When Language Fades and Culture Is Forgotten — Aged Care for CALD Australians
One-third of Australians over 65 were born overseas. One in five speaks a language other than English at home. For many elderly migrants, English was a second language learned for work — and as cognitive decline occurs, it is the first language lost.
Culturally and Linguistically Diverse (CALD) elderly Australians face unique barriers to aged care. Language difficulties make navigating My Aged Care almost impossible without help. Cultural attitudes to aged care — shame about accepting outside help, expectation that family will provide all care, reluctance to discuss health concerns with strangers — mean many CALD elderly people receive less support than they need. Food, religious observance, gender preferences for carers, and family structures all differ across cultures. This guide covers the specific challenges CALD elderly face when living alone, the language services available (many are free), culturally specific aged care providers across Australia, government multicultural programs, and how families can bridge the gap between cultural expectations and practical safety.
CALD Elderly in Australia: The Numbers
of Australians over 65 were born overseas
speak a language other than English at home
ancestries represented in Australia
less likely to access aged care services (CALD vs English-speaking)
The Unique Challenges CALD Elderly Face
Language Barriers in Healthcare
Many elderly migrants arrived in Australia in the 1950s-1970s and learned enough English for work, but never developed fluency in medical terminology. As cognitive decline progresses, English — the second language — is lost first. An elderly Italian woman who spoke English competently for 40 years may revert entirely to Italian after a stroke or as dementia develops. She cannot explain symptoms to an English-speaking doctor, cannot understand medication instructions, and cannot navigate the My Aged Care phone system (1800 200 422) without an interpreter.
Cultural Attitudes to Aged Care
In many cultures, placing a parent in aged care — or even accepting home care from a stranger — carries deep shame. In Chinese, Vietnamese, Greek, Italian, and many other cultures, family care is an obligation, not an option. Adult children feel guilt about needing help; elderly parents feel abandoned when help is offered. This cultural dynamic means CALD elderly people often refuse services they desperately need, and family carers burn out trying to do everything alone. The concept of "aged care" itself may not translate culturally.
Isolation After Losing a Spouse
For many CALD elderly women, their husband was their primary link to the English-speaking world — handling finances, medical appointments, and government interactions. When he dies, she loses not only her partner but her translator, navigator, and advocate. Social isolation is compounded by language: she cannot join English-speaking community groups, may not drive, and her cultural community may have dispersed from the original settlement area. Loneliness in a language no one around her speaks is a profound form of isolation.
Dietary and Religious Requirements
Standard aged care meal services (Meals on Wheels) may not accommodate halal, kosher, vegetarian Hindu, or culturally specific dietary needs. For elderly Chinese Australians, bland Western food is unfamiliar and unappetising. For Muslim elderly, halal compliance is non-negotiable. Religious observance — daily prayers, Sabbath, Ramadan fasting — must be respected by care workers, but mainstream services often lack awareness. When dietary needs are not met, elderly people do not eat enough, leading to malnutrition and decline.
Gender Preferences for Personal Care
In many cultures, being assisted with bathing, toileting, or dressing by a person of the opposite gender is deeply distressing. This is particularly significant for Muslim, Hindu, and some Southern European elderly women. Standard home care services may send whichever worker is available, without considering cultural preferences. If an elderly woman refuses care from a male worker, she goes without — and no one knows until a crisis occurs.
Language Services Available (Many Are Free)
| Service | Phone | Cost | What It Covers |
|---|---|---|---|
| Translating and Interpreting Service (TIS) | 131 450 | FREE for private calls to medical providers, pharmacies, My Aged Care. FREE for non-English speakers calling government services. | 160+ languages available 24/7. Phone interpreting within minutes. On-site interpreting can be booked for medical appointments. GPs can access TIS for free during consultations. |
| My Aged Care Multilingual Line | 1800 200 422 (then request interpreter) | FREE | My Aged Care operators can connect a three-way call with TIS interpreters. All aged care assessments can be conducted with an interpreter present. |
| National Relay Service | 133 677 | FREE | For people who are deaf, hard of hearing, or have a speech impairment. Text relay, video relay (Auslan), and captioned relay available. |
| State-Based Interpreter Services | Varies by state | FREE for government-funded health services | On-site interpreters for hospital appointments, aged care assessments, and community health. VIC: VITS Language Loop. NSW: Multicultural NSW. QLD: NAATI interpreters via QLD Health. |
| Ethnic Community Organisations | Varies | Usually free or low cost | Many ethnic community organisations provide bilingual case workers who can navigate the aged care system in the person's first language. See culturally specific providers section below. |
TIS Tip: GPs Can Use TIS for Free
Many GPs do not know that the Translating and Interpreting Service (TIS) is available to them at no cost for patient consultations. The Department of Home Affairs funds free TIS access for medical practitioners. GPs should call TIS (131 450) and register as a medical practitioner for free ongoing access. This transforms the quality of care for CALD elderly patients who cannot explain their symptoms in English.
