+ 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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Aboriginal and Torres Strait Islander

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Malaysian

Maltese

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New Zealander

Polish

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Sri Lankan

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Generalist

  • Malta (officially known as The Republic of Malta) is located in the continent of Europe.
  • Malta consists of three islands; Malta, Gozo and Comino. The islands are surrounded by the Mediterranean Sea.
  • Valletta is the capital city of Malta.
  • Malta is the 208th largest country with a total area of 316 square kilometres (Central Intelligence Agency, n.d).
  • Malta is one of the most densely populated countries in the world.
  • The population of Malta is approximately 415,196 (Central Intelligence Agency, 2016)
  • The major ethnic group of Malta are the Maltese people.
  • Generally, the climate is pleasant in Malta. Summers are warm and dry, and the weather is winter is mild and rainy.

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

  • Maltese people arrived in Australia as early as 1810 as convicts, followed by the first free settlers in 1838 and later as an organised migrant group in 1883.
  • The organised migrant group consisted of 61 Maltese labourers that were employed to work on sugar plantations in North Queensland.
  • The harsh working conditions experienced by Maltese migrants led many of them to return to Malta.
  • Maltese migration to Australia slowly increased after 1905.
  • Maltese Clubs were formed in the 1920s in South Australia, Queensland, Melbourne and Sydney.
  • Following World War II, Australia’s immigration policy saw the migration of significant numbers of Malta-born people due to the poor economic conditions in Malta and because of Maltese government schemes to limit the Maltese population.
  • The majority of Maltese migrants to Australia were semi-skilled or unskilled and they often had limited education.
  •  Some Maltese medical practitioners also migrated to Australia.
  • Melbourne and Sydney became the major areas of Maltese settlement.
  • Maltese immigration to Australia reached its peak during the 1960s, however, migration numbers have declined significantly since the mid-1970s.
  • Many Maltese in Australia are Catholic, and the church has played a vital role since the early years of Maltese settlement.

History of Malta

  • 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

  • Malta is defined as an “individualist” culture.
  • This means that Malta is a society where the preference is for people to look after themselves and their immediate family.
  • Malta scores 59 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.
  • In “individualist” cultures, employees are expected to be self-reliant and show initiative.

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 Malta

  • The major religious affiliation in Malta is Roman Catholic - greater than 90% (Central Intelligence Agency, 2011).
  • The Constitution of Malta, adopted as a legal order on 21 September 1964, establishes Catholicism as the state religion and it is also reflected in various elements of Maltese culture.
  • Recent polls conducted, however indicate non-believers are increasing (approximately 4.5% said they did not believe in God) and 2.6% identified as Muslim (Times of Malta).

In Australia

  • Malta-born people in Australia are predominately Catholic and Anglican. A small proportion indicated that they do not have a religious affiliation.
  • Those with Catholic faith may exclude certain foods during the period of Lent (before Easter) and may also not eat meat on Fridays.
  • Attendance at Sunday Mass has declined over the years, particularly with the younger generation. Attendance at church may however still be expected for observant Catholics, and absence may be frowned upon by some of the older Maltese generation.

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

  • Priority to the immediate family is most common in Malta.
  • Immediate families are close within the Maltese culture and regular catch ups are common.
  • The immediate family are usually involved in key decision making, providing full support and administering treatment (where possible).
  • Relatives and close friends may also assist, but to a lesser extent.
  • Maltese people tend to have close and frequent contact with the maternal (mother’s) side of the family.
  • Single people usually live with their parents, irrespective of their age.

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 Maltese is available in the “Language and communication, resources” section of this app.

Resources

Generalist

  • Maltese generally prefer connected networks of people and communication.

In Australia

  • The main languages spoken at home by Malta-born people living in Australia are; Maltese, English and Italian (Australian Bureau of Statistics 2011).

In Malta

  • Maltese and English are the official languages of Malta. (Central Intelligence Agency 2005).
  • The majority of the Maltese population, (90.1%) speak Maltese.
  • Others languages spoken include; English (6%) and multilingual (3%) (Central Intelligence Agency 2005).
  • Italian is often understood by Maltese people and the younger generation may also understand other languages such as French and/or German.

