Convention 2010_Aged Paper Ageing: The Current Situation in Australia Abstract: Maurice Cauchi Elderly Maltese i.e. those 65 years and older now form a third of the total Malta-born generation. In this paper three major issues will be considered. Firstly a summary of the demographic situation in Australia as emerged from the last census (2006) will be given. Secondly, a picture of the social life of elderly persons who are still active will be presented, based on surveys carried out recently in Melbourne. And thirdly and perhaps most importantly, the needs of the immobile, frail elderly who form the most needy category will be highlighted and the efforts of the Maltese Community Council of Victoria s role in tackling these needs will be summarised. 1. Introduction In discussing the current situation of aged Maltese in Australia, we should consider a number of issues with a view to making some recommendations. The main issues which I believe should be tackled are as follows: 1. What is the current situation relating to aged Maltese, and how is that different from that depicted at the last Convention in 2000? 2. What are the main issues affecting aged Maltese? 3. What is expected of leaders of the Maltese community and of the Maltese Government? I shall be dealing with the first and partially the second issue, while my colleagues will deal with the other topics as indicated in the programme. 2. How many aged persons in Australia? The total number of Malta-born persons living in Australia is slowly declining, from a high level of 57,000 in the 1980s, to 43,700 in 2006 (which was the last census carried out in Australia). There has been a drop of around 4-8 % in the Malta-born population with every 5-yearly census ( i.e. about a drop of over 1% per annum). The rate of loss will of course increase with the years as we all get older. The graph below shows the projected number of Malta-born persons over the next decade. Assuming that there is no significant increase in the number of Maltese migration, by 2020, the number of Maltese-born in Australia would be expected to be less that 20,000 with an annual loss rate of 5% and less than 10,000 with an annual loss of 10% 1
Projected Drop in Malta-born Population 50,000 40,000 Population 30,000 20,000 10,000 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Year (from 2006) Figure 1: Projected population of Malta-born in Australia over the next decade, based on the assumption that the annual loss rate is 1%, 2%, 5% or 10% The proportion of aged persons to the total population of Malta-born persons is increasing dramatically. At the last census (2006), there were14,486 persons aged 65 years and over. This means that one-third of the Malta-born population fall within this category. The greatest proportion was in SA (36%) and the smallest in ACT (27%) (see Table, Appendix 1). The majority of Maltese-born aged are to be found in Victoria (46.6%) following by New South Wales (40.4%). The rest of the Maltese aged population is to be found in Queensland (6.5%), South Australia (4.1%), West Australia (2%), and ACT (0.7%). i Conclusion: total population of Malta-born is decreasing rapidly, while the proportion of aged persons is increasing rapidly. 3. A picture of current social conditions of aged Maltese. Several surveys have been carried out to study the social conditions of Maltese aged. One of the first ones was that by Lawrence Dimech in 1992. ii Since then several other surveys have been carried out. In the last year two surveys were carried out in Victoria and in this section I shall briefly describe the findings. These surveys dealt with mobile elderly persons attending a typical social club at the Maltese Centre in Victoria with a view to understand the economic and social circumstances that these people live in (See Appendix 2 and 3 below). The vast majority owned and lived in their own homes with only 7% living in rented accommodation, and only 6% lived with children or relatives. The vast majority lived with their spouses, but there was a significant proportion (14%) living alone, and, while living alone is not equivalent to loneliness, it is one important factor. Mobility is an important issue in relation to participation within society. The vast majority stated that they had their own car, with only 18% stating that they did not have their own car. However, one point to stress is that a significant proportion of 2
women do not drive and will find it very difficult to cope adequately when their husband is not longer available. Most Maltese aged depend on a pension for their income, with only a small proportion (16%) having a superannuation or other private means of self-support. The main sources of relaxation were: attendance at social clubs (63%), radio, including Maltese radio (65%), and television (75%). SBS television also rated highly being watched by 65% or respondents. Other topics for diversion included watching videos, listening to music, gardening and, rarely, using computers. Physical activities were mainly obvious by their absence. Maltese have kept contact with the mother country in various ways, not least by actually making it a point to visit at regular intervals. Almost half of the respondents stated that they had visited Malta in the last five