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TX: 23.01.08 - Ethnic Minority Care

PRESENTER: JOHN WAITE AND PETER WHITE

Downloaded from www.bbc.co.uk/radio4
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WAITE
Now it's predicted that Britain's ethnic minority elderly population is going to increase ten-fold in the next 20 years to around two million. So today, as part of our ongoing Care in the UK season, we're going to be looking at whether the care needs of these communities are being met effectively and whether cultural differences within some communities is affecting care because this Friday a conference will discuss the stigma that people with Multiple Sclerosis say they experience within the Asian community. So do elderly and disabled people from ethnic minority backgrounds need specialist tailor-made social care services? Peter went along to a day centre in Harlesden in North London, run by the Asian People's Disability Alliance and was taken on a tour of its services by coordinator Myash Armin [phon.] and committee member Jyoti Raja.

ACTUALITY - DAY CENTRE CHATTER

ARMIN
We have got a prayer room there, because of the Muslims they have to prayer four or five times a day and they need their privacy and we've got a special room for them.

WHITE
How many different religions do you cater for here?

ARMIN
We have got three or four religions - Hindus, Muslims - and they've got all different names, so in the religion there's different sects, so we have to look for their own different needs. One example is Swaminarayan Temple which is next door to us, this is the biggest temple in Europe. And they don't eat onion and garlic, so we have to make sure that when we order their food make sure that it's not onion and garlic.

WHITE
So is that an issue with personal carers as well - your religion and its observances?

ARMIN
Yes very much because you know that's where the problem comes if there are different people comes and they don't understand their cultural background and spiritual background. It really affects their feeling.

WHITE
So if you're getting different carers everyday or every week then that's an even bigger problem?

ARMIN
You have to explain to them all the time, it's very, very difficult to take it in, they feel dejected that nobody's listening to them and nobody's thinking about them, so they want to just forget about everything as say we don't need your service anyway and they've missed out on other services which they're entitled to.

You know Peter what they are doing is Tai Chi. It is a floor exercise, all hand movement, legs movement, body movement and we have got an instructor here who teaches them. If they like to do Tai Chi they can do Tai Chi, if they want to play sports activity they can play sports activity, so we do provide different choices for them. So you want to go the IT room to see that, I'll take you.

Elder people missed out on this technology. Now we have got a problem of bringing them out of the computer room because they realise there is a whole world waiting for them and so they go to their homeland to read the newspapers in their own language and they also go to their own town because every town has a website in India, Pakistan and all, so they go to the town and like to read about what's going on in their town.

We also provide different festivals, we have got Diwali Festival going on, we have got Baisakhi, which is Punjabi festival, we've got eight festivals, we only do Christmas here. Some of the people, like elders, like to have fasting and there's a fasting food they want, not the regular food. Because we have got a caterer who understands their needs they also provide this fasting food.

This is the kitchen. Because we haven't got industrial kitchen so we can't cook the food we order the food from the Swaminarayan Temple what we do here, in this kitchen, is to warm up the food and then we provide two hour services.

WHITE
So what's for lunch today Myash?

ARMIN
Yeah today is vegetarian lunch. You'll get chapatis and rice and dahl and they also give sweets, elder people always like sweets.

WHITE
Pity we can't stop.

ARMIN
You are welcome, you are welcome for the food anyway if you like.

RAJA
We had a big person who was now like 30 years in the hospital, for 30 years he never tasted Indian food and he was Indian and he was asking nobody knows what he wants. And he came out he couldn't speak and when he came here he was lively, he was eating his food and we - it was shocked.

ARMIN
People are getting more dementia. In the Asian background if there's somebody speaking their own language then they can respond better, better than in other mainstream centre. I've got one dementia client here, he's so happier in this environment. When he started he didn't want to stay here but now he wants to come here, he doesn't want to go away. Now when they come to collect him he doesn't want to go. So that makes a difference of all the environment - cultural environment not language environment - the food he likes, it makes the completely different life. And that's the reason this type of centre is still required in this country.

WAITE
Myash Armin was talking to Peter White. We're joined now by Kalyani Gandhi, director of the Policy Research Institute on Ageing and Ethnicity and Sonal Patel, committee member of the Asian MS Support Group, one of the organisers of Friday's conference I talked about called MS Stigma and Cultural Barriers. Kalyani, why firstly is there going to be this age bulge that's being predicted for the ethnic minority elder population?