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

  • Maltese people tend to be very friendly and hospitable.
  • Initial meetings usually involve a handshake and introductions. Business cards may also be given.
  • Maltese people are usually addressed by their full title such as Mr or Mrs at first meetings and also in formal settings.
  • It is common for people to move to a first name basis after initial introductions, however it is best to ask people their preference.

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

  • 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

  • Maltese people are usually friendly and hospitable.
  • Relationships are important and most Maltese like to build personal relationships with family, friends, colleagues and clients.
  • Clear and concise communication is generally valued.
  • Some conversations may become quite heated, particularly around topics such as politics and sport.
  • It is common for Maltese people to have loud conversations. This should not be confused as a sign of anger.
  • Maltese can be quite persuasive and some do not like to take ‘No’ for an answer.
  • Maltese people may be bilingual, and some (particularly the younger generation) may know three or more languages.

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

  • Direct eye contact is preferred by Maltese.
  • Use direct eye contact during conversations (particularly during meetings), but be aware that staring at another person for long periods of time may be considered intrusive.

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

  • Maltese are expressive people and often use vivid hand gestures when speaking.
  • Many Maltese believe that the “evil eye” (which is often described as a curse from a look, or comments made to them) is something that might tempt their fate for example; by causing them misfortune or injury. Either the sign of the cross, or “Qrun” (bull’s horn) is used to ward off the evil spirit of the “evil eye”. To make the bull’s horn sign, one needs to extend their pinky (smallest finger) and index finger, while keeping the others folded back.
  • The “o” sign, made by joining the thumb and index finger, is considered sexually insulting.
  • Many Maltese consider the “v” sign, made by extending the index and middle finger with the palm facing outwards, to be a rude gesture.

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

  • An arm’s length is generally considered an appropriate amount of space when communicating.
  • Hugging is a very big part of Maltese culture amongst family and good friends.
  • Maltese may manoeuvre their way through a crowd rather than wait in a queue, for example, to ensure they get a good seat on a bus.

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

  • Maltese are generally not punctual. Instead, they tend to practice flexibility with time.
  • Maltese do not take lateness personally.
  • For some, even appointments, schedules and meetings are adjustable and breaks are taken when appropriate. For others, punctuality is expected and appreciated for business meetings.

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

  • Malta was ranked 108th on a global index measuring gender equality out of 144 countries. (World Economic Forum, Global Gender Gap Report 2016).

Marriage

  • Traditionally, Maltese men were the providers in the family. Women resigned from employment upon marriage to raise children and tend to household duties, however this is no longer the case.
  • The gender roles and attitudes of women in the workforce are continuing to change. Younger generations of women are employed, although there are pay disparities between men and women.
  • Whilst men may help with some household duties, there continues to be a considerable division of duties based on gender. Cooking, spring cleaning and many other domestic duties are generally expected to be performed by females.
  • Marriage is considered sacred and a lifelong commitment and couples often stayed married because they feel it is the right thing to do.

Same-sex Relationships

  • Many Maltese, especially the younger generation, are open towards same-sex relationships.
  • A gender identity bill was passed into law in 2015.
  • Civil unions and adoptions by gay couples are legal in Malta.

Rainbow Europe index

  • Malta is one of the most LGBTI friendly countries in the world.
  • Malta scored 87.75% and is ranked 1st on the Rainbow Index for LGBTI friendly countries. On this scale, 0% represents gross violations of human rights and discrimination and 100% represents respect of human rights and full equality. (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.

Statistics on Dementia in Malta

  • It is estimated that there were 5301 people living with dementia in Malta in 2012. This represented 1.26% of the total Maltese population, which is one of the highest rates of dementia worldwide. (Alzheimer’s Europe 2012).

