Older refugees

Older refugees face particular risks during displacement, and face additional barriers to access protection and assistance, including during resettlement and integration.

Stakeholders involved throughout the integration process should develop a thorough understanding of the needs, capacities and barriers that older persons may face, and plan dedicated strategies to address them.

This chapter analyses which are the most common obstacles that older persons may face, and shares strategies on how to ensure positive integration outcomes.

Overall considerations

Older refugees often act as holders of the cultural heritage of their communities and transmit important cultural knowledge to the receiving community and to younger generations, supporting intergenerational goals. This role is particularly important for refugee children and young people since, as discussed elsewhere in this Handbook, engagement with their cultural roots and values is important in the process of developing their identity in the receiving community.

In many countries-of-origin, older people are often looked up to for their wisdom and life experience and are a source of advice and support to their children and grandchildren. Older persons also support the integration of refugee families through their involvement in childcare and domestic tasks. If older refugees are supported in their integration, they will be better equipped to play this role in resettlement societies.

When adequately supported, many older refugees can as well make important economic contributions to receiving communities through their participation in paid and voluntary work.

Responsive planning

Ageing is associated with increasing challenges to earning an adequate income and increased expenditures, especially on healthcare. Often poor health and social isolation are compounding factors. As resettled refugees may be at particular risk in this regard, appropriate planning is critical to ensure that both their human rights and dignity are safeguarded.

For younger refugees, the success of integration is usually measured in terms of their acquisition of the target language and achievement of economic self-reliance. While for some older persons these may be appropriate goals, for others, integration objectives need to be considered in the context of the occurrence of disability, health conditions or other potential factors. Success may need to be measured in terms such as their independence and extent to which they are respected and valued in their own families and communities.

Older refugees are a small proportion of resettled refugees. Older persons may have chronic health issues and require specific nutrition interventions, and may be at heightened risk of violence, discrimination and exclusion within their own communities. The situations faced by older men and women may also be very different, depending on social and cultural roles assigned to gender in their community. Older people with disabilities may face additional barriers to access basic information and services unless programmes are adapted to their specific needs.

Refugee and resettlement experience

Older refugees face some unique challenges in the processes of both ageing and integration. Older persons in the resettlement country will have had the opportunity to gradually plan for older age and to acquire the skills and resources for dealing with it. In contrast, older refugees are required to make these adjustments in an unfamiliar environment and with few material resources. Many will have to come to terms with very different social conditions for ageing than they may otherwise have anticipated in their countries-of-origin. Older refugees have less opportunities available to them to rebuild their lives and regain their former status and financial position. In view of the time needed to retrain or have qualifications gained elsewhere recognised, they may be forced to accept a labour force position well below that occupied in their countries-of-origin.

Some of the challenges resettled refugees face in seeking employment are discussed in employment section. These may be compounded for older refugees by the reluctance of some employers to hire older workers. Further, the higher rate of chronic conditions and disability among some resettled refugees may make them face additional barriers and obstacles to access employment.

In countries-of-origin, older persons are generally valued for their wisdom and life experience, and authority and status that is vested in them. In receiving communities, however, this position is likely to be reversed, as the process of displacement may also “displace” older persons from their roles. Children and youth tend to integrate at a faster rate than older persons. As a result, older refugees may become dependent on children and grandchildren for the most basic of tasks such as paying bills or reading correspondence. As well as undermining their traditional authority, this can be a cause of humiliation and shame.

Also, of concern may be negative attitudes toward ageing in some receiving societies. These have the potential to affect the self-esteem of older refugees as well as the esteem in which they are held by other family members. Without their traditional role and authority, older refugees may struggle to find an alternative meaning and purpose to their lives.

Resettled older refugees are also vulnerable to social isolation in the receiving society. Families struggling with their own integration may find it difficult to find the time to spend with older relatives.

Older refugees may also have limited access to social and recreational programs (e.g. day centres, communal meal services). This may be due to transportation, accessibility, reduced mobility, language difficulties and the fact that these programs may not readily accommodate the dietary requirements and religious and cultural practices of older refugees.

While age can be a period of great vitality, it is also associated with increased health problems and a potential increase in support needs for daily tasks. In many countries-of-origin older persons with health conditions and in need of continuous health support are cared for in the home by the extended family. Refugee families in resettlement countries facing their own integration challenges may struggle to provide this support. At the same time, both families and older refugees may be reluctant to access services in the resettlement country due to fear or distrust.

Service and programme responsiveness

A highly targeted approach to planning is required. A number of methods have been adopted to improve the responsiveness of services and programs to older refugees, including:

• securing the co-operation of services providing programmes for national older persons to offer programmes in refugee community venues (such as community centres or places of worship),
• refugee agencies working with established service providers to develop programmes for older refugees in existing facilities for national older persons.
• providing support to established services to enhance their capacity to provide culturally and linguistically responsive programmes to older refugees (e.g. bilingual staff, technical support).

The success of these approaches is highly dependent on effective partnerships between refugee agencies, refugee communities and established services and programs for older persons in the receiving community.

The experience of receiving societies is that older refugees do require more intensive integration support and that this needs to be recognised in funding and contractual arrangements, particularly for services providing integration case management and building social connections.

