+ 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

  • Italy is located in the continent of Europe.
  • Italy shares borders with the following four countries; France, Switzerland, Austria, and Slovenia.
  • Rome is the capital city of Italy.
  • Italy ranks as the 72nd largest country with a total area of 301,340 square kilometres (Central Intelligence Agency n.d.).
  • Italy has a population of 61,855,120 (Central Intelligence Agency 2015).
  • Italian is the major ethnic group of Italy. Other ethnic groups include; German, French, Slovene-Italians, Albanian-Italians and Greek-Italians (Central Intelligence Agency 2011).
  • The climate of Italy varies in different areas. Northern Italy has very cold, snowy winters and very hot summers. Southern parts of Italy can be significantly milder in winter. Temperatures vary less considerably to the northern parts of Italy in the summer.

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

History of Migration to Australia

  • Missionary work was conducted by Italian priests in Queensland, Western Australia and Northern Territory during the nineteenth century.
  • In the 1850s, during the gold rush period, Italian communities were established in Victoria and Western Australia. When the gold ran out, many Italians moved to work in other parts of Australia.
  • An Italian community known as ‘New Italy’ was established in New South Wales by a group of migrants from northern Italy. This is now known as Woodburn.
  • Italian communities were also established by Italian fishermen along the south coast of New South Wales, Port Pirie and Fremantle.
  • Also, during this time, Italian labourers that arrived in Australia, worked in the cane fields in North Queensland. Many Italians also became market gardeners.
  • A significant proportion of Italian migrants lived in the cane crop regions of Queensland by the late 1930s.
  • Italian migrants were predominantly young, single men, and they mainly came from Sicily, Calabria and Veneto.
  • The majority of Italian migrants were economically poor, had limited education and little or no English skills.
  • Italians worked long hours to provide for their family.
  • Many Italian migrants found work with other Italians, and lived in areas where there was a significant number of other Italians.
  • During World War II, Italian males were arrested, treated poorly and interned in camps as ‘enemy aliens’. Many Italian women and children were forced to seek shelter with friends and relatives as they were unable to keep their homes without their husband’s income.
  • Also at this time, Italian prisoners of war were shipped from United Kingdom and other Allied bases to Australia for internment.
  • Most of the Italian prisoners were taken to work on the land due to food shortages, and many chose to immigrate to Australia after the war ended.
  • Italian immigration increased significantly after the war with displaced persons and many established Italian migrants sponsored their families and relatives.
  • Italians revived the Australian tobacco industry and by 1950, Italians farmers controlled 75% of tobacco production. 
  • Improvements in the Italian economy after 1971 saw some Italians return to their homeland.
  • Italians worked hard in Australia and by the mid-1970s, many Italians who migrated after World War 11 ran successful businesses, owned their own homes and many also owned at least one rental property.
  • The good fortune of Italians often incurred resentment from their Australian peers, who weren't driven by the same work ethic.
  • Australians of Italian heritage have made a significant contribution to the cultural, social and economic life of Australia.

History of Italy

  • 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

  • Italy is defined as an individualist culture, however, the culture in Northern Italy is mid-range (between individualist and collectivist).
  • Italy scores 76 on the Individualism versus Collectivism index (IDV) (Hofstede Centre).
  • Northern Italy, however, has a score of 50 on the Individualism versus Collectivism index (IDV) (Hofstede Centre).
  • The index scale ranges from 0-100, with 50 as a mid-level. The low numbers indicate “collectivist” cultures where people generally act primarily in the interests of the group. High numbers indicate “individualist” cultures where people generally tend to prioritise looking after themselves and their immediate family.

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

  • Italian-born Australians are predominately Catholic and there is also a small minority that are Jehovah’s Witnesses.
  • Religion and religious practices such as observing holy days on the Italian religious calendar are very important to many older Italians as it provides a sense of community and culture.
  • It is common for Italians to attend Sunday Mass, visit the graves of loved ones and pray either alone or in groups using Rosary beads.
  • Many elderly Italians have icons, such as pictures of saints, the holy family and statuettes of the Madonna and Jesus in their homes.
  • A “scapula” (a form of necklace received at The Sacrament of Confirmation) may be worn by older Italians.