years. Only a very few stated that they had never visited Malta since their arrival in Australia. It is interesting to note that none of the participants indicated that they had used an interpreter during the previous year. This could merely indicate their perception that their knowledge of English was adequate, a perception that could turn out to be wrong. Also relevant that they made very few extra demands on local government services, which included primarily help with cleaning. Health Issues: As is to be expected in this age group, a considerable proportion of participants stated that they had a health problem, as follows: blood pressure (48%), arthritis (44%), diabetes (30%), eyesight (20%), and hearing (18%). This is a selected population, but typical of the average senior Maltese living in Australia today. Of major concern is the fact that health problem form a very significant issue which is likely to get worse over the coming years. Related also to this is the lack of inclusion of any form of exercise in their daily regime. Likewise, the issue of loneliness is likely to increase with the demise of one of the spouses. This will have a considerable impact also on their mobility, seeing that most females cannot drive their own car. This survey also emphasizes the reliance that these persons have on radio and television, with never a mention of print media. Moreover, it emphasizes the fact that the computer revolution has completely bypassed these persons. The survey was not intended to answer questions relating to other needs, particularly retirement villages, nursing homes and other housing needs. (which will be dealt with by Paul Borg). 4. Elderly in need. In contrast to those elderly persons discussed above, there is a smaller but increasing community of elderly persons who are immobile and who are in greater need of assistance. It is in this category and we find the largest proportion of those who are isolated and who require all the help that they can get. I shall mention some of the more important issues in this category, and also to mention what the Maltese Community Council in Victoria has tackled these issues. a. Isolation: 3
Surveys have shown that most elderly persons prefer to stay at home. Even when family members are available, they spend a considerable time by themselves. Many family members these days stop short of having elderly relatives actually living with them, as this interferes too much with their daily routine. The result is that after losing their spouse, many elderly persons find themselves living alone and in isolation. To overcome this, several programs have been initiated from time to time. These have included the following: 1. Government-sponsored programs enabling voluntary organisations like the MCCV to employ staff to look after a small number of elderly frail persons. They are brought to the Centre and looked after for several hours a day for 4 days a week. At the moment the MCCV deals with 25 such persons and there is a considerable waiting list. 2. A home visitation scheme. In Melbourne, a visitation scheme was initiated with the help of the Knights of Malta, later supported by grants from the government which allowed the employment of a co-ordinator. This scheme had to stop when there were not enough volunteers available to run the scheme. Some financial help could induce volunteers to resume this service. 3. Library on wheels: Videos, tapes, books etc: This scheme was started in Melbourne some time ago through the library at the Maltese Centre. Again this activity depends on delivery of these by volunteers. 4. Radio & TV: Radio in Maltese has been a great comfort to many and is available to most persons in Australia. As mentioned earlier this is one of the most important source of entertainment to all elderly Maltese. However, TV is restricted to half an hour a week and does not reach all sections of the country. Greater efforts are required to ensure greater coverage b. Placement of elderly persons in homes This topic will be covered by Paul Borg. As one grows older, and particularly when one finds oneself alone, the big decision is whether to stay at home and manage as best you can, or to find some suitable accommodation in a nursing home, or alternative accommodation. It is a generally accepted fact that most people, and perhaps Maltese in particular, do not want to leave their home, and will do their utmost to stay there as long as they possibly can. I can tell stories of people in their 80s, even when almost totally blind, who prefer to stay at home and do their own cooking, at great risk to themselves, rather than end up in an anonymous nursing home. Hence the need for ensuring that these people are not forgotten. In Melbourne there are currently some 250 Malta-born persons in nursing homes a statistic which rather difficult to get. iii We have only one home run by the Maltese Dominican sisters where staff are fluent in Maltese language and are aware of the cultural needs of their clients. It caters for 4 or 5 Maltese out of a total of 50 residents. 4
