+ General Country Information
+ History
+ Concept of Time
+ Family and friends
+ Gender
+ I or We Attitudes
+ Manners and Taboos
+ Spiritual care
+ Communication Style
+ Greetings
+ Language and Communication
+ Non-verbal Communication - Eye contact
+ Non-verbal Communication - Gestures
+ Non-verbal Communication - Personal Space
+ Attitudes and understanding of dementia and other health issues
+ Attitudes to end of life care
+ Attitudes to pain
+ Attitudes to residential care
+ Care information
+ Cultural Activities
+ Cultural Traits
+ Food and Diet
+ Music
+ Special Days - Christmas
+ Special Days - Easter
+ Special Days - New Year
+ Special Days - Other
+ Superstitions

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Generalist

  • Croatia is located in the continent of Europe.
  • Croatia shares its land borders with six other countries: Bosnia and Herzegovina, Hungary, Montenegro, Serbia, Slovenia and Italy. (World Atlas)
  • The capital city of Croatia is Zagreb.
  • Croatia is ranked as the 127th largest country with a total area of 56,594 square kilometres (Central Intelligence Agency, n.d).
  • The population of Croatia is approximately 4,464,844 (Central Intelligence Agency, 2015).
  • The major ethnic groups of Croatia include: Croat 90.4%, Serb 4.4%, other 4.4% (including Bosniak, Hungarian, Slovene, Czech, and Roma) (Central Intelligence Agency, 2011).
  • The climate in Croatia varies depending on the location. The lower Croatian coastal areas have mild, wet winters and warm summers, Central Croatia which (includes the Dinaric Alps) has a continental climate with hotter summers and cold and snowy winters, and the eastern part of Croatia has a moderate continental climate.

Tips

  • Understand that a person’s country of birth does not define their culture. Whilst we are “born into culture” we are not “born with culture”. A person’s “culture” is something that is learnt from our environment and by our individual experiences. It continuously adapts to our changing circumstances throughout our lives.
  • Determine what culture or cultures your care recipient identifies with.
  • Keep in mind that the culture in metropolitan areas varies with culture in rural areas and that culture in different regions within a country may also vary significantly.
  • Learn about your care recipient’s life history, and who they identify with, to determine their individual cultural traits. Document any significant details.
  • Understand how your care recipient’s culture informs their values, behaviours, beliefs assumptions, likes, dislikes and sensitivities.

Resources

Generalist

  • Croatia was part of the former Yugoslavia, therefore separate Australian census data on Croatians was not captured before 1996.
  • Some Croatians may refer to themselves as 'Yugoslavian', or 'former Yugoslavian'. Be aware of possible sensitivities and/or animosities.

History of Migration to Australia

  • Croatians migrated to Australia during the gold rush period in the 1850’s.
  • The first Croatian settlers were mostly from the historical region of Dalmatia and they mainly worked in the mines or in the sugar cane fields.
  • Following World War II the Yugoslavian-born population, including many Croatians, increased significantly in Australia with people migrating under the Displaced Persons Scheme.
  • The Yugoslavian government opened its borders in the 1960’s, allowing people to work overseas. Consequently, approximately 100,000 Yugoslavian people (including Croatians) migrated to Australia.
  • Many Croatians were under ASIO surveillance in Australia for alleged terrorist activities organized by the Yugoslav secret service during the 1960s and 1970s.
  • Another wave of migration, (of almost 30,000 people) mainly under the Humanitarian program, took place after 1991 due to the conflict and the breakup of Yugoslavia. (Australian Government, 2015)
  • Today, Croatians in Australia originate from all parts of Croatia.

History of Croatia

  • Refer to History Resources section

Tips

  • Determine exactly where your care recipient was born and where they lived. For example; was your care recipient born in Australia, or did they migrate to Australia? If they migrated, how and why did your care recipient migrate to Australia? What experiences and associations do they have of their home country? If they have lived in other countries; where have they lived? How long did they spend in other countries and what did they do whilst they were there?
  • Be aware and sensitive to any stress that may have been experienced as a result of their history (this may include; family separation, homesickness, conflict, depression and isolation).
  • The knowledge of a person’s history may assist with a better understanding of the care recipient as well as any associated psychological issues resulting from their past.
  • Understand how your care recipient’s culture informs their values, behaviours, beliefs assumptions, likes, dislikes and sensitivities and document any significant details.

Resources

Generalist

  • Croatia is defined as a “collectivist” culture. This means Croatian people act primarily in the interests of the group (The Hofstede Centre).
  • Croatia scores 33 on the Individualism versus Collectivism (IDV) index. (Hofstede centre).
  • The index scale ranges from 0-100 with 50 as a mid-level. The low numbers indicate “collectivist” cultures, and high numbers indicate “individualist” cultures.

Tips

  • Identify and document if your care recipient is an “individualist” with an “I” attitude of self and immediate family, or a “collectivist” with a “we” or group attitude, or if they have both “collectivist” and “individualist” traits.
  • Allow for a “collectivist” person to feel the comfort of doing most things in a group setting and for an “individualist” person to have more opportunities for themselves.