In Italy

  • The major religious affiliation in Italy is Roman Catholic.
  • Italy has the highest number of Catholic churches per capita than anywhere in the world.
  • The church still has influence in society despite reduced levels of attendance.
  • The church promotes appropriate behaviour within relationships. For example, respect should be given to those who are older, those who have achieved success, and from people that come from well-connected families.
  • A patron saint is associated with every day of the year. Children are generally named after a saint and will celebrate their saint’s day like it is their own birthday.
  • Trades and professions also have a patron saint associated with it.

Religion and its role in dementia care

  • The role of religion in dementia care differs between individuals.
  • Religion may play a significant role and provide comfort in difficult times.
  • Those with Catholic faith may exclude certain foods during the period of Lent (before Easter) and may also not eat meat on Fridays.
  • Other people may keep religion separate from daily life.
  • Priests are well respected within the Italian community and may be sought for advice by families during difficulties and health issues.

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 and is the foundation of Italian culture.
  • Family greatly influences the lives of its members, and they provide stability, emotional and financial support to each other.
  • There are difference between the family associations between the areas of Italy. For example, in the north of Italy, the household generally consists of only immediate family. However, households in southern Italy generally include extended family members.
  • Carers are generally preferred to be family members in the event of health issues such as dementia, however the level of support provided is dependent on the family itself.
  • Italian Men generally take on decision making roles and Italian women usually carry out all of the caring duties.
  • It is also common for the spouse to take on the primary caring role and they will generally do all that they can to continue this role, even when it is beyond their ability. Carer burnout and stress is quite common.

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 Italian are available in the “Language and communication, resources” section of this app.

Resources

Generalist

In Australia

  • The main languages spoken at home by Italian-born Australians are Italian and English.
  • Hundreds of different dialects exist from the various regions and provinces within Italy and many of these dialects, as well as “formal” Italian, are spoken within Australia.

In Italy

  • Italian is the official language of Italy.
  • Regional dialects are spoken by approximately half of the Italian population. These may not be mutually understood and are often considered as separate languages. For example; Friulian is a dialect spoken by people in northeastern Italy.
  • Other languages spoken within Italy include; German, French and Slovene (Central Intelligence Agency).

Language and dementia

  • Many elderly Italians migrated to Australia when English proficiency was not necessary, and before English classes on arrival for were either not available, or not readily accessible. Therefore, literacy levels of older Italian people may be low and people may be illiterate in their own language as well as in English.
  • Information targeted at older Italians should be pitched at the appropriate level of literacy and it is best to be kept clear and concise.
  • Information sessions should include an Italian speaker where possible.
  • As dementia progresses, a person may revert to a different dialect of Italian. This may create issues with communication for family members and others who may not be able to understand or speak the same dialect.
  • The use of Italian radio, movies and newspapers may be beneficial.
  • Service providers should be sensitive to terminology around dementia as some words have negative connotations which can contribute to stigma when translated into Italian.
  • Use of positive language and identifying how an Italian person with dementia can still be involved in activities is very important.

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

  • Italians often use enthusiastic and formal greetings.
  • A persons’ formal title should be used until you are invited to refer to them by their first name.
  • First impressions are important, therefore be sure to demonstrate politeness and respect when greeting Italian people, especially when meeting them for the first time.
  • Many Italians are loud and quite animated when they meet with family and friends.

Man greeting Man

  • A handshake and direct eye contact is the norm when meeting.
  • A light hug may be exchanged between good friends and family.
  • In some regions, good friends and family may exchange a kiss on each cheek when meeting.

Woman greeting Woman

  • A handshake is common on first meeting.
  • Good family or friends may give several light kisses on the cheeks. (These may be a light touch of the cheeks rather than kisses and the number of kisses may vary).

Greetings between Men & Women

  • For an initial meeting a handshake (initiated by the woman) is common.
  • Between good friends and family, several light kisses on the cheeks are common. The number of kisses may vary.

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.

Resources

Generalist

  • Italians generally have a loud, diplomatic yet direct communication style.
  • Italians are known to be quite enthusiastic and animated during conversation. This should not be confused for anger.
  • Communication is often formal in public situations and more casual in private settings.
  • Italians tend to display emotions openly. For example; anger, joy and sadness.
  • Persuasion is commonly used by Italians.