Most other homes cater for all ethnic groups and do not provide ethnic-specific services of any kind. Most residential homes do not give enough importance to cultural needs. A program was initiated by MCCV to give some idea of Maltese culture to carers in these situations (See Appendix 3, below). The suggestion has been made before (see FOMA Recommendations, 2000), that there could be the occasional requirement of elderly persons to settle in Malta. A case in point, an elderly man, well-off, and capable of paying for a private facility, would like to settle in Malta. All that is requested is facilitation of the process to enable this to happen. This requires links between social services in Malta and overseas. Recommendations At the last Convention held 10 years ago, a number of recommendations were made relating to the elderly, namely: The Elderly 15. that special arrangements be made to facilitate the entry and accommodation in Malta of elderly Maltese living overseas. 16. that Maltese language and Malta-content audio, visual, Braille and other resources be made available to Maltese elderly living abroad. 17. that the Government of Malta take steps to arrange for the portability of pensions of Maltese living, overseas in countries where this is not currently in place. 18. that Maltese communities living overseas lobby on behalf of the Maltese elderly SO that they receive culturally and socially appropriate services from their local authorities. At this meeting we have to review these recommendations and adjust them to today s needs. Re the first recommendation (rec 15), relating to accommodation in Malta for elderly now living in Australia, I believe it is frankly rather impractical and would apply if at all to a small number of persons. However, it is incumbent on us to find out how many elderly people feel that they should be repatriated at this late stage of their life, and whether the Government is prepared to accept the small number of persons in question. Re Rec 16, the need for increased Malta-content audio-visual material, including Braille: I believe that this should remain as an important recommendation. Re Rec 17: portability of pensions: this applies particularly to countries where this is not the case. At this conference, these should be highlighted. Rec 18: re culturally appropriate services: this remains a crucial recommendation and all of us should ensure to whatever extent possible that governments and service providers understand the issues involved. One cannot, however, but feel that we are fighting a losing battle, where economic issues are likely to thwart our efforts. On the other hand I believe every effort should be made to provide adequate radio and print material for the elderly 5
Services required by ageing Maltese In my book Maltese Migrants in Australia (1990) published 20 years ago, I emphasized the needs of the ageing migrant as follows: 1. Need for linguistically appropriate services. Maltese have the lowest number of interpreters, Maltese-speaking nursing staff and social workers pro rata. 2. Need for culturally appropriate services: This is something which governments do their utmost to forget about. Everybody seems hell-bound to ensure that ethnic specific services disappear and everybody is channelled into mainstream services. One understands that this is driven by economic considerations, but the fact remains that it is detrimental to the needs of most ethnic groups. 3. Need for information targeted to the ethnic age. Hence the importance of ethnic radio and the tokenistic appearance of Maltese television in Australia. 4. Need for appropriate consultative and participatory processes. 5. Need for appropriate training strategies: efforts to train nurses, social workers and others who come in contact with what is to them a foreign culture, in order to give them some background appreciation of the needs for the aged. Such a program is currently being undertaken by the MCCV in Victoria. 6. Need for co-ordination of services and programs: One often gets the impression that government departments work in complete isolation from each other with few attempts at coordination of the various services provided by them. 7. Need for appropriate planning and data collection systems. This is essential preliminary in any planning procedures. Lack of funds often prohibit such ongoing research. Lawrence Dimech in the study mentioned already came to the same conclusions. He emphasized the need for coordination of aged and welfares services, raising of awareness and education of the community about issues relating to ageing, dissemination of information on Maltese media relating to existing services, expansion of interpreter services, as well as the increasing need for pastoral care for these persons. These suggestions are equally, and in some instances even more relevant today than they were when they were published more than two decades ago, particularly with the increase in the number of persons requiring such services. Concluding remarks It would not be an exaggeration to suggest that issues relating to age are the most urgent current issues relating to Maltese abroad. They involve a rapidly increasing section of the population with ever increasing needs. They are a population who find it increasingly more difficult to cope with everyday life and who therefore require constant attention. It is easy to say that issues relating to ageing persons are the responsibility of the governments of the respective countries where they have lived over the past 6