Resources

Generalist

In Australia

  • Major religious affiliations of Croatian-born people include Catholic and Eastern Orthodox (Australian Bureau of Statistics, 2011).
  • A small amount of Croatian-born people stated that they do not have a religion (4.6%) (Australian Bureau of Statistics, 2011).

In Croatia

  • The main religion in Croatia is Roman Catholic (86.3%)
  • Other religions include: Orthodox 4.4%, Muslim 1.5%, as well as those who are non-religious or atheist 3.8% (Central Intelligence Agency, 2011).

Religion and its role in dementia care

  • The Catholic Church is very important in the Croatian community and Croatians are especially devoted to the Blessed Virgin (called "Gospa"). 
  • People may speak to the priest about illness, especially if they are unsure who else they can turn to.

General

  • Different cultures and religions have different expectations of care in regards to toileting, dressing and feeding.
  • Every culture and religion vary greatly in spiritual needs and this may impact on the acceptability of certain treatments and medications. Therefore, it is paramount to identify the care recipient’s religion and cultural background to appropriately address the supports and services required.
  • For further information, refer to Spiritual care resources.

Tips

  • Accept and respect that customs, religious and spiritual beliefs vary from one culture to another and that the beliefs of your care recipient may significantly differ to your own beliefs.
  • Utilise resources and attend training sessions to increase your own knowledge about different religious and spiritual beliefs.
  • It is useful to ask care recipients a range of questions such as; ‘what helps you cope in difficult times’ and ‘what is important to you’ to determine ways to enhance their care.
  • Be aware of the significance of spiritual needs to your care recipient. Identify and document their religious beliefs and spiritual needs such as; any special requirements regarding food, personal care, linguistic needs or religious impacts towards treatments and/or medication.
  • Identify and provide access to relevant religious literature, radio, TV, live stream services, DVDs and CDs.
  • Support care recipients to maintain religious networks and religious representation and facilitate outings to places of worship.
  • Acknowledge and observe days of religious significance to your care recipients in a culturally appropriate manner.

Resources

Generalist

  • The extended family has a significant role for Croatian people.
  • Relatives remain close to Croatians.
  • Family is at the heart of the social structure, and they provide support in times of need.
  • Weekends in particular are generally reserved for family time.
  • There is an expectation that children will take care of their elderly Croatian parents.
  • In Australia, commitments such as work and children may mean that it is not possible for family members to be able to act as the primary caregiver for their parents. This may create stress and conflict within the family. 

Tips

  • Be aware and sensitive to the fact that some people may have become separated from family for a range of reasons including; Stolen Generations, war, conflict, disaster or migration.
  • Families and friends from different cultures will have a different understanding of dementia and their expectation of care for their loved one may vary significantly.
  • Provide communication and information in accordance with their language and literacy level and facilitate all achievable care expectations.
  • Gain an understanding of the dynamics of your care recipient’s family and friends and engage with them whenever required/needed.
  • Ensure that roles in decision-making about care of the person with dementia have been clearly established and documented.
  • Research indicates that carers of people living with dementia experience greater strain and distress than carers of other people.
  • It is important to be sensitive to the feelings of shame and guilt that family members and friends may be experiencing.

“Family and friends” resources

  • A range of information to help support family and friends is available in the “Family and friends, resources” section below.
  • A range of health information helpsheets in Croatian are available in the “Language and communication, resources” section of this app.

Resources

Generalist

In Australia

  • At home, Croatian-born people in Australia predominantly speak Croatian, English and Serbian.
  • The majority of Croatian-born Australians speak English well (78.2%), whilst 20.5% do not speak English well or at all (Australian Bureau of Statistics, 2011).
  • Older Croatian migrants may have received little formal education in their own language and have low English literacy.

In Croatia

  • Croatian is the official language in Croatia (95.6%), Serbian is spoken by 1.2% and 3% speak other languages (Central Intelligence Agency).

Written text

  • The oldest Croatian texts date back to the 11th century and were written in the Glagolitic alphabet. The Glagolitic alphabet was eventually replaced by the Latin alphabet in Croatia.
  • In 1850, Serbian and Croatian writers and linguists created a standard written form based on the widely-used Štokavian dialect.

Language

  • Croatian language contains many words of Latin and German origin, but many new Croatian words are created by combining and adapting existing ones.

