Tamil Caregiver Project

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• Tamil Caregiver Project
• Aging at Home - Innovations Showcase
• Presented by Jeyasingh David, Manager, Tamil
  Caregiver Project
• Amanda Falotico, Director Community
  Outreach
• April 23, 2008

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Sri Lanka The Country

• A small island below India
• Social Democratic Republic
• Sri Lanka was under colonial rule for 450 years
• Sri Lanka has free health service including drugs
• Sri Lanka has free education including university
• Sri Lanka produced the worlds first woman
  executive head of state (Prime Minister)
• Population 20,000,000
• Sinhalese 74, Tamils 18, others 8
• Religions
• Sinhalese mainly Buddhist, Tamils mainly Hindus
• Others Christians and Muslims

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Sri Lankan Tamils in Canada

• Mostly refugees due to internal strife
• Unplanned migration ill equipped to adapt
• Major influx post 1983 400,000 in Canada
• Toronto has the highest concentration of Tamils
  in the world, specifically in Scarborough,
  Ontario (200,000)
• Most Tamils are Saivite Hindus
• Most seniors are sponsored by their children .
• High interest in healthcare education
• Often need assistance in accessing the healthcare
  maze owing to barriers of language, culture,
  religious affiliation, etc.
• Face barriers to full service accessibility for
  the first 10 years.

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Caregiver Quote

• In Sri Lanka, the strength during times of need,
  such as a disability, comes from the extended
  family. It is normal for caregiving
  responsibilities to be shared by many in the
  family and neighbors. This is not the case here,
  and in most cases a single caregiver is
  responsible for providing 24 hour care to a
  disabled spouse, parent or child.
• - Buva

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The Tamil Caregiver Project
The Tamil Caregiver Project was developed to
provide targeted healthcare education and support
to Tamil speaking caregivers. The Projects goal
is to facilitate understanding and access to
respite as a quality-of-life outcome.
The concept of Caring for the caregiver is
unfamiliar in this culture. Immediate family
members believe that caring for other family
members is their duty. There are cultural
pressures to care for the elderly at home.
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• Creative Funding

• 2000-2003
• J.W. McConnell Family Foundation

• 2003-2005
• Partnership with Scarborough Community Care
  Access
• Centre

• 2005-2010
• Tamil business community commitment for
• 100,000 /year for 5 years mainly through an
  annual
• bowl-a-thon

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Listening and Learning

• Community Input
• Hosted community Focus Groups
• Hosted Education Consultations with Service
  Providers, Faith and Community Leaders
• Established a Steering Committee
• Worked with Community and Faith Leaders
• Received Feedback at Education Sessions and
  Cultural Celebrations

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Voiced Needs

• Healthcare education and resources in Tamil
  language
• Culture brokering
• Need for culturally sensitive long term care
  services
• Need for spiritual support

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Innovative Action

• Mobile workshops and seminars conducted in Tamil,
  English and American Sign Language.
• Topics include
• Organ donation, brain health, diabetes
  awareness, dental care, heart and stroke, end of
  life issues, elder abuse, healthy life style,
  healthy eating, etc.

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Innovative Action

• Leverage of non traditional media outlets and
  settings to raise awareness in the Tamil
  community
• Participation in Tamil trade shows
• Advertising and creating awareness through the
  ethnic communities voice, vision and print media
• Posting information in dental and family doctors
  offices, churches and temples, through Tamil
  realtors and insurance agents and take out
  restaurants.

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Innovative Action

• Culturally Sensitive Long Term Care (LTC)
  services
• Established dedicated wing for Tamils and Tamil
  Advisory Committee in one long term care home
• Facilitating culturally sensitive service in
  three LTC homes in Toronto
• Connecting the community with residents
• Organizing celebration of Tamil festivals
• Sensitivity Training to healthcare professionals

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Innovative Action
Social responsibility or more specifically, care
of the sick and dying is not mandated as a
component of the temple structure or priestly
ministry in the practice of the Hindu religion.