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 to.

Language and Communication resources

  • 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

  • Italian people use and expect direct eye contact.
  • Many Italians consider it very rude to not use direct eye contact, particularly when greeting a person.

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

  • Italian people are generally very expressive, both vocally and with frequent use of gestures and touch.
  • Hand movements are often used during conversation to emphasise what is being said.
  • Some specific gestures may have meaning to an Italian person. For example, extending the pinky (smallest finger) and index fingers whilst bending the middle and ring finger can suggest that one’s wife is being unfaithful.
  • Flicking one’s fingers under one’s chin can indicate not knowing or caring.
  • Using the index finger to tap one’s head may suggest that someone is “crazy”.

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

  • Personal space is usually appreciated.
  • An arm’s length is generally considered an appropriate amount of space.
  • Less space may be appropriate between friends and family.

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

Italian people are generally not punctual. Instead, they tend to practice flexibility with time.

  • Lateness in a social setting is more acceptable than being late in a business setting.
  • The concept of punctuality varies in different parts of Italy. For example, punctuality in Milan is up to 20 minutes late, whilst in the south 45 minutes late is considered punctual.

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

  • Italy was ranked 50th on a global index measuring gender equality out of 144 countries. (World Economic Forum, Global Gender Gap Report 2016).

Marriage

  • Men and women can be the head of the household.
  • Laws state that there is equal parental authority over children.
  • Both spouses are equally entitled to initiate divorce.

Inheritance

  • Men and women have equal right to inheritance.

Same Sex Relationships

  • Italy was ranked 32nd with a score of 25.9% on the Rainbow Europe Country Ranking. On this scale, 0% represents gross violations of human rights and discrimination and 100% represents respect of human rights and full equality. (Rainbow Europe).

Women

  • In Italy, women are considered socially and legally equal to men. Although for older Italians, women may still be perceived as the housewife and homemaker.
  • Women work across a range of industries. However, they tend to have lower salaries than their male colleagues.
  • Italian women tend to do the majority of housework and child rearing, although younger Italian fathers with wives in the workforce may participate in household work.

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 Italy

  • The 2015 World Alzheimer report estimated that there were 1.2 million Italians living with dementia (World Alzheimer Report 2015).

Perceptions of dementia

  • Italian-born Australians view of dementia varies within the community.
  • A common response to dementia is denial and minimising the signs and symptoms.
  • Dementia may be incorrectly viewed as forgetfulness and as a normal part of ageing.
  • Some community members have a limited understanding about dementia.
  • Older Italian people may use the term ‘sclerosis’ to refer to dementia, as this term was commonly used in the past.
  • Social isolation has been identified by Italian people as an issue for people with dementia, because some Italian community may not know how to behave around a person with dementia.
  • Carers may feel the need to apologise or explain behaviours of the person they are caring for, as they may feel guilt or responsibility for the behaviour of care recipient.
  • The word ‘dementia’ in Italian has mental health connotations and therefore stigma may exist around it.

Diagnosis and treatment

  • The family doctor is generally the initial source of assistance that Italian people would seek. However, there may be delays in seeing their medical practitioner until a person is experiencing more severe symptoms.
  • Diagnosis may therefore be delayed and treatment options may be limited as a result.

Attitudes and Issues with Ageing

  • Family is traditionally responsible for the care of older relatives.
  • Italians may be reluctant to accept care services for elderly people, including the use of residential care facilities.
  • There may be language and cultural differences between older Italian people and the younger generations, which may impact on meaningful communication.

Attitudes to Disability and Mental Illness

  • Stigma exists around mental illness and consequently older Italian-born people are reluctant to access mental health services.
  • It is uncommon for people with a disability in the Italian-born community to be institutionalised. Instead, families tend to provide care and protection.

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

  • Traditionally, Italian parents and relatives are cared for by their family and care responsibilities usually rest with women.
  • In Australia, as many family members are engaged in the workforce, the sense of responsibility for providing care is shifting and services may be sought.
  • Older Italians may have specific ideas and cultural expectations regarding health and care issues.
  • Placement in residential care facilities can cause tensions between families. It may also lead to gossip by others in the community who may criticise the females in the family for not taking on the carer role.
  • Admission into an Italian-specific residential care facilities are generally preferred over mainstream facilities.
  • Language issues may also be problematic, as older Italians may not speak English. This can lead to isolation if younger generations do not speak Italian.