Culturally Specific Aged Care Providers
These organisations provide aged care services tailored to specific cultural communities. They employ bilingual staff, serve culturally appropriate food, and understand the cultural context of care.
| Community | Organisation | Location | Services |
|---|---|---|---|
| Italian | Co.As.It (Italian Assistance Association) | VIC, NSW, QLD | Home care, residential care, social programs, Italian-speaking staff, Italian meals, cultural activities |
| Greek | Fronditha Care | VIC | Home care, residential care, dementia care, Greek-speaking staff, Orthodox chapel, Greek cuisine |
| Chinese | Chinese Community Social Services Centre (CCSSC) | NSW | Home care packages, social support, Cantonese/Mandarin-speaking case managers, Chinese meals |
| Vietnamese | Vietnamese Community in Australia (VCA) | VIC, NSW, QLD | Aged care navigation, bilingual case workers, cultural liaison, community transport |
| Arabic/Lebanese | Arab Council Australia | NSW | Bilingual aged care support, cultural advocacy, home care navigation in Arabic |
| Indian | Multicultural Aged Care (MAC) | VIC | Home care, residential care, Hindu/Sikh/Muslim dietary options, multilingual staff |
| Jewish | Jewish Care | VIC, NSW | Home care, residential care, kosher meals, Sabbath observance, Holocaust survivor support |
| Polish | Polish Community Council | VIC, NSW, SA | Social support, bilingual aged care navigation, Polish-speaking community visitors |
| Croatian/Serbian | Australian Croatian Community Services (ACCS) | VIC | Home care, social programs, Croatian/Serbian-speaking staff, cultural events |
| Pan-Asian | Asian Women at Work / CASS Care | NSW | Multilingual home care (Mandarin, Cantonese, Korean, Japanese, Vietnamese), culturally appropriate care planning |
Finding Your Community's Services
If your community is not listed above, contact the Federation of Ethnic Communities' Councils of Australia (FECCA) on (02) 6282 5755 or visit fecca.org.au. FECCA maintains a directory of ethno-specific organisations across Australia. You can also search the My Aged Care provider finder (myagedcare.gov.au) and filter by language spoken.
Government Multicultural Aged Care Programs
Partners in Culturally Appropriate Care (PICAC)
A Department of Health-funded program that helps aged care providers deliver culturally appropriate services. PICAC organisations operate in each state:
- VIC: Centre for Cultural Diversity in Ageing (CCDA)
- NSW: Multicultural NSW — Ageing, Disability & Home Care
- QLD: Diversicare
- SA: Multicultural Aged Care (ACH Group partner)
- WA: Ethnic Communities Council of WA
- TAS: Migrant Resource Centre Tasmania
PICAC organisations provide training, resources, and advice to aged care providers. They can also help families find culturally appropriate services in their area.
Aged Care Diversity Framework
The Australian Government's Aged Care Diversity Framework requires all aged care providers to deliver inclusive services. Under the framework, providers must:
- Ask about cultural, linguistic, and religious needs during assessment
- Provide access to interpreter services (not rely on family members to translate)
- Accommodate dietary requirements based on cultural or religious needs
- Respect gender preferences for personal care workers
- Include cultural needs in the individual care plan
If a provider is not meeting these requirements, contact the Aged Care Quality and Safety Commission on 1800 951 822.
Community Visitors Scheme (CVS)
A government-funded program that matches volunteers with isolated elderly people for regular friendly visits. For CALD elderly living alone, CVS can match them with a visitor who speaks their language. This is particularly valuable for elderly people who have limited English and no local family.
How to access: Contact My Aged Care (1800 200 422) or ask your local CVS provider. Visits are typically fortnightly and free.