Refugee community support and capacity building

Social connections section discusses strategies to strengthen refugee communities and to build their capacity to support resettled refugees. These efforts will be particularly important for older refugees:

• in the face of dislocation and the stresses of integration, connection with their traditional culture can provide a source of continuity and comfort.
• having opportunities and access to safe spaces to practice their faith may be particularly important for older refugees.
• for those struggling to acquire the language of the receiving country, contact with their own community may be their only opportunity, outside of the family, to communicate in a meaningful way.
• refugee communities play an important role in supporting the development of special services for older refugees and in providing advice and support to general services to assist them in providing culturally and linguistically relevant services. They are also an important source for recruiting bilingual workers to programs for refugee older persons.

The following will be important factors to consider in the placement of older refugees:

• personal safety and security. The experience of resettlement countries is that older refugees may feel particularly vulnerable to threats to their personal safety, contributing to anxiety and social isolation.
• family and community-based support.
• health and support services, in particular, services established for older persons, and how they are made available to older refugees.
• public transport. Access to public transportation reduces older persons’ dependence on others and enables them to participate in social activities.

The particular needs of older refugees will have to be considered during the case management assessment. In circumstances where older refugees are dependent on family support, it is important that the whole family is involved in the assessment and that interventions are developed to strengthen the functioning of the family and thereby its capacity to support older refugees. Families will also need to be informed about the services and supports available to older refugees.

A number of factors can prevent older refugees from acquiring various forms of income support, including pension entitlements. Among other factors:

• not having acquired enough contribution years in either the country-of-origin or host countries to be entitled to a pension.
• not being able to transfer their pension contributions from their country-of-origin’s pension system and/or receive payments.
• not benefiting from national social protection systems, including universal social pensions, due to eligibility criteria. In some receiving societies, eligibility for retirement income may be dependent on a history of participation in the labour force or being a citizen.

In these circumstances, there may be a need to review income support provisions to support older refugees to meet prevailing eligibility requirements, and to advocate for dedicated income support for older refugees while long term changes apply.

Older refugees are less likely to speak the language of the resettlement country and may be slower to acquire a new language. Accordingly, language assistance will be critical for this group, particularly in key services and systems (e.g. income support, health care) and specialist services for older persons. Older refugees may be unable to understand written information in either their own language or that of the receiving society. Many will depend on others to explain written information or explain or affirm information provided orally. For this reason, information provided directly to older persons should, wherever possible, be supplemented with materials in at least two formats, written and audio. Older persons begin to lose the capacity to speak their second language as they age, indicating the need for target language maintenance programs. Please consult the section on refugees with disabilities for more information on other types of support.

Language training

The importance and benefits of language training for resettled refugees are discussed in the section on language support and apply equally to older refugees. In addition, language programs can give older persons a focus for re-establishing routine, for socialising, and learning about the resettlement country. Some countries offer dedicated language training programs for older refugees and have developed specialist curricula. In many cases these are delivered in services for older persons, often in the context of a broader social and recreational program or as part of a communal meal programme.

Orientation programmes can help older refugees to understand the lifestyle, practices, values and beliefs of the receiving society. As indicated above, orientation is more likely to be effective if provided as part of an integrated programme of social support and/or language training. Many older refugees will benefit from ‘hands-on’ orientation aimed at helping them to learn basic skills such as dialling telephone numbers, using internet, social medial and finding important information online, and using public transport. It is important for them to receive information on available services, relevant processes and admissibility criteria.

While older refugees and their families may prefer to be housed together, in many receiving societies there is a limited housing supply suitable for extended families. Where appropriate housing is not available, consideration may need to be given to housing older persons close to family members and other community supports as well as be accessible to local transport, if available. Please refer to the section on refugees with disabilities for other considerations regarding the accessibility of housing and transportation.

Refugees who are approaching but have not reached retirement age, or who wish or need to work beyond that age may require more intensive employment counselling and job placement support. For planning purposes this group is generally understood to include those aged 45 years and over. In the USA, some economic self-reliance initiatives targeted to older refugees have built on and affirmed their roles as advisers and supporters of children and grandchildren. These have included working with older refugees to establish childcare co-operatives and offering them training to work as assistants in social support agencies. Through their participation in these programs, participants are also able to build their understanding of the receiving society, thereby bridging the gap between them and younger generations. Some countries have achieved particular successes with mentoring programs for older refugees.

Care will need to be taken when offering post arrival health assessment to older refugees. They may be particularly reluctant to disclose information about their health prior to or following resettlement, either because they fear that this may jeopardise their application for resettlement or their residency status or because they do not wish to worry or burden other family members.

Older persons may be particularly receptive to traditional models of health care and these have been utilised by health services serving older refugees in a number of countries.

In those receiving societies in which health care is funded through work-related or private health insurance schemes, consideration will need to be given to ensuring that older refugees who are beyond employment age have access to an appropriate and affordable standard of health care.

Health care providers and refugee advocates will need to familiarise themselves with relevant religious and cultural observances, including those related to the process of dying, treatment of the deceased, and processes for sending remains back to countries-of-origin (where this is possible) for burial. As indicated in the section on mental health resettled refugees may be particularly exposed and impacted by psychosocial issues as they age in the resettlement country. This will need to be taken into account in professional development and other capacity building initiatives targeted to health and social support workers serving older persons.

In some resettlement countries a certain level of language proficiency is required to qualify for citizenship. Recognising that older persons may find it difficult to learn a new language, some countries have more flexible criteria for them. Efforts to support older persons to qualify for citizenship will be particularly important in countries where citizenship is a condition of eligibility for government-provided retirement income. Some countries (e.g. Australia and Canada) exempt older refugees from the language requirements of citizenship, in recognition to the additional challenges that this group may face in acquiring a new language.