Tips

  • Being able to communicate effectively is crucial to the physical and emotional well-being of the care recipient.
  • Be careful not to underestimate or assume the communication capacity of a person with dementia.
  • Ensure that the care recipient has participation in decisions that affect them.
  • The words you use when speaking to, and about, a person with dementia matters. It is important to always use positive and enabling language and to not use words that may cause offense.
  • Ensure the health care and personal care plans and reviews identify and support the linguistic needs of your care recipient and their family.  Be mindful that linguistic considerations should include the care recipients’ menu choices, food services, their religious and spiritual needs, and their ability to participate in activities. Determine what language(s) they are able to speak, read and write. Communicate with them and provide information according to their language preference and literacy level.
  • Identify and record and health issues such as poor hearing, poor eyesight, dehydration or problems with dentures to ensure there is no miscommunication with your care recipient.
  • Be aware that most people with dementia will revert back to their native tongue and/or other languages they have learnt.
  • Care recipients should always be given the choice to use professional translators and interpreters. Provide professional translators and interpreters to your care recipients and/or to their family whenever they request the need, when the care plan is developed, when the care plan is reviewed and at any time when “informed consent” is required.
  • Care recipients often prefer to communicate with a care worker from their own cultural background therefore the use of bilingual staff or volunteers should be always be considered and provided whenever possible. The care recipient should however be given this choice rather than it be assumed that this is their preference.
  • Provide visual aids, use gestures and physical prompts, and learn and use key words in the person’s own language to improve communication during routine care and other simple service interventions.
  • Ensure that communication is adapted to the care recipient’s level of dementia and understand the importance of allowing more time for those in later stages to understand and respond to you.
  • Support your care recipients' individual choices by providing access to media such as radio, TV, live stream services, DVDs, CDs and books in their preferred language.
  • All staff and volunteers should undertake training in cultural awareness, appropriate communication and the correct use of telephone and on-site interpreting services.

Language and Communication resources

  • Refer to the “Language and Communication, Resources” section below for a wide range of information (including communication cards, signage, health information in community languages, etc.)
  • Translating and Interpreter contact details and other relevant information is available in the "Links, Translating and Interpreting" section. 

Advice and Support

  • Seek advice and support from the Dementia Behaviour Management Advisory Service (DBMAS) if required – phone 1800 699 799.
     

Resources

Generalist

Meeting and Greeting

  • Croatian people generally tend to be formal when greeting. For example, people use Mr, Mrs, Miss and the person’s surname.
  • Close friends and family address others by their first name. Sometimes Croatian people will invite others to refer to them by the first name only, but it’s best to wait for an invitation first.
  • With social gatherings, women are usually introduced first and then men are introduced.
  • When meeting people with a range of age groups, the eldest are usually greeted first.                                                         

Men greeting Men

  • A firm handshake is common, even in less formal settings such as on the street.

Women greeting Women

  • A handshake is the norm in formal or business settings.
  • Light kisses on the cheeks (which are more of a touch than a kiss) are the norm when meeting with friends.

Men greeting Women

  • A handshake is the norm in business or formal settings.
  • Light kisses may be used between good friends.
  • Hugs may also be used between good friends and family.                                                   

Tips

  • Start building trust and rapport from the first time you meet your care recipient. Ensure you correctly pronounce their name. Smile and speak clearly. Be respectful and make sure the care recipient understands you.
  • Establish and document how your care recipient prefers to be greeted. Take into account; formality, titles, preferred name(s), any different greeting expectations from different genders or from people from a different generation, and the way(s) they like and dislike to be greeted. 
  • Understand that a person with severe dementia will think that each time they see you during the day is for the first time. Therefore ensure that you greet them in an appropriate, friendly and caring manner each time you meet.

Language and Communication resources

  •  A wide range resources such as language apps, language guides, translating and interpreting services etc. are available in the “Links” section of this app.

Advice and Support

  • Seek advice and support from the Dementia Behaviour Management Advisory Service (DBMAS) if required – phone 1800 699 799.

Resources

Generalist

  • Croatians are generally straight forward communicators. For example; if someone disagrees with what has been said, it is generally fairly obvious.
  • Words are best chosen carefully when speaking, especially when meeting for the first time.
  • Croatians tend to use loud voices and animation during conversation. This is not usually a sign of anger, but rather just a form of expression.
  • Croatians may view people that speak softly as not being confident.
  • The use of humour is quite common, for example; to make light of situations. It may also be used in relation to someone’s flaws, however this is not meant to offend.
  • Subjects including the war, economic status and politics are best avoided.
  • Comparisons between Serbian and Croatian people, as well as between Bosnians and Croatians are also best avoided.

Tips

Care recipient

  • Identify the communication style of your care recipient.
  • Be aware that communication styles vary from one culture to another.
  • Realise that physical, sensory, psychological and social issues can impact on the ability to communicate effectively. Make a note of any that are relevant to your care recipient.

Care worker

  • To ensure that the care recipient can understand you avoid speaking too quickly or using slang, acronyms or jargon. Also try not to give too much information at one time.
  • Be aware not to use patronising speech or a demeaning tone as this can lead to a communication breakdown.
  • Remember than non-verbal communication such as body language is just as important as verbal communication. Ensure that your tone matches your body language to avoid miscommunication.
  • Be kind and caring in your communication with the care recipient. Remember the person with dementia has a lifetime of experiences and is a person with feelings, even though may have lost the capacity to think or behave like they used.

Language and Communication resources

  •  A wide range resources such as language apps, language guides, translating and interpreting services etc. are available in the “Links” section of this app.

Advice and Support

  • Seek advice and support from the Dementia Behaviour Management Advisory Service (DBMAS) if required – phone 1800 699 799.

Resources

Generalist

  • Direct eye contact is expected and appreciated by Croatians. 
  • Avoidance of eye contact may be considered as a sign that you do not care for a person.
  • Use of eye contact with wide eyes can be perceived as disagreeing with what another person is saying.

Tips

  • Determine and document if the care recipient prefers direct or indirect eye contact and if there are any different expectations from different genders or from people from a different generation.