Cultural Considerations in Care Planning
| Consideration | Examples | How to Address |
|---|---|---|
| Food requirements | Halal, kosher, vegetarian Hindu, Buddhist vegetarian, Chinese cuisine, Mediterranean diet preferences | Ask about dietary needs explicitly. Ethno-specific providers often provide culturally appropriate meals. Meals on Wheels in some areas offers halal or kosher options. Document requirements in care plan. |
| Religious observance | Daily prayers (Islam — 5 times daily), Sabbath (Judaism — Friday sunset to Saturday), Sunday Mass (Catholic), temple visits (Buddhism/Hinduism) | Schedule care visits around prayer times. Ensure workers respect religious practice. Provide access to religious leaders for spiritual support. |
| Gender preferences | Many Muslim, Hindu, and some Southern European women will not accept male carers for personal care. Some elderly men from patriarchal cultures may resist female authority figures. | Document gender preference in care plan. Request same-gender workers from provider. Use ethno-specific providers who understand these requirements automatically. |
| Family decision-making | In many cultures, health decisions are made collectively by the family, not by the individual alone. The eldest son or the family patriarch may be the decision-maker. | Include family in care planning meetings. Provide information in writing (translated) for family discussion. Respect collective decision-making while ensuring the elderly person's voice is heard. |
| Attitudes to mental health | In many cultures, depression, anxiety, and dementia carry significant stigma. Mental illness may be seen as a family shame or spiritual failing, not a medical condition. | Frame mental health support as "wellbeing" or "emotional support." Use bilingual mental health professionals who understand cultural context. Normalise help-seeking within the cultural framework. |
| End-of-life practices | Buddhist chanting, Islamic washing rituals, Jewish Shiva, Hindu cremation timing, Catholic Last Rites, family presence at death | Discuss end-of-life wishes early, with cultural sensitivity. Palliative care plans must include cultural and religious requirements. Some cultures do not discuss death directly — work with family. |
How KindlyCall Daily Calls Support CALD Elderly
Consistent English Practice
For CALD elderly who still speak English, a daily phone call provides consistent practice that helps maintain their English language skills. Language fluency declines with disuse — an elderly person who stops speaking English because they live alone and have no English-speaking contacts will lose their ability to communicate with healthcare providers, emergency services, and their wider community faster.
Family Alerts in English
Even when the daily call is in English, the wellness information gathered — mood, pain levels, medication compliance, mobility, social activity — is reported to family members in clear, structured English summaries. This bridges the communication gap for adult children who may speak English fluently but whose parent is declining in their ability to communicate health concerns in either language.
Routine and Connection
For CALD elderly living alone, daily phone calls provide the routine and human connection that their culture traditionally delivered through extended family living arrangements. In cultures where the elderly were never expected to live alone, the absence of daily family contact is deeply isolating. A consistent, caring daily call — even in English — provides the structure and connection that helps them feel less forgotten.
A Note on Language
KindlyCall currently operates in English. We recognise this is a limitation for CALD elderly whose English has declined. We are actively exploring multilingual support. In the meantime, our service works best for CALD elderly who still have conversational English, with family members receiving summaries to monitor wellbeing. For elderly people who speak little or no English, we recommend combining KindlyCall with a Community Visitors Scheme volunteer who speaks their language, and using TIS (131 450) for all healthcare interactions.
Key Contacts & Resources
| Organisation | Phone | What They Provide |
|---|---|---|
| Translating and Interpreting Service (TIS) | 131 450 | FREE 24/7 phone interpreting in 160+ languages. Free for private medical calls and government services. |
| My Aged Care | 1800 200 422 | Aged care assessment, Home Care Packages, CHSP. Interpreters available on request. |
| Federation of Ethnic Communities' Councils (FECCA) | (02) 6282 5755 | Peak body for CALD communities. Directory of ethno-specific organisations. Aged care advocacy. |
| Aged Care Quality and Safety Commission | 1800 951 822 | Complaints about aged care services not meeting cultural needs. Interpreters available. |
| Carer Gateway | 1800 422 737 | Support for family carers including CALD-specific resources, respite, counselling. |
| Centre for Cultural Diversity in Ageing (VIC) | (03) 8823 7979 | Resources, training, and advice on culturally appropriate aged care. National online resources. |
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