"More often we see both parents working, they have small children to attend to," says Mr Suchdev, who with members of the trust surveyed 500 South Asian elderly in care. "They can't care of their elderly parents. But when [elderly parents] are going into the rest home, the results are not positive. They are becoming depressed, which affects their health, their lifespan, and it returns stress to their children."

"The results reflected a great need. That's why we are planning to have a resthome that is tailormade for them."

Mr Suchdev says that initially the resthome would cater for those who are no longer able to live at home and eventually would provide extra care facilities for elderly with more acute needs.

Statistics New Zealand considers that about two-thirds of the growth in New Zealand's Asian population from 2006-2021 will occur in the Auckland region, and almost half of the national growth will occur in Auckland central suburbs and Manukau (see panel). The estimated Asian population across the whole of the country at June 2011 was 501,100, and in 2021 it's projected to be 694,100. Of those, 63,600 will be 65 or older.

The trust has established a core working group who will begin by sourcing a suitable property to house 43 elderly South Asians to be cared for by medical staff of the same cultural background.

Mr Suchdev said the area they're looking in is quite wide, from Blockhouse Bay to Remuera, but they're not restricting themselves if they find the right place: "If there's a speciality shop, people don't mind going a distance to get there."

The project is estimated to cost $3 million and once a site has been found various groups will be approached to help with funding.

Similar issues are being experienced by other ethnic groups. Chinese New Settlers Services Trust executive director Jenny Wang says: "There is definitely that demand from the Chinese community to provide culturally appropriate care. They have those same cultural barriers with food, activities and what is culturally appropriate."

Mrs Wang says the service is not ready to discuss plans but is also looking into how they can provide culturally appropriate care for elderly Chinese.

Bevan Chuang, a member of the Ethnic Advisory Board to Auckland Council, says while she agrees with the idea of culturally appropriate rest homes, what must remain paramount is the ability to provide medical care for the elderly.

"My grandmother was in a Chinese-owned rest home and while it might seem a good idea, we had to take her out because she suffered dementia and they weren't providing the level of care she needed. She was meant to be eating soft food and she kept ending up in hospital because she was choking on the hard food they were feeding her. So I support the idea in principle if they are not at that stage where they need extra care."

Kathy Peri, a lecturer from Auckland University's school of nursing, recently completed a PhD on the need to develop better residential-care facilities.

"Many rest homes try to make it as person-centred as they possibly can and many rest homes do that really well and take into account cultural things. There is an absolute drive to provide individualised care."

While she did not want to comment on the concept of a rest home tailored specifically to the South Asian community, she says our caregiving workforce is multicultural and that is "a good thing".

Just this week it was announced some rest homes would be having "cultural evenings" so Kiwi residents could get to know the culture of their carer, after an influx of largely Filipino and Asian rest home workers.

She says that generally the transition for any elderly person into a rest home is difficult.

"It's quite an upheaval and often can happen quite quickly. Most older people don't want to go into a rest home but there comes a time when they just can't manage at home. The move can have quite an effect psychologically, despite everyone's best efforts. Some transfer into rest homes quite easily, but for others that loss of home, of memorabilia, can be hard."

She says that for all cultures food is important in different ways.

"For old people, food's always an interesting topic and in any sort of institution food can be an issue."

But Mr Suchdev says it's more significant than that. "I've been visiting a man in a rest home who tells me: 'Every hour feels like 24 hours'."

Leave us a comment in the box below or on our Facebook page or email letters@theaucklander.co.nz