Resources

Generalist

There are certain non-verbal gestures which are generally considered rude, these include:                        

  • Waving and pointing the index finger.                            
  • Giving someone the middle finger, which can be perceived as a threat.                                                    
  • Extending the pinky (smallest finger) and index fingers whilst bending the middle and ring finger can signify anger and ill will.                                                            
  • Raising the thumb, index finger and middle finger all at once. This is a Serbian gesture, which is associated with Serbian nationalism. It is best to avoid this.

Tips

  • Any gestures you use need to be respectful to the person with dementia.
  • Body language can provide important clues and increased understanding for both the carer and the care recipient. However many gestures have different meanings in different cultures therefore take care to ensure there is no miscommunication.
  • Document any gestures that the care recipient prefers to use or any gestures they find offensive.
  • Determine if the care recipient has expectations from different genders or from people from a different generation in relation to the use of touch. For example; if they find it appropriate/comforting for someone to hold their hand when they are upset or in pain.

Resources

Generalist

  • Roughly an arm’s length of distance between people is the norm, especially at initial meetings. People who are familiar with one another may be comfortable with less distance.
  • Touch when speaking is not common, especially when initially meeting.
  • Light touch is common between people who know each other.
  • Women may hold hands or link arms when walking.

Tips

  • Determine and document how the care recipient feels about their personal space and if there are any different expectations from different genders or from people from a different generation.
  • Allow for a “collectivist” person (with a “we” or group attitude) to feel the comfort of doing most things in the space with others (group settings) and for an “individualist” person (with an “I” attitude of self and immediate family) to have opportunities to have personal space for themselves.

Resources

Generalist

  • Croatian people are generally not punctual. Instead, they tend to practice flexibility with time.
  • Being late is often expected and not generally considered rude.
  • In most situations anything up to 15 minutes late is acceptable.

Tips

  • Determine and document how the care recipient and the family view “the concept of time”. For example; do they like to be punctual? Do they expect others to be punctual?
  • Ensure the care recipient's concept of time does not adversely impact on meal times, activities and other scheduled events.
  • Be mindful that shaming and blaming someone for being late can cause feelings of guilt and low self-esteem. Instead, use positive communication. For example; you might ask “Would a different time would be more suitable”?

Resources

Generalist

Global Gender Gap Index 2016 rankings

Croatia was ranked 68th on a global index measuring gender equality out of 144 countries. (World Economic Forum, Global Gender Gap Report 2016).

Marriage

  • Traditional roles (including cooking, cleaning and child rearing) are expected from Croatian women, even if they work.
  • Each partner has a right to file for divorce. Exceptions include if the wife is pregnant or if they have a child under one.
  • For elderly couples, the husband may speak on behalf of his wife even in her presence.
  • Older Croatian men may be insulted if a woman tells him what to do.
  • More equality is evident with younger couples.

Same Sex Relationships

  • In Croatia, life partnerships are recognised for same-sex couples through the Life Partnership Act.
  • Same-sex couples (life partners) are equal to married couples in everything except adoption.

Rainbow index

  • In 2016, Croatia was ranked 10th out of the 49 European countries on the Rainbow Index, with a score of 66.5%.
  • The Index is based on a scale of 0% (gross violation of human rights, discrimination) to 100% (respect of human rights, full equality).
  • Rankings are made in relation to the laws and policies that have a direct impact on LGBTI people’s human rights. (International Lesbian, Gay, Bisexual, Trans & Intersex Association, 2016).

Tips

  • For many people with dementia the gender of the care workers is important, particularly in sensitive situations. Determine and document if they have any preferences, concerns or expectations regarding care provided by someone of a different gender.
  • Accept and respect that male-female roles in families may vary significantly among different cultures.

Lesbian, gay, bisexual, transgender or intersexed (LGBTI) people with dementia

  • Don’t assume the gender preference of the person with dementia.
  • Recognise that even those that have children may not be completely heterosexual and understand that it could take some time for a care recipient to gain enough trust to share personal information about their gender preference.
  • Begin by evaluating yourself and any assumptions, phobias, biases or beliefs that you might hold internally.
  • Utilise resources and attend training sessions to increase your own knowledge about LGBTI people.
  • Understand the importance of your first and immediate reaction or response. Be aware of your own reactions - not only what you think, but also be aware of what you say and what body language you use.
  • Most LGBTI people have experienced rejection, stigma, discrimination and abuse and therefore have a fear of receiving inadequate treatment, being denied services or facing further discrimination or prejudice. It is vitally important to create a non-judgmental open and caring atmosphere free from discrimination. Confidentiality is also a vital aspect of care for LGBTI care recipients.
  • Be careful with the terminology you use to the care recipient and their partners.
  • Provide partners of LGBTI care recipients with the same respect and privileges that you would give to a spouse or relative.      

Resources

Generalist

World Alzheimer’s Day

  • Alzheimer associations around the world unite for World Alzheimer’s Day on the 21st of September, to make a difference for people with dementia and their families and carers worldwide.