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

  • The way Italian people express pain may vary between regions.
  • However, most Italians are forthcoming about their pain and suffering and they are generally very expressive when it comes to sickness and pain.
  • Italian people often prefer to have company when they are in pain, and have an expectation of attention, sympathy and pain relief.
  • Family support and encouragement during illness and pain is important.
  • Italian people usually place a lot of trust in their doctors and specialists.
  • 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

  • Traditionally, Italian families stay with their dying relative until they pass away.
  • For Catholic people, rites and rituals are a very important part of end of life.
  • The priest administers the Last Rites and the Rosary prayers are recited. This is often done prior to the patient passing away and sometimes even just after death, and may include the presence of family members.
  • Burial is generally preferred over cremation. Although some people may wish to be cremated so that their ashes can be taken back to Italy.
  • A religious service is conducted prior to the burial of the body.
  • After someone dies, it is commonplace for friends and relatives to visit the home of the mourning family to wish their condolences and flowers. This act is known as ‘lutto.’
  • The night before the funeral The Rosary may be recited at the funeral home.
  • A viewing is held for family and friends to say their final goodbyes.
  • Mass may be held one week, one month and then annually after the anniversary of the death of a loved one.
  • Traditionally, older women wear black during mourning, although this tradition is becoming outdated.
  • Family members generally visit the grave of their loved ones regularly.
  • A small shrine, including a photograph and flowers, may be prepared in the home in memorial of the deceased family member.
  • Grief may be expressed openly by family and relatives.
  • 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

  • Personal and family honour is very important therefore be careful to ensure you do not offend Italian, their family, their town, their friends, or their religion.
  • Men tend to display ‘strong masculine pride.’
  • Jealousy may arise if wives are approached by other men in a casual manner.
  • Appearance is considered very important. Italian people are generally well dressed and may expect others to be the same.
  • In business dealings, avoid chewing gum, leaning on things or slouching.
  • It may be considered rude to talk about religion, the mafia, politics or personal family matters.

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 are common in Italian culture and may influence daily life. For example; a pinch of salt may be thrown over the left shoulder to ward off bad spirits if salt is spilt.
  • Many superstitions originated in ancient history and are based on religious beliefs or communal rites. Other superstitions were developed to encourage prosperity and discourage strife.
  • Superstitions are carried on from one generation to the next, and it is often considered safer to believe them, than not to.

Common superstitions believed by Italians include:

  • “Malocchio” (meaning Evil Eye)
  • This is often described as a curse, a look, or comments made, that might tempt a person’s fate by causing them misfortune or injury. To ward off the “evil spirit” one needs to make the “horn sign” by extending their pinky (smallest finger) and index finger, while keeping the others folded back. 
  • “Corno” (horn-shaped charm)
  • For protection against “Malocchino”, many Italians wear a “corno” as a necklace and/or hang them in prominent places, like in their cars.
  • Friday the 17th
  • Many Italians see Friday the 17th as a day of ill fate.

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

  • Food is a key component of Italian culture.
  • Sharing a meal with friends and family is considered very important to Italians and they may be reluctant to eat alone.
  • Many Italians are Catholic and may observe religious and cultural customs such as Lent, and not eating meat on Fridays.
  • Those with religious beliefs might also pray or cross themselves before a meal.

Some favourite Italian dishes include

  • Soups, such as minestrone or a clear chicken broth with tiny pasta/pastina such as “stelline”
  • Ricotta cheese
  • Pasta dishes
  • Grilled capsicum with oil dressing
  • Tomato salad
  • Olives

General food and diet information

  • Breakfast usually consists of a cup of coffee.
  • Meals are predominantly eaten at lunch (midday) and at dinner time.
  • Bread (without butter or margarine) accompanies most meals.
  • Desserts are usually not sweet and typically include a piece of fruit.
  • Meals are often accompanied with red wine.
  • Water is a popular drink.
  • Tea is not a typical drink in Italy.

