Culturally Appropriate Assessments
There are several key considerations for practitioners undertaking aged care assessments of Greek clients. They are:
- effective communication to ensure accuracy
- participation of family members
- culturally appropriate assessment tools
They apply to Aged Care Assessment Services (ACAS), cognitive screening tests, Home and Community Care assessments (HACC) and behavioural assessments in residential facilities.
Effective Communication
Facilitating effective communication is crucial to accurately assessing the needs of your elderly client. It will also be a support to the rapport you need to establish directly with your client. Depending on your client’s proficiency in English, it is important to use client-focused questions and responses directly with your client. Communicating questions and responses through bilingual family members does not ensure accuracy in translating your questions into Greek or your client’s responses translated into English. Greek Language and Communication contains crucial information about a range of communication issues, including the necessity of using interpreters and translations
Also, keep in mind that even if your client once had a strong proficiency in English, this may have been eroded with the onset on dementia, and that in these circumstances bilingual speakers often revert to their first language.
Involvement of Family Members
The involvement of family members in assessments of elderly Greek clients almost goes without saying. Family members can contribute useful information about a client’s level of ability and changes in physical and mental capacity, as well as information about the client’s background and life experiences that they would not communicate directly to a professional.
However, it is important for practitioners to define the role of family members in the assessment process. Briefing the family prior to the commencement of the assessment on their participation and role in the process is a valuable exercise. It will help to clarify both the process and the purpose of the different aspects of the assessment. Importantly, practitioners need to ensure that questions requiring a response from the client are not answered by family members.
Culturally Appropriate Assessment Tools
Assessments should be constructed around culturally appropriate questions and content. The ‘Mini Mental’ cognitive screening test is widely used with elderly clients. The questions asked of a client in this test assume that both historical dates and personal dates have the same significance across cultures. For example, the dates of World Wars and client birth dates are common questions, and they assume that such dates are significant for clients from all backgrounds.
However, Greek elders born prior to 1930 did not have their date of birth officially recorded by state authorities. For many, their recorded date of birth was officially registered many years after their birth, a date they became familiar with only later, in their teens or as adults. A date of greater personal relevance and significance is that of their name day, the date on which a celebration is held annually in their honour.
The Rowland Universal Dementia Assessment Scale (RUDAS) is a recently developed cognitive screening tool that has gained widespread use as a screening scale. It is free of cultural bias and is worth considering in the assessment process.
Culturally appropriate assessments could also involve a joint or supported assessment undertaken in collaboration with a Greek-speaking worker from a Greek-specific aged care service. The Greek-speaking worker’s role would be that of a cultural broker, providing the practitioner with contextual cultural information about the assessment, the client and family dynamics.
This approach was piloted in 2007 between City of Port Phillip HACC assessment staff and Fronditha Care’s Community Services staff. It had positives outcomes for elderly Greek clients, municipal HACC assessment officers and Fronditha Community Services staff.
This approach has multiple benefits:
- it provides additional cultural information and support for the assessment
- it encourages contact with a Greek-specific aged care service
- it assists the client in their introduction to aged care services