Dementia in Croatia

  • There is no official register of people with dementia in Croatia. This is despite the fact that about 16% of the population is aged 65 years and over.
  • Estimates suggest that the prevalence of dementia in Croatia is approximately 80,000 (Mimica and Presečki, 2010a and 2010b).
  • Psychogeriatric departments exist in hospitals.
  • There are residential care facilities for people with dementia, but they are only located in urban areas and towns.
  • Rural areas lack dementia care and there are almost no day respite centres for people with dementia in Croatia.

Perceptions of dementia

  • Awareness and understanding of dementia in the Australian community is increasing. Whilst there is awareness and acceptance about dementia amongst Croatian community members in some states, education and awareness is still needed in many regions.
  • Dementia may still be falsely viewed as a normal part of forgetfulness that comes with ageing.
  • People may blame memory loss rather than admitting that there is a greater issue.
  • ‘Dementia’ has greater recognition than ‘Alzheimer’s disease’, although there may be a lack of understanding about the difference and relation between the two.
  • People may confuse dementia for a mental illness.
  • Mental health issues carry a significant amount of stigma in Croatia and consequently it may not be openly discussed in the community.

Diagnosis and treatment

  • The first point of contact for a Croatian person with memory issues will often be their general practitioner. However, an acceptance of memory loss as a normal part of ageing can delay diagnosis.
  • Croatians may hide the symptoms of memory loss for fear of the stigma attached.
  • Doctors are generally respected and considered as people of authority.
  • Croatian doctors are preferred and will usually be sought to avoid language barriers. Non-Croatian speaking doctors may be visited to avoid long waiting times.
  • Most Croatians use modern medicine and do not generally believe in alternative therapies.
  • Croatians may also have the tendency to believe that medications mean that lifestyle changes are not necessary.

Attitudes to counselling

  • Most elderly Croatians need an interpreter to utilise counselling services.
  • The younger generation is more likely to seek counselling services.

Tips

  • The amount of understanding and acceptance of dementia may vary significantly among different cultures, families and individuals. Determine the understanding of dementia of the care recipient and their family, if they accept dementia and if stigma is associated.
  • Provide information to the care recipient and their family according to their language preference and literacy level.
  • Ensure that people with dementia and their families are aware of dementia information and of support services available.

Dementia resources

  • A wide range of information is available in the Attitudes and understanding of dementia disability and illness, resources section below.
  • Contact details for Alzheimer’s Australia offices are available in the “Links, Alzheimer’s Australia offices” section of this app.

Advice and Support

  • Seek advice and support from the Dementia Behaviour Management Advisory Service (DBMAS) if required – phone 1800 699 799.

Resources

Generalist

In Croatia

  • Residential care was viewed negatively in Croatia in the past.
  • However, in the last 25 years Croatia has developed some services for the aged, especially in urban areas.

In Australia

  • For the older Croatian generation that migrated to Australia in the 60s and 70s, residential care is generally not acceptable because didn’t exist in Croatia at all at the time of their migration. Also, it was considered to not be the right thing to do to a family member, regardless of how frail or aged he/she was.
  • For the younger generation that migrated to Australia in the 80s or after, attitudes towards residential care is more positive.
  • Croatian people may fear being isolated if they are placed in a non-Croatian speaking facility.

Tips

  • The meaning or value of residential or community care may vary greatly among cultures.
  • Be aware that many people will not want to hear about or talk about residential care until crisis point.
  • Understand that families and friends from different cultures will have different expectations for the care of people, particularly in regards to toileting, dressing, feeding and other self-help skills.
  • Allow the care recipient and their family to make choices to suit the individual’s care needs.
  • Ask care recipients questions about what can be done to achieve quality of life and help them have meaningful lives that enable them to pursue their cultural interests and passions in accordance with any frailty, disability or cognitive impairment.
  • Understand and facilitate all achievable care expectations of the care recipient and their family.

Resources

Generalist

  • Croatian people may tolerate pain in silence or refuse pain killers.
  • Pain behaviour studies suggest there is a need to be cautious of ethnic or cultural stereotypes. Therefore, even though there are findings of general cultural differences it is considered very important to evaluate the pain of each person individually.
  • Clinical recommendations regarding pain treatment are available in the “Attitudes to pain Resources” section of this app.

Tips

  • Research indicates that pain and discomfort are frequently under reported and under treated amongst people with dementia.
  • Ensure care recipients and their family understand pain relief medication and treatment options by providing information in their preferred language and in accordance with their language ability.
  • Religion and culture may influence your care recipients pain experience including; their pain expression, pain language, remedies for pain, social roles and expectations and perceptions of the medical care system.
  • Understand that for some religious or spiritual beliefs, fate and/or karma may mean that your care recipient also believes their illness and pain are caused by a higher power.
  • Care recipients may feel it is important to accept their pain in order to demonstrate their religious / spiritual faith. This may also impact their request for pain medication and treatment.
  • Identify and support the cultural and religious impact on the acceptability of certain treatments and medications.
  • Identify, respect and document how your care recipient and their family view and express pain.
  • Pay particular attention to verbal expressions of pain during later stages of dementia and ensure adequate treatment is provided.