Dinning Etiquette

  • It is important to be well dressed, even if an invite suggests an informal dress code.
  • Punctuality is reasonably flexible. It is typically acceptable to arrive between 15 to 30 minutes late if invited to dinner or a party.
  • It is considered polite to bring a gift such as wine or chocolates.

Table manners

  • Wait to be invited to sit down.
  • Generally, the hostess is the first to sit and first to eat and people will follow her lead.
  • The fork is held in the left hand and the knife in the right during a meal.
  • The host will generally give the first toast.
  • A guest should return a toast later in the meal.
  • It is common practice for Italians to share their food.
  • Many Italians say “Buon appetito” (enjoy your meal) before eating.
  • Elbows should be kept off the table during a meal.
  • Guests are usually expected to take a second helping during a meal so it is best to take a small first helping.
  • A small amount of food left on the plate is considered acceptable.
  • An empty, or partially empty wine glass is usually refilled. A near full glass is generally not refilled.
  • Cheese is often picked up with a knife rather than with fingers.

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 Italian people

  • Italian families usually play a vital role at all stages of decision making, and in the receiving and giving of news, regarding the care of their loved one.
  • Traditionally, placement of an elderly family member into residential care was a cultural taboo and could be considered a disgrace to the family. Whilst this may still be frowned upon by some, residential care facilities and hostels are now available in Italy.
  • Italian-specific residential care facilities are generally better accepted and have less stigma for an older person and their relatives.
  • Western medicines are usually taken without objection, although this may be supplemented by home remedies.
  • Coining (a form of dermabrasion therapy) may be practiced by older Italians. This is believed to treat a variety of ailments. It is generally performed on the forehead, nose, between the eyes, abdomen, neck, chest or back. Coining can produce bruises or marks, and this should not be confused for signs of abuse.
  • Other traditional health beliefs may be practiced such as the belief that illness may be caused by the ‘evil eye’.

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

  • There are expectations and obligations of the Italian community based on sibling status and gender roles. There is also a belief that everyone should fulfil their ‘duty.’
  • Family structure is inclusive of the extended relatives.
  • Children are considered important within the Italian community and are involved in family activities.
  • Food is a key component of Italian culture.
  • Personal appearance is considered extremely important and can reflect social status, family background and level of education.
  •  “Bella figura” (good image in the eyes of society) is crucial to Italians and people are often judged based on their image. This not only includes dressing well, but also the way a person projects themselves, their confidence, style and demeanour.
  • To present yourself well in thought, word and deed is considered a matter of personal dignity.

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 in Italy.
  • The date of Easter is set around the time of the March Equinox.
  • Easter and Lent are very significant for Catholic Italians.
  • Lent (also known as Quaresima) is the forty days of fast before Easter. It is symbolic of the forty days that Christ spent in the desert before his crucifixion.
  • Some Italians will not eat meat during Easter time, whilst others will not eat meat on Fridays.
  • Common Easter food includes; eggs, Easter pie, and lamb.
  • “Buona Pasqua” is Happy Easter in Italian.

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 in Italy.
  • For Catholic Italians the Christmas celebrations start eight days before Christmas, with special 'Novenas' or a series of prayers and church services.
  • Meat, and sometimes dairy, are avoided on Ash Wednesday and Good Friday.
  • It is a tradition for a light seafood meal to be shared before attending Midnight Mass on Christmas Eve.
  • Catholic Italians may also attend church on Christmas day before sharing a big meal with family.
  • People may have a Christmas manger or an Il Presepio display in their homes at Christmas time.

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 Italians.
  • Celebrations begin on New Year’s Eve, 31st of December and continue until New Year’s Day.
  • Catholic Italians usually attend a mass.
  • At many Italian New Year's Eve parties, people play ‘tombola’ (a game similar to bingo).
  • Traditionally, bullets are shot into the air at midnight to mark the end of the year.
  • Firework displays are also used to celebrate the beginning of the New Year.
  • Celebrations may continue until sunrise.
  • Traditional feasts are shared with family and friends, accompanied by Spumante or Prosecco (Italian sparkling wine).
  • Lentils are often a featured dish as they symbolise money and good fortune.
  • Spiced sausage (known as cotechino) or stuffed pig’s trotter (zompone) is eaten in many parts of Italy. Pork is meant to symbolise the richness of life in the coming year.