GANDHI
Hello. Yes the population that came into this country at the early stages of migration was a much younger working age population and what we're finding now is it's only now in this decade and the forthcoming two decades that this population is going to age. And was not that the population figures of an ageing group was not prevalent earlier is going to now be in significant numbers that you quoted earlier.

WAITE
But I always thought Kalyani that care in the Asian community was usually provided by the family rather than paid carers, are things changing somehow?

GANDHI
Definitely so. Our research as well as our work with frontline community organisations has shown that older people in different settings would like their family to care for them, just like in the mainstream. Different patterns of jobs, people moving away, people migrating out of England, people also - the housing space standards that are existing in this country that don't allow large families to live together is causing more and more often minority older people to now seek assistance support, social care, from public sources.

WAITE
And what barriers do the elderly and disabled people from ethnic minorities face in trying to obtain good quality social care?

GANDHI
I mean earlier we heard about barriers of language, diet, accessing information issues, there are also significant barriers on engaging older people in civic process, in participating in leadership positions in directing policy, so it's not just about older people in minorities receiving social services but there are significant barriers in older people from minorities setting the direction and the direction of travel.

WAITE
So they're missing out on social services support and social care?

GANDHI
Very broadly yes they are, there are obviously patterns of variations in different parts of the country because settlement patterns, economic backgrounds, people's own social mobility really affects their access and usage of services. So you will find quite significant variations in the country depending on the communities and the diversity within the community. So it's not easy to generalise and say they are missing out across the board but they're significantly missing out in particular areas.

WAITE
Now Sonal you're conference on Friday is about the stigma that Asian people with MS feel within the Asian community, how big a problem is that?

PATEL
I think it's quite a wide problem. There doesn't seem to be enough information for Asian communities about a condition such as MS. And what we're trying to do is actually educate and raise awareness of the condition.

WAITE
So people don't speak about it, it's almost a taboo subject is it?

PATEL
It is almost a taboo subject. I mean I know people that just don't sort of like recognise the condition in the culture itself and they think that they've done something bad in their previous life or God's punishing them and they don't understand the condition at all.

WAITE
So I mean if you don't speak about something it's very easy to be very ignorant about it and symptoms are misinterpreted aren't they.

PATEL
Yes they are, it's like some people could be sort of like really fatigued and really tired and they're just automatically seen as just being lazy or they have balance issues and they're automatically seen as being either drunk or taking drugs or just not being able to do anything.

WAITE
Do Asian people then, with MS, do they experience problems accessing social care?

PATEL
I think they do to a certain extent. There is just lack of information about MS in the community and also with health professionals and social care services that people just don't know where to get information from.

WAITE
Now Kalyani, just back to you for a moment, are you saying from your research that specialist, sort of tailor-made, services need to be put in place for older ethnic minority people?

GANDHI
In some cases it's absolutely necessary where communities are not able to access mainstream services. The long term direction of travel is really to ensure that the mainstream sectors can provide for a whole host of ethnic groups, including the majority and the minority, and people ultimately have individual choices. So it's not about tailoring a service for an ethnic group but it's tailoring a service for the individual and allowing the individual to make the choice that they want.

WAITE
Because we must remember that I mean we can't just lump all ethnic groups together can we, they're very different from one another. And what is it that you would like to see Sonal?

PATEL
I'd just like to see better access to services for the whole community at large. I just think that there are support groups and information groups out there for people and they're just not being widely recognised by the ...

WAITE
How do you do that if you've got such, as you've been saying, such a big cultural barrier?

PATEL
Well I do think that little groups like us - the Asian MS Suport Group - are trying to get out there and just raise awarenss of the condition within the community and by doing information days and awareness events I think that's taking a step forward in the right direction about trying to address some of the bigger issues that do exist.

WAITE
Well we'll leave it there - Sonal Patel and Kalyani Gandhi thank you both very much indeed. And as we head towards the final week of our Care in the UK season don't forget to fill in the care questionnaire, 150,000 people have visited the site and their comments could help shape future govenrment policy. I'll only take you a few minutes to fill in, just a few clicks and you're done, it's on the Care in the UK website which you can find via bbc.co.uk/radio4/youandyours.

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