Resources

Generalist

  • The direct question of resuscitation to the patient is generally considered to be culturally intrusive. The preferred approach by many Croatians is to firstly speak to the next of kin regarding the topic, and to then approach the patient in a more informal way.
  • Bedside vigils with a visit from the Priest may be part of the preparation for the end of life.
  • Mass is often held in the church before burial, including the reciting of The Rosary. Prayers are said at the grave and people gather in the decreased family’s home for refreshments following the events.
  • A sound understanding of the dying patient’s meaning of end of life care is imperative to truly deliver individualised palliative care.

Tips

  • Understand that attitudes to end of life care, death and dying are diverse and may include a range of factors such as cultural and religious beliefs.
  • Be aware that the acceptance of certain treatments and medications are likely to be impacted upon by cultural and religious factors.
  • Identify and support “end of life choices” of care recipients and their family. Note: these are formally known as “Advanced Care Directives” or “Advanced Care Planning” depending on the state or territory in Australia that you are in. Ensure their choices are documented and strictly followed.
  • Ensure the linguistic needs of care recipients are addressed in end of life religious and spiritual support.
  • Ensure family members have access to appropriate resources and support in their preferred language and in accordance with their language ability.

Resources

Generalist

  • The war is generally a very sensitive topic and is best avoided.
  • Sensitivities may exist between Serbians and Croatians. Comparisons between people of the two cultures should be avoided.
  • The gesture of raising the thumb, index and middle finger at the same time is connected with Serbian nationalism and should be avoided.

Tips

  • “Manners” and “taboo” expectations and beliefs may vary greatly among cultures resulting in differing emotions and behaviours in your care recipient.
  • Be aware of your own beliefs and expectations of “manners” and “taboo” beliefs and how these may differ to those of your care recipient.
  • Be aware of judging other people's behaviour, expectations and beliefs according to the standards of your own culture.
  • Be aware that the care recipient may judge your behaviour according to the standard of their own culture.
  • It is important to recognise, accept and document individual interpretations of “manners” and “taboo” expectations and beliefs of your care recipient and their family.

Resources

Generalist

Superstitions that some Croatians may believe include:

  • Opening an umbrella in the house or placing it on the table or the bed is considered bad luck.
  • If you see a black cat on the road you should spit 3 times to avoid bad luck.
  • Place garlic above the front door to keep the vampires away.
  • A stomach ache can be eased by holding crossed knives on the stomach.

Croatian proverb

  • ‘Without suffering there is no learning – no pain, no gain’ (in Croatian: Bez muke nema nauke).

Tips

  • Superstitions may be considered as old wives’ tales, family traditions or have a significant meaning and be taken seriously.
  • Be aware of your own beliefs and how these may differ to those of your care recipient.
  • Be aware of judging other people's superstitious beliefs according to the standards of your own culture.
  • Be aware that the care recipient may judge your beliefs according to the standard of their own culture.
  • It is important to recognise, accept and document individual interpretations of superstitious beliefs.

Resources

Generalist

  • The list of traditional Croatian food is very long and it varies from place to place.

Some favourite foods include;

  • Cabbage rolls
  • Homemade soup (such as chicken soup and bean soup)
  • Meat such as; chevapchichi sausages, Paprikash (a dish prepared with paprika), smoked ham, Kulen (a flavoured minced pork sausage), fried chicken, goulash and roast pork
  • Fish and seafood
  • Homemade cakes and pastries (apple or ricotta cheese strudel, poppy seeds or walnut cake, donuts, vanilla slice).

Other food commonly eaten includes;

  • Fresh cheese, cream, vegetables, bread, lamb or piglet on the spit and extra virgin olive oil. 

Dining etiquette

  • The fork is held in the left hand and the knife in the right.
  • The napkin should be unfolded and placed in the lap for formal meals.
  • Wait until the host begins eating before starting the meal.
  • It is considered polite to refuse a second helping, until the host insists.
  • Leaving a little food on the plate suggests that you have finished eating.

Tips

  • Food is an important aspect of cultural identity, therefore it is important to identify food preferences, likes and dislikes including eating habits, meal times, preferred setting, preferred eating utensils etc.
  • Identify and facilitate cultural food when possible and ensure the impact of religion on food services is documented, adhered to and regularly reviewed.
  • Provide menu choices and food services information in the preferred language of care recipients, or with pictures if the person has difficulty reading. 
  • Consider alternative ways to facilitate culturally appropriate food such as; obtaining recipes from family/friends, specific meal delivery services, community groups, seniors’ clubs, or and/or other clubs.
  • Ensure that the care recipient is given food choices throughout all stages of dementia.

Food and diet resources

  • A wide range of information (including religious food requirements, nutrition information and recipes) is available in the “Food and diet resources” section below.

Advice and Support

  • Seek advice and support from the Dementia Behaviour Management Advisory Service (DBMAS) if required – phone 1800 699 799.

Resources

Generalist

  • A person-centred care approach helps organisations provide accessible, responsive and flexible services that meet the diverse needs and preferences of people living with dementia in our community. 
  • Many people with dementia want to remain independent for as long as possible and rely on the community care system to help them achieve this.