Attitudes and understanding of dementia in Malta

  • Common misconceptions include; the belief that symptoms of dementia are the consequence of old age and that the symptoms of dementia will pass.
  • Dementia is still considered a “taboo” subject by some Maltese.

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, family members take care of their elderly parents, and often make sacrifices to ensure their loved ones final years are happy and peaceful.
  • Residential care is often considered as a last resort with preference to remain in their own homes as long as possible.
  • Reluctance to accept placement into residential care comes from a range of factors including the different type of food and missing home.
  • More recently, families are utilising residential care facilities for their relatives.

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

  • Medications and pain relief are generally accepted by Maltese, although some people may prefer to use home remedies first.
  • Euthanasia is generally not accepted, following the teachings of the Catholic Church.
  • 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

  • For many Maltese, it is preferable if death and dying are referred to indirectly.
  • Upon a persons’ final moments of life, the family and priest are usually in attendance, and they generally stay until the person passes away.
  • It is common for Maltese to pray for the souls of the departed.
  • The house of the deceased is visited by people wishing their condolences to the family.
  • An old custom following the death of a family member was to cover all the mirrors in the house with black cloth. This was done as a sign of respect and vanity was considered to disrespect the dead. This custom is not widely practiced today, however relatives of the deceased may place a small black cloth on the door-knocker.
  • A sound understanding of the dying patient’s meaning of end of life care is imperative to truly deliver individualised palliative care.

Burial

  • A Catholic burial is most common, but cremation is becoming accepted.
  • Rosary prayers are often held the night before burial and may include the viewing of the body.
  • Family graves, which accommodate four or five coffins, are considered more honourable than common graves.
  • Preparation of the body and funeral services follow the Catholic Church procedure.
  • Following the burial people gather at the deceased person’s home for refreshments.
  • A Requiem Mass is usually held for the deceased and annually on the anniversary of death, and for some families also more often.
  • Some women will wear black whilst mourning, and men may wear a black arm band and black tie.
  • Customs are rapidly changing and the duration that black is worn varies depending on the individual and on the closeness of the relationships to the deceased person. For example; a wife might wear black for a year or more, children for much less.

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

  • Maltese culture defines correct behaviour and conduct in a variety of ways depending on age, familiarity, status and social connections.
  • Maltese consider “saving face” behaviour to be important as it protects their family honour as well as respect for individuals.
  • Being bare chested and wearing beach attire, such as bikinis and short shorts, are only considered appropriate for the beach.
  • Appropriate attire is also considered important when attending church.

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

  • A common Maltese superstition is the “evil eye”. Many Maltese believe that the “evil eye” (which is often described as a curse from a look, or comments made to them) is something that might tempt their fate for example; by causing them misfortune or injury. Either the sign of the cross, or “Qrun” (bull’s horn) is used to ward off the evil spirit of the “evil eye”. To make the bull’s horn sign, one needs to extend their pinky (smallest finger) and index finger, while keeping the others folded back.

Some other Maltese superstitions include the following:

Bad luck superstitions

  • Breaking a mirror
  • Spilling salt or oil
  • Wearing new clothes on Friday
  • Working on Good Friday.

Good luck superstitions

  • Money, or a ring soaked in a child’s bath water
  • Seeing a white moth
  • Spilling wine

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

  • Maltese food is often rich and seasonal.
  • Cultural traditions relating to Catholic religious activities include; abstaining from meat on Ash Wednesday (the first day of Lent) and Good Friday. Some Maltese people do not eat meat on any Friday.
  • Feasts days are celebrated to commemorate various Saints (refer to Special Days).

Breakfast

  • Often consists of a cup of tea or coffee and toast.

Main meals

  • Soup, such as “Minestra” may begin a meal.
  • Homemade vegetable soup and chicken soup are often very popular with elderly Maltese.
  • Meals often include pasta, meat and vegetables, followed by dessert or fruit.