• Spiritual Care
• Trained 10 Hindu Spiritual Support Workers
• Established connections with Spiritual Care Teams
  in Hospitals and Long Term Care homes
• Regular visits by Spiritual Support Workers to
  hospitals in Scarborough
• Established Canada Saivite Council for Spiritual
  Support in Healthcare with charitable status for
  sustainability

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Innovative Action

• Culture Brokering
• Sensitizing the Tamil community to their health
  care options
• Facilitating access to healthcare services
• Tamil translation and interpretation services
• Emotional support
• Educate healthcare professionals to create
  cultural and faith sensitivity and responsiveness

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Innovative Action

• Strategic Partnerships and Links
• Established effective use of the Tamil voice,
  vision and print media
• Created pathways with traditional healthcare and
  home support service agencies
• Collaborated with Community Organizations
  SACEM, Tamil Eelam Society, Many Tamil Seniors
  Organizations, Tamil Service Providers Coalition,
  Canadian Tamil Chamber of Commerce, Canada
  Medical Dental Development Association, Tamil
  Disability Organizations.
• Collaborated with numerous organizations
  including Alzheimer Society of Toronto, Canadian
  Cancer Society, Arthritis Society, Diabetes
  Association, DECNET (Diabetes Education Community
  Network of East Toronto)

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Innovative Action

• Transferable Model
• A similar community development and community
  driven approach is being adapted for several
  other immigrant ethnic populations.
• Not every strategy worked, but we learned a lot
  of new lessons and were able to make adjustments

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Outcomes and Benefits

• The client experience
• Improved quality of life for caregivers and care
  receivers through the Tamil Caregiver Project
• Evaluations indicate that caregivers feel more
  supported, feel better about themselves, and feel
  recognized for the work they do as a caregiver.
• For the first time I slept through the night
  without fear of bombs -a comment-

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Our Challenges

• Gaining the trust of the community
• Finding suitable terms in Tamil for translations
  specifically medical terminologies
• Promoting Canadian practices to ethnic
  communities e.g. living will, funeral
  preplanning.
• Differences in doctor patient relationships the
  need to ask questions
• Making use of the system to redress elder abuse
  and domestic violence
• Class and caste consciousness
• Clannishness
• Religious beliefs impacting on healthcare options

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Transferable Model Tips for Success

• Be visible and identifiable in the community.
• 9-5, 5day week does not always work.
• Think in a non traditional healthcare approach
  and focus on how the businesses reach out to
  people and apply those principles
• Use presentation titles that piques curiosity
• Post flyers in take out restaurants serving
  ethnic foods.

What are hoppers?
What lessons did we learn?
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Transferable Model Tips for Success contd.

• Take the service to the community rather than the
  community coming to you e.g. Schools, mosques,
  seniors meeting places, etc.
• Enlist the support of community leaders and faith
  leaders, but stay focused on your goal
• Create healthy and trusting partnerships with
  ethnic organizations and mainline organizations.
  Build bridges.
• Put energy into participant evaluations and
  comments. This will help charter your path for
  the future.
• May Allah reward you the best and provide you
  more opportunities to serve all communities. -
  a comment-
• Create reports and documents for sharing with
  hospital and community sectors. Knowledge
  transfer is important
• Educate the main stream healthcare service
  providers about how to deliver culturally
  sensitive services.
• Be sensitive to cultural and faith needs in
  organizing events

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Thank You
Nantri


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Providence Healthcare Contact Information

• Providence Healthcare
• 3276 St. Clair Avenue East
• Scarborough, ON M1L 1W1
• Tel [phone]
• Website www.providence.on.ca
• Amanda Falotico
• Director
• Community Outreach
• 416-285-3666 Ext 4024
• afalotico_at_providence.on.ca
• Jeyasingh David
• Manager
• Tamil Caregiver Project
• 416-285-3666 Ext 4152
• jdavid_at_providence.on.ca