Other common superstitions include:

  • A tradition common in southern Italy, is to throw old things out the window, as a way to mark readiness to accept the New Year.
  • Wearing red underwear for the occasion is said to bring good luck.

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

There are many significant days celebrated within the Italian culture.

In addition to Easter and Christmas, significant days include: Baptism, the First Holy Communion, Confirmation, Name Days (a day of the year that is associated with a person’s given name) and Saint days (which have spiritual and cultural links with the patron saint of the village of their birthplace).

Other days of significance include:

  • 6 January – “La Befana” (Epiphany)

This is an important part of the Christmas festivities in Italy originating from a fairytale about a woman who flies on a broomstick bringing presents to children.

  • Ash Wednesday

This takes place 46 days before Easter Sunday. Catholic Italians consider this to be one of the most popular and important holy days in the liturgical calendar. Ash Wednesday opens Lent, a season of fasting and prayer. 

  • 25 April - Liberation Day 

This national holiday in Italy is celebrated with food festivals, marching bands, concerts and rallies. It marks the fall of Mussolini’s Italian Social Republic and the end of the Nazi occupation in 1945, and honours those that served in the Italian Resistance.                                                                                                                     

  • 2 June - Constitution Day

The celebration of the Italian Republic is a national holiday in Italy, and in Australia many Italian organizations hold dinner dances to celebrate this memorable day.
 

  • 13 June - Saint Anthony of Padua

Saint Anthony of Padua died on 13 June 1231. He is remembered for his Catholic preaching as well as his expert knowledge of scripture. He is the patron saint of finding things or lost people.

  • 3rd Sunday in July - Festa del Redentore

In 1576, the Senate in Venice voted for an erected church to be dedicated to Christ the Redeemer as an offering and a plea for divine help to . In July of the following year, the city was declared free of disease. An annual church service and festivals are held each year in celebration.

  • 1st Sunday in August - Joust of the Quintana

The Quintana is a jousting.

  • 15 August - Assumption of the Blessed Virgin Mary

This Feast Day is celebrated by Italian Catholics to Blessed Virgin Mary and her bodily assumption into Heaven.

  • 2nd Sunday in August - Palio Del Golfo

A rowing contest held in Italy.

  • 4 October - Saint Francis of Assisi

St Francis died in Italy on October 4, 1226. He is a well-known and loved patron saint of animals and the environment, and is remembered and celebrated with a feast day for his generosity to the poor, his willingness to minister to the lepers and for his love of animals and nature. 

  • 1 November - All Saints Day

This is a day of honor each of the saints. It begins at sundown on the 31st of October and finishes at sundown on the 1st of November.

  • 2 November - All Souls Day

This day commemorates the faithful departed, including one’s relatives.

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

  • Italians enjoy socialising and drinking Italian coffee in the morning and/or afternoon with family, neighbours and friends.
  • Card games that are popular amongst elderly Italian people include; “Briscola”, “Tre Sette” and “Scopa”. These games use Italian regional card packs e.g. Triestine, Trevigiane or Siciliane, and Napoletane packs.
  • Other popular activities include; knitting, crochet, bingo (known as “tombola”), bocce, dancing, listening to Italian music, radio and watching TV.
  • Many older Italians enjoy gardening (especially growing vegetables).       
  • The Sicilian puppet theatre known as Opera dei Pupi is a well-known cultural activity.

Reminiscence       

  • Smell or taste - Using smell kits, different cultural foods. Suggestions include; coffee, basil, mint, tomato sauce, freshly baked bread, lemon, oranges and mandarins.
  • Sight - Cultural photographs, slides, films, painting pictures, looking at objects. Suggestions include; photos of Rome, the Vatican the Pope, Churches in general, pictures from the town or village of birth. (Refer to the “Cultural activities resource” section for some visual ideas).          
  • Touch - Touching cultural objects, feeling textures, painting and pottery. Pampering, massage hands, 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

Generalist

  • Italian music is diverse and originates from folk traditions. Music varies from region to region and can include; Celtic, Spanish and Arabic influences.
  • Opera is a traditional form of Italian music.
  • Italian pop music tends to incorporate traditional Italian music.
  • Popular Italian artists include; Claudio Villa, Adriano Celentano, Nilla Pizzi, Mina or Casadei.

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