decades. It is, however, incumbent on all of us who claim to have a social conscience to ensure that their needs are met. Such needs are related to the fact that they are Maltese living in a relatively foreign country, a country, incidentally, which becomes more and more foreign as one loses one s ability to communicate adequately and where one become more and more dependent on those with little cultural affinity with oneself. 7
Appendix 1 Malta-Born Aged Statistics (Census (2006)) City, Municipality, Shire 0-14 yrs 15-24 yrs 25-44 yrs 45-64 yrs 65+ years TOTAL % 65+ Vic 124 143 1,781 12,048 6,756 20,852 32.4 NSW 68 97 1,207 9,752 5,849 16,973 34.5 Qld 18 15 225 1,581 938 2,777 33.8 ACT 0 0 30 188 80 298 26.8 SA 0 9 106 923 592 1,630 36.3 WA 12 13 111 590 271 997 27.2 Totals 222 277 3460 25082 14486 43527 33.3 Appendix 2: Ageing survey: Maltese Aged: Analysis of a Survey carried out by the Maltese Community Council of Victoria Surveys of needs of aged persons have been undertaken several times over the past 20 years, with perhaps the most comprehensive being that of Lawrence Dimech: A minefield of needs published 28 years ago. The survey carried out by the Maltese Community Council of Victoria last year shows some changes since then. The following is an analysis of this survey: Analysis There were 209 responses to this questionnaire, of whom 100 (48%) were male and 109 (52%) were female. Most of the participants had arrived in the 1950s and thereafter, with a small number arriving before then. (See figure 1) 8
Year of Arrival Year 1990 1980 1970 1960 1950 1940 1930 1920 0 50 100 150 200 250 Number of persons Figure 1: Year of arrival: Note that there were hardly any more arrivals after 1975. Age at arrival Figure 2 shows the distribution of age of participants on arrival. It can be seen that the vast majority were aged between 15 and 40 years, with a small number arriving as children, with a very few over the age of 40. Age Distribution on Arrival 60 50 Age (Years) 40 30 20 10 0 0 50 100 150 200 250 Participant Number Figure 2: Scatter-graph showing age on arrival. Very few were 40 years of age or older.. Age distribution today By contrast, Fig 3 shows that this cohort of participants form a very tight band within the 60-80 age group with some reaching the venerable age of 100 years. 9
Age Distribution Today Age - Years 120 100 80 60 40 20 0 0 50 100 150 200 250 Participant Number Figure 3: Age distribution of participants today. Note that most of these persons will be over the age of 70 within the next decade. Requirement of aged persons: Participants were asked whether they had made use of services from the Local Council, the Government agencies (eg Centrelink) over the past 12 months.. Responses show that 91 (44%) made use of Local Government services, and another 69 (33%) made use of other Government agencies. In addition, another 25 (12%) required hospitalisation. Isolation A question was asked as to whether the participant lived alone or with other members of the family (husband, wife, daughter etc). Of these, 29 (14%) stated that they lived alone. Some comments 1. There is a very high proportion of those who arrived in the 1950s and 1960s who are now reached well beyond retirement age. 2. The proportion of respondents making use of government services has reached over 70%. 3. A significant proportion (12%) required hospitalisation over the 12-month period. 4. While the majority of respondents still live with family members, a significant number (14%) live alone and may suffer from isolation. Appendix 3: Ageing Survey No 2: A second survey was carried out (January 2010) to take a picture of the lifestyle of those attending a typical seniors club (Newport Seniors Group). iv 71 persons filled in a questionnaire and the following are the results: 10
A. Age and gender: the majority were over 65 years of age with those over 70 constituting 54% of the group. Females formed 47% of the total. B. Accommodation: the vast majority lived in their own houses or apartments. Only 7% lived in rented accommodation. The vast majority lived with their spouses with only a few stating that they lived with their children or, rarely, relatives (6%). However, a significant proportion of participants (14%) stated that they were living alone. C: Travel arrangements: The majority had their own car, with only 18% stating they did not have their own car. D. Income: the vast majority were on a pension with a relatively small proportion (16%) living on a superannuation or other independent means. E. Relaxation: the main sources of relaxation were: attendance at social clubs (63%), radio (including Maltese radio): 65%, television (75%). SBS television also rated highly being watched by 65% or respondents. Other topics for diversion included watching videos, listening to music, gardening and, rarely, using computers. Physical activities were mainly obvious by their absence. F. Health Issues: As is to be expected in this age group, a considerable proportion of participants stated that they had a health problem, as follows: blood pressure (48%), arthritis (44%), diabetes (30%), eyesight (20%), and hearing (18%). G. Visits to Malta: (See graph below). Almost half of the respondents (45%) stated that they had visited Malta in the last five years. Only a very few stated that they had never visited Malta since their arrival in Australia. H. Other issues: It is interesting to note that none of the participants indicated that they had used an interpreter during the previous year. This could merely indicate their perception that their knowledge of English was adequate, a perception that could turn out to be wrong. Also relevant that they made very few extra demands on local government services, which included primarily help with cleaning. Visits to Malta years 25 20 15 10 5 0 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 Number Visits to Malta: Figure shows the distribution of persons who have visited Malta over they years. It shows that half of the participants have visited Malta in the last 5 years. A considerable number have done so several times over the past few years. 11
Appendix 4: Maltese Community Partnership programme (CPP) v The Community Partners Program (CPP) aims to promote and facilitate increased and sustained access to aged care information and services by culturally and linguistically diverse communities with significant aged care needs. The primary outcomes of the CPP will include: More aged care support services delivering culturally appropriate care to older persons from culturally and linguistically diverse communities; Older people from culturally and linguistically diverse communities having increased access to culturally appropriate age care support services; Older people from culturally and linguistically diverse communities having greater capacity to make informed decisions about aged care support services. (CPP Definition taken from Dept. of Health & Ageing Website) The MCCV is the only organisation in Victoria that provides and runs welfare programmes specifically for the Maltese community in Victoria. Through these programmes the MCCV is the main link between service providers and service seekers. In Victoria, there are no Maltese-specific residential facilities. In order to alleviate this problem we will work closely with 5 residential facilities in order to immerse staff in Maltese culture, traditions, language & how to provide culturally appropriate activities to Maltese residents in their care. These homes will then be promoted to perspective Maltese residents as residential facilities equipped in providing Maltese culturally appropriate care. In order for these residential facilities to be considered as residential facilities equipped in providing Maltese culturally appropriate care, staff members employed at the partner-facilities have to take part in & complete: Maltese Cultural Programme: 1hr. PowerPoint presentation on Maltese History, Culture, traditions etc. Maltese Language Workshop: To provide residential facility staff with basic knowledge and proper pronunciations of useful Maltese words and phrases in order to better communicate with elderly Maltese. (short oral overview will be undertaken after workshop). Cultural Activity Provision (C.A.P): To show facility staff how to organise and prepare for traditional Maltese activities. (Staff participation in the organisation, preparation and delivery of activity). 12
After the residential facility staff have completed all these activities they will be given a record of participation by the Maltese Community Council of Victoria stating that the residential facility is at present prepared to provide Maltese culturally appropriate care Information session for Carers: During these sessions it is envisaged that carers will meet and create friendships & networks with other people who are in the same situation as themselves. During this session a representative from Carers Victoria will be on hand to give valuable information on services that can be given to carers and other benefits such as from Centrelink. Two of these sessions will be held one in Parkville and the other in Sunshine. A campaign to raise the profile of carers: CARERS NEED CARE TOO, will be launched in the Maltese Community. The aim of this campaign is: To give recognition to carers and of their very important role within the wider community. To create support for carers within the Maltese community, most especially amongst the diverse Maltese clubs & associations. To encourage carers to know where to get assistance and not feel ashamed of asking for it. To encourage carers to learn to let go and enjoy themselves without feeling guilty, and that they deserve a break. To make the best use of Maltese media, Parishes and local newspapers to promote our campaign in order to reach as many Maltese carers as possible. References. i The number of persons aged 60 and over was exactly half of the total Malta-born population. (Census 2006). There were 12,332 persons in the age bracket 60-69 (28.2%0 and 9,430 (21%) aged 70 and over, giving a total of 21,762 (50.0%) aged 60 and over. ii Lawrence Dimech: The Ageing Maltese: a minefield of need and neglect. L Valette Social Centre, 1992. iii Information provided by Paul Lia, Maltese Community Council of Victoria. iv I am indebted to George Saliba for organising the distribution and collection of the questionnaire for this survey. v This section has been prepared by Paul Lia, welfare worker, MCCV. 13