Other popular Maltese dishes include

  • Bragjoli – a roulade of beef served with gravy
  • Lampuki pie – a pastry covered fish casserole made with spinach, cauliflower, chestnuts and sultanas
  • Stuffed octopus, squid and cuttlefish served with tomato sauce.
  • Roasts.
  • Ravioli with ricotta filling serviced with tomato sauce.
  • "Qassatat tal-irkotta" (Ricotta pies).
  • Hot Pastizzi – that include ricotta cheese, peas, meat or anchovies encased in pastry. These are a popular finger food.

Specialty food for ceremonial occasions

  • Tender lamb is eaten at Easter.
  • Rabbit stewed in wine, and it is common for the sauce to be served with pasta as a first course.

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 Maltese people

  • Family support is an important priority within the Maltese community and they often make sacrifices to help enable their relatives to live happy and peaceful final years.
  • Many Maltese people regard old age as something vulnerable.
  • The pressures of modern life have made it more difficult for families to take care of their ageing family and more recently residential care facilities are being sought.

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

  • Malta is rich with cultural traditions, many of which relate to religious activities such as feasts, processions and fireworks to honour patron saints.
  • Family and protecting family honour is important.
  • Maltese people are usually very helpful and hospitable people.
  • Maltese may have a relaxed manner when it comes to adhering to rules, although this varies from person to person.
  • Maltese can be quite persuasive and some do not like to take ‘No’ for an answer.

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 Malta.
  • Celebrations are predominantly religious, with daily church services taking place during the Holy Week of Easter, to commemorate the death and resurrection of Christ.

Key religious events of Easter

  • The first day of Lent is Ash Wednesday. This is considered the most important religious day in the calendar as it opens the Easter season of fasting and prayer. There are 46 days between Ash Wednesday and Easter and no meat is eaten on this day.
  • Holy Week begins a week prior to Good Friday (the day of Christ’s crucifixion) and is marked by the statue of Our Lady of Sorrows being carried through the streets of various Maltese towns and villages with a procession of the faithful.
  • Palm Sunday is the Sunday before Easter and marks the last seven days of Christ before His death and resurrection.
  • Maundy (or Holy) Thursday is the eve of Good Friday and marks the final supper of Christ with the Apostles. Celebrations may include “Washing of the Feet” and people may visit seven different churches.
  • Good Friday is the day that marks the crucifixion of Christ. People gather to celebrate the passion of Jesus and meat is not eaten on this day. Within many towns and villages in Malta, a procession of statues takes place in the streets and participants represent biblical characters.
  • Easter Sunday marks the day of Christ’s resurrection, and this is a joyful time. Church bells ring and a procession of the Risen Christ moves through the streets. People celebrate with their family by sharing a special lunch and good wishes to one another. Traditionally, people give chocolate Easter eggs and ‘figolla’ an almond-filled pastry covered in icing sugar. Figolla come in various shapes such as rabbits, lambs, fish or hearts.

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 from 24th December to 25th December and is an important time of year for Catholic Maltese.
  • The majority of the Maltese population is Catholic so the Midnight Mass Service church services are full.
  • Along with Christmas trees and Christmas lights, cribs (known as presepju) are put up in public as well as in homes. The cribs made of clay, representing the crib of baby Jesus, are filled with figurines (called pasturi) to recreate the nativity scene.
  • Another tradition is to sow seeds (including wheat, grain and canary seeds) on cotton buds five weeks before Christmas. These produce grass-like shoots that are used to decorate the crib or figurine of baby Jesus.
  • It is traditional for a young child to deliver the church sermon on Christmas Eve and on Christmas Day during mass. This tradition is called ‘Priedka tat-Tifel.’
  • In Maltese Happy/Merry Christmas is 'Il-Milied it-Tajjeb'.
  • A popular Maltese Christmas carol is “ninni la tibkix izjed” (sleep and cry no more).
  • Christmas in Malta is a time of celebration with family and is the feast or the occasion of loving, giving, a time of presents and getting together.
  • Traditional Christmas food would include; a roast chicken, “hasi”, in a casserole full of potatoes and vegetables, “Qaghqa tal-Ghasel” (Honey/Treacle ring biscuits) for dessert and “Imbuljuta tal-Qastan” (hot Chestnut and Cocoa).