Additional care considerations for Croatian people

  • The majority of older Croatian people use modern medicine and do not believe in alternative therapies.
  • Croatian people are often willing to accept community services in order to stay in their homes for as long as possible.
  • It is not uncommon for older Croatian people to clean their house prior to the arrival of service providers, as they believe it is unacceptable to have visitors if the house is not clean. This may create the perception that help is not required.
  • There is often a high expectation on the quality of service provided by care workers.
  • Older Croatian people view domestic activities such as washing and cleaning as ‘women’s jobs.’ This means that there may be a preference for a female care worker.
  • A female care worker is considered appropriate in situations where personal care such as bathing and dressing are required.

Tips

  • Identify and document the care needs of your care recipient and continuously re-evaluate how their dementia progression affects their care needs.
  • Make every effort to understand a dementia behaviour before attempting to manage it, as you will often discover that what lies behind it is a genuine attempt to communicate an unmet need.  

Care information resources

  • A wide range of information is available (e.g. personal hygiene, sleeping, incontinence etc.) in the “Care information, resources” below.
  • Advice and Support - Seek advice and support from the Dementia Behaviour Management Advisory Service (DBMAS) if required – phone 1800 699 799.
  • Employee/employer resources - A range of information is available under “Links – Other useful weblinks”.

Resources

Generalist

  • Croatian people are very proud of their heritage and are often considered nationalists.
  • Croatians refer to Croatia as ‘Our beautiful homeland’ (‘Lijepa naša’). This is also the name of the Croatian national anthem.
  • Folklore helps to preserve Croatian culture. This includes poetic songs, melodies, symbolic rituals, music, dance, costumes and jewellery.
  • The family home is considered sacred by many Croatians.
  • Family and church are important and children are considered a blessing.
  • Traditionally, children will not leave home until they get married.

Tips

  • Everyone has “culture”. This includes a number of factors such as ethnicity, identity, age, gender, education, sexual orientation, ability/disability, values, beliefs, attitudes etc.
  • Recognise your own cultural traits and influences and be mindful not to judge other people’s behaviour and beliefs according to the standard of your own culture.
  • Be aware that your care recipient may judge your behaviour and beliefs according to the standard of their own culture.
  • Your care recipient may be “similar to others” but “no two people are the same” so take care not to generalise or make assumptions about them. Gain general cultural information from resources to assist with conversations to allow you to identify your care recipient’s individual cultural traits.
  • Understand and document how your care recipient’s individual cultural traits impact their care needs.
  • Increase your knowledge about different cultural practices and issues through resources, cultural background information sessions and/or cultural awareness training.
  • Cultural Traits resources
  • Find information (such as guides and cultural profiles created by other organisations) in the “Cultural Traits, resources” section below.
  • You will also find information including; links to community contacts, cultural profiles, useful weblinks etc. in the “Links” section of the app.

Resources

Generalist

  • Easter is celebrated by Croatians.
  • Easter observances begin on Palm Sunday and continue through the week until Easter.
  • Croatia is predominantly Roman Catholic, which means that Easter is considered one of the holiest times of the year.
  • Religious services start on Palm Sunday and continue through the week until Easter.
  • “Sretan Uskrs” is “Happy Easter” in Croatian.
  • It is compulsory to do thorough home cleaning for weeks before Easter.
  • On the Tuesday before Ash Wednesday carnivals are held everywhere in Croatia.
  • Ash Wednesday is the start of the Lent period.
  • On Ash Wednesday and Good Friday Croatian people fast.
  • During Lent there is no singing, music, balls or dancing until Easter.
  • The Easter celebration is the end of the Lent period.
  • Over the Easter weekend there is no work, instead people attend Church, prepare and enjoy special Easter food and enjoy painting Easter eggs called “pisanice”.

Tips

  • Understand the importance of Easter to your care recipient and accept and respect that customs and beliefs about Easter are different from culture to culture.
  • Identify, document and support any spiritual/religious needs of your care recipients.
  • Identify, document and facilitate any dietary requirements.

Resources

Generalist

  • Christmas is celebrated by Croatians.
  • Christmas is celebrated from Christmas Eve to Epiphany (the first Sunday after New Year).
  • A real Christmas tree is decorated on Christmas Eve.
  • Also candles are lit, with ribbon in red, white and blue (representing the Croatian flag) wrapped around it. They are then placed amid green wheat as a display.
  • Before dinner, the whole family sits together to pray.
  • On Christmas Day the family stays at home and spends time together enjoying specially prepared food.

Tips

  • Understand the importance of Christmas to your care recipient and accept and respect that customs and beliefs about Christmas are different from culture to culture.
  • Identify, document and support any spiritual/religious needs of your care recipients.
  • Identify, document and facilitate any dietary requirements.

Resources

Generalist

  • New Year is celebrated by Croatians.
  • Celebrations begin on New Year’s Eve, 31st of December and continue until New Year’s Day.
  • New Year is celebrated with a lot of different food and wine, starting from New Year’s Eve.
  • On New Year’s Day people visit each other to say “Sretna nova godina!” which means “Happy New Year!”

Tips

  • Understand the importance of New Year to your care recipient and accept and respect that customs and beliefs about New Year are different from culture to culture.
  • Identify, document and support any spiritual/religious needs of your care recipients.
  • Identify, document and facilitate any dietary requirements.

