Who Cares? Report on the Health Related Quality of Life and Individual Level of Need of Chinese Elderly in Northern Ireland

Author(s): Deborah Gadd and Lili Braid
Document Type: Report
Year: 1999
Publisher: Chinese Welfare Association and South & East Belfast Trust
Place of Publication: Belfast
Subject Area(s): Culture/Identity, Health, Ethnicity, Equality Issues, Social Care
Client Group(s) : Elderly, Minority Ethnic Groups, Parents

Abbreviations: NI - Northern Ireland, CWA - Chinese Welfare Association, SEBHSST - South & East Belfast Health & Social Service Trust

Background to the Research

  • The Chinese population in NI is around 8,000 and the population is relatively young. Respect and care for the elderly has been a key feature of Chinese culture. Elderly Chinese people living in NI have had little opportunity for formal education and speak little or no English.
  • This report was developed by CWA in partnership with SEBHSST as part of a 2 year pilot project. The report sought to identify the health related quality of life of the Chinese elderly within the Trust.

Research Approach

  • Thirty members of the Hoi Sum Elderly Group aged 60 and over, living in the Trust area, were interviewed using the Easy Care Elderly Assessment System. The results of the survey were then compared with the results from the same survey administered to a randomly selected group of elderly currently registered with Social Services within the indigenous local community.

Main Findings

  • Eighteen of the participants were male and 12 female. Forty-one percent of the sample were aged between 65-70 years, 33% were aged between 71-80 years and 23% were aged between 60-64. The average age of the group was 69 years.
  • Seventy per cent (21 people) of participants rated their health as 'fair' to 'poor'. Many of this group suffer from health problems such as diabetes, angina, kidney disease and high blood pressure.
  • The majority of respondents (20 people) have no hearing difficulty, of the one-third who reported hearing difficulties only 3 have hearing aids.
  • Forty per cent (12 people) of respondents reported difficulties with their eyesight, suffering from conditions such as glaucoma, cataracts or the side effects of diabetes.
  • Twenty per cent of participants (6 people) stated having difficulty in chewing food because they wear dentures or their dentures were ill-fitting.
  • All respondents reported having no problems with their speech and had no problems communicating with family or friends within their community. However, all have difficulty making themselves understood to doctors, hospital staff, in shops and in the wider community, because they do not speak English.
  • Barely 7% (2 people) of participants live alone, nearly 57% lived with their spouse and/or immediate family. Around 27% live as one of three generations under one roof. In the majority of cases the house is owned by the son. Ten per cent live with people they are not related to.
  • In relation to daily activities such as housework, preparing meals and money, 80% need some help or are completely dependent on their family to provide support. Nearly 47% need help when taking medicine, as they are unable to read the dosage instructions.
  • Just over 53% (16 people) of respondents need assistance to manage stairs and around 43% (13 people) need help to walk outside.
  • One-fifth (6 people) of the sample reported occasional accidents with their bladder and none were receiving help to cope with this.
  • All respondents stated that they could keep up their personal appearance without help and 80% reported that they could bath/shower without assistance. Of the 20% who need help to bath/shower the question was one of mobility.
  • Nearly 97% of respondents stated that their accommodation was sufficient.
  • Ninety per cent (27 people) of respondents stated that their financial circumstances were 'good' to 'satisfactory'. Three people reported that their circumstances were 'bad' - as they were completely dependent on the immediate family.
  • None of the respondents reported being abused by anyone, however there may be reluctance among the elderly to report abuse whether it comes from within the family or from the wider community.
  • None of the respondents reported ever having been treated for a mental health problem, however, within the Chinese community as with the wider society, mental illness carries a high degree of stigma.
  • Sixteen (53.3%) respondents reported feeling 'downhearted/sad' in the past month 'a little of the time', 8 (26.6%) felt this way 'some of the time', 2 (6.6%) 'most of the time' and 4 (13.3%) 'none of the time'.
  • Sixty per cent of respondents (18 people) stated that they were lonely either 'sometimes' or 'often' and 40% (12 people) 'never' felt lonely.

Conclusions

  • The Chinese elderly who took part in the survey enjoy a reasonably high level of independence and fairly good levels of health. Although a significant number suffer from physical illnesses and problems common to the elderly in general.
  • In relation to language, the elderly people surveyed are totally dependent on others, usually family members to interpret on their behalf, not only in accessing health and social services but in communicating with personnel within these services.
  • Few Chinese families are aware of the range of provision, such as home helps, chilled meals, occupational therapists, available to the elderly. Cultural expectations of sons or daughters to look after their elders often inhibit families from accessing such services.
  • The dispersed and fragmented nature of the Chinese community, coupled with language difficulties means that Chinese people (and particularly the elderly) are isolated from the wider community. As many members of the community work in the catering industry many of their elderly relatives are left on their own for long periods of time.

Comparing the Chinese Elderly with Local Irish Elderly

  • Chinese elderly were more likely to rate their health as 'fair' to 'very good', no one from the local community rated their health as 'very good' and almost twice as many rated their health as 'poor'. The implications are that the Chinese elderly are less likely to access services even when they know about them. They are less likely to know about services such as home helps, chilled meals etc.
  • Fewer Chinese elderly live alone compared with local elderly people, this may be due to the importance of looking after the elderly in Chinese culture. It may also explain why few Chinese elderly people claim to have mental health problems or feel sad and lonely. It may also account for their claim that they are able to carry out more physical tasks.
  • There are no great dissimilarities between the groups when it comes to personal grooming, satisfaction levels with accommodation. Neither group reported suffering abuse within or outside the home.
 

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