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's Day is celebrated.
  • Celebrations begin on New Year’s Eve, 31st of December and continue until New Year’s Day.
  • New Year is a joyous event where spirits are high and people are full of energy.
  • Malta is known as one greatest party destinations within Europe.
  • Celebrations on New Year’s Eve include dining in restaurants, visiting clubs and pubs and being part of the community atmosphere.
  • Champagne and wine as well as the best Maltese food are featured during this time of 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

In addition to religious holidays such as Christmas and Easter, the Maltese have a number of other religious festivities and cultural events, such as:

  • 10th February – Feast of St. Paul’s Shipwreck

This is the first major feast day of the year celebrated in Malta. Saint Paul brought Christianity to the islands and is the patron saint of Malta. As recorded in the New Testament of the Bible, on this day in 60AD Saint Paul was shipwrecked on Malta.

  • 19th March – Feast of St. Joseph

This is a public holiday in Malta to celebrate Saint Joseph, the husband of the Blessed Virgin Mary.

  • 31st March – Freedom Day

Malta celebrates with a public holiday on the

  • 7th June – Sette Giugno

Maltese commemorate the 1919 riot that took place as a result of unemployment, low wages and the high cost of living, and four Maltese were killed by the British Army. It is a day for remembering the fallen and reflecting on history and identity as a distinct people.

  • 29th June - Feast of St. Peter & St. Paul

This Maltese national holiday is to celebrate two great Saints, Peter and Paul. It is common for celebrations to be held in the Buskett gardens and include cooked rabbit and folk music.

  • 15th August – Feast of The Assumption of the Virgin Mary

This Feast Day is celebrated by Maltese Catholics to commemorate the passing away of the Blessed Virgin Mary and her bodily assumption into Heaven.

  • 8th September – Feast of Our Lady of Victories

This public holiday in Malta commemorates the end of the 1565 Great Siege and the end of the French occupation in 1800.

  • 21st September – Independence Day

A day Malta celebrates gaining independence from Britain in 1964.

  • 2nd November – All Souls Day

This day commemorates the faithful departed. Maltese usually attend Mass and visit cemeteries.

  • 13th December – Republic Day

A celebration of when Malta became a republic in 1974.

More recent cultural events of Malta include:

  • The Malta Fireworks Festival
  • The Malta Arts Festival
  • Notte Bianca
  • The Malta Jazz Festival
  • Mediterranean Gozo

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

  • Maltese place high importance on leisure time.
  • Favourite activities include; watching TV, reading books, going out with the family, swimming, craftwork,  listening to music, cooking and gardening.
  • Malta is known for its lace, which dates back to the Knights of Malta period.
  • There are still modern day lace makers that keep the traditional Maltese craft alive.

Reminiscence

  • Smell or taste - Using smell kits, different cultural foods. Suggestions include; oranges, lemons, marjoram, mint, basil, thyme, garlic, cinnamon, cloves, anise and coriander.  
  • Sight - Cultural photographs, cookbooks, slides, films, painting pictures, looking at objects. (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

  • Traditional Maltese folk music (known as “Ghana” in Maltese) originated in the 16th century.
  • Ghana is believed to be a combination of Sicilian ballads with Arabic music.
  • Traditional Ghana included a folk singer (ghannej) and other musicians who would accompany the singer. More recently the “ghannej” is accompanied by three guitarists.
  • Traditional instruments include; the “zaqq” (a type of bagpipes), the “zavava” (a drum), the “tambur” (tambourine) the “argunett” (a mouth harp) as well as the accordion.
  • There are two main types of Maltese folk singing (ghana); Botta U Rispota (or Spirt u Pront) and Ghana Tal-Fatt.
  • Botta U Rispota is considered the most popular form of “ghana” and usually includes two singers that have a “sing off”. Each singer takes turns improvising new verses on the spot.
  • In Ghana Tal-Fatt, the singer usually sings a melancholic tale that ends in tragedy.

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