Resources

Generalist

The following dates may be considered as a “special day” by Croatians:

  • 6th  January - The Holy Epiphany
  • Croatians, along with many other Christians around the world, celebrate Epiphany. This religious day marks the following two events in Jesus Christ’s life, according to the Christian Bible: three wise men, or kings, visited the infant Jesus; and St John the Baptist baptized Jesus.
  • 1st May - Labour Day
  • This day is associated the start of spring as well as the celebration of workers.
  • May (date varies each year) - Corpus Christi (also known as the Feast of the Most Holy Body of Christ, and the Day of Wreaths
  • On this day Christian Croatian honors the Holy Eucharist.
  • 22nd June - Anti-Fascism Day
  • In remembrance of 22 June 1941, the anti-fascist commitment and affiliation to allies in World War II.
  • 25th June - Statehood Day
  • Croatians celebrate the declaration of independence from Yugoslavia that took place in 1991.
  • 5th  August - Homeland Thanksgiving Day
  • This day is held as a memorial to Croatia’s War of Independence to honour those who died in the war.
  • 15th  August - Assumption Day/Feast of the Assumption
  • Christian Croatians celebrate the belief that God assumed the Virgin Mary into Heaven following her death.
  • 8th  October - Independence Day
  • Croatians celebrate their independence.
  • 1st  November - All Saints Day
  • A celebration of all Christian saints.
  • 26th  December - St Stephen Day
  • Croatians commemorate Saint Stephen, the first Christian martyr.

Other special days include:

  • Birthdays
  • Name Days (a day of the year that is associated with a person’s given name)

Tips

  • Understand the importance of any significant days to your care recipient and accept and respect that customs and beliefs about special days are different from culture to culture.
  • Identify, document and support any spiritual/religious needs of your care recipients.
  • Identify, document and facilitate any dietary requirements.

Resources

Generalist

  • Music and songs are central to Croatian culture.
  • Traditional musical styles vary according to regions.
  • There are many different festivals held in Croatian which demonstrates their old and rich culture.
  • Some types of folk music include: Ganga, Klapa, Tamburica, Guste and Diple.

Tips

  • Music is the most powerful universal language.
  • Music provides an external rhythm and can restore a person back to themselves, and to others, at least for a while.
  • People tend to remain contactable as musical beings on some level right up to the very end of life.
  • It is important to understand your care recipient’s music likes and dislikes and to provide them with their choice of music to listen to.
  • Create a personalised music playlist for your care recipient for their maximum benefit and enjoyment.
  • Provide opportunities for the person with dementia to watch live music performances.
  • Providing music a person relates to can have a wide range of benefits to the care recipient. Benefits may include; helping to improve their mood, responses, memory function, increase social interaction, improve verbal and non-verbal communication and restore a sense of identity.

Resources

Generalist

  • Gingerbread was traditionally made in northern Croatia. It is usually made in the shape of a heart and decorated with bright colours.
  • Lace, a type of handicraft is made within Croatia. Different types of lace are produced, including: needle-lace, bobbin-lace and aloe-lace.
  • Wooden toys are a traditional handicraft of Zagorie. These are made by men and then painted by women.
  • The “Kolo" dance is one ethnic dance amongst many different popular ethnic dances in Croatia.
  • Dancing, singing and fishing are important leisure activity for many Croatian people.
  • Elderly Croatians generally like to play bocce, chess, cards and sport.

Reminiscence

  • Smell or taste - Using smell kits, different cultural foods. Suggestions include; sage, bay leaf, rosemary, lavender, chamomile, basil and garlic.
  • Sight - Cultural Photographs, Slides, Films, Painting pictures, looking at objects. (Refer to the “Cultural activities resources” section for some visual ideas).                                                         
  • Touch - Touching cultural objects, feeling textures, painting and pottery. Pampering, massage hands, combing hair, etc. if it is considered culturally appropriate by the care recipient and they trust you to do this without being intrusive.   
  • Sound - Personalised playlists, listening to familiar tunes from the radio, C.D's, YouTube, listening to cultural performances, or making music using various instruments. (Refer to the “Music resources” section for some music ideas).

Tips

  • It is important to understand your care recipient’s activity likes and dislikes and their personal history to plan appropriate activities for them.
  • Your care recipient should be provided with a choice of activities to participate in.
  • Participating in suitable activities can help a person with dementia to achieve purpose and pleasure, help to improve their mood, responses, memory function, increase social interaction, sleep, improve verbal and non-verbal communication and restore a sense of identity. Activities also play a significant part in increasing the person’s wellbeing and confidence which will decrease responsive behaviours or ill-being.
  • It is important that activities are suitable to the level of ability of the person with dementia. People with dementia should be encouraged to participate as independently as possible and be given the choice to participate or to watch others.
  •  Always talk to the person’s doctor before starting them on a new exercise program and ensure the program designed for them takes into account their current health and ability.
  • Alzheimer’s Australia SA, local council libraries or community organisations may be able to loan suitable cultural activities such as music, games, videos etc.

Cultural activity resources

  • For cultural activity information and ideas refer to the “Cultural activities, resources” section below.
  • For local community contact details refer to the “Links, Community Contacts” section of this app.

Resources