+ 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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Vietnamese

Generalist

  • Vietnam is located in the continent of Asia (specifically South Eastern Asia).
  • Hanoi is the capital city of Vietnam.
  • Vietnam shares land boarders with China, Laos and Cambodia.
  • Vietnam is the 66th largest country in the world, with a total area of 4616 square kilometres.
  • The population of Vietnam is 95,261,021 (Central Intelligence Agency, 2016).
  • The major ethnic groups of Vietnam include; Kinh (Viet) 85.7%, Tay 1.9%, Thai 1.8%, Khmer 1.5%, Muong 1.5%, Mong 1.2%, Nung 1.1%, Hoa 1%, other 4.3%.
  • The climate of Vietnam is tropical and monsoonal, with rainy, warm and dry seasons.

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

  • The first group of Vietnamese permanent migrants to Australia, were wives of Australian troops that married Vietnamese people.
  • Between 1972 and 1975, many Australian families adopted Vietnamese orphans (whose parents were killed in the Vietnam War).
  • The majority of Vietnamese migration to Australia occurred between 1975 and 1985, after the end of the Vietnam War, when many Vietnamese fled their country in fishing boats and arrived in Australia as Refugees.
  • Since the early 1980s, many Vietnamese have been sponsored to Australia by family members.
  • The Vietnamese community is Australia is one of the largest culturally and linguistically diverse groups.

History of Vietnam

  • Refer to History Resources

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

  • Vietnam is considered a “collectivist” culture.
  • This means that there is a strong commitment to the ‘group’ whether that be family, extended family or extended relationships.
  • Vietnam scores 20 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, and high numbers indicate “individualist” cultures.

Tips

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

Resources

Generalist

In Vietnam

  • Vietnamese people with religious affiliations are predominantly; Buddhist (7.9%), Catholic (6.6%), Hoa Hoa (1.7%), Cao Dai (0.9%), Protestant (0.9%) or Muslim (0.1%) (Central Intelligence Agency 2009).
  • A large proportion of Vietnamese people do not have religious affiliations (81.1%) (Central Intelligence Agency 2009).

In Australia

  • The main religions of Vietnamese-born Australians include: Buddhism and Catholicism (Australian Bureau of Statistics, 2011).

General

  • Vietnamese culture and concept of life has been deeply influenced by religions, including; Buddhism, Confucianism and Taoism.

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

  • Extended family is the dominant Vietnamese family structure.
  • Multiple generations (up to three or four) may live in the same household.
  • Vietnamese families are traditionally patriarchal whereby the father or eldest son will make the important decisions for the family. The mother is considered to hold responsibility for family harmony, and may also be responsible for the family budget and schedules.
  • Family often plays a strong role in patient communication and decision making and the care recipient generally accepts the authority of the family.
  • Respect for elders is important and traditionally, they are taken care of by their family.
  • Elders had a strong influence in decision-making in Vietnam, however, in Australia they often don’t have the same influence (due to a lack of money and land) and some are financially dependent on their children.
  • Some Vietnamese elders in Australia are isolated (both socially and culturally) from younger generations.
  • Vietnamese people have great respect for deceased ancestors and often believe that the dead influence the living.
  • Relatives pay respect to their ancestors, and on the anniversary of a person’s death ceremonies are held in their honour. Deceased ancestors are also remembered during certain festivals and they may be ‘consulted’ prior to decisions or occasions (for example; a wedding or birth).

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

Resources

Generalist

In Australia

  • In Australia, Vietnamese-born people mainly speak Vietnamese, Cantonese and English (Australian Bureau of Statistics, 2011).
  • Over half the Vietnamese-born Australians who speak another language other than English at home, 56.5% spoke English very well or well. A considerable proportion (42.1%) however do not speak English well or not at all (Australian Bureau of Statistics, 2011).
  • English literacy is generally very low for elderly Vietnamese in Australia and this can create barriers to accessing relevant aged care and support services.

In Vietnam

  • Vietnamese is the official language of Vietnam.
  • Other languages spoken in Vietnam include; English, Chinese, Khmer, French and mountain area languages such as Mon-Khmer and Malayo-Polynesian (Central Intelligence Agency, 2016).
  • Vietnamese is a tonal language, and with each syllable there are six different tones that can be used. This changes the definition and can make it difficult for foreigners to understand the language.

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

Man greeting man

  • A gentle, brief handshake is the most common form of greeting.
  • Some people may use a two handed handshake when greeting (arrivals and departures).

Woman greeting woman

  • Handshakes are a common type of greeting.
  • A nod of acknowledgement is also often used.

Man greeting woman

  • Handshakes (initiated by the woman) are a common type of greeting.
  • A nod or slight bow may also be used in place of a handshake.

Naming conventions

  • Vietnamese people may prefer to be referred to by their title such as; Dr, Mr or Mrs.
  • Traditionally, Vietnamese people write their surname first, then their middle name and lastly, their given name.
  • Many Vietnamese names are unisex.
  • Vietnamese people commonly adopted western names.

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

  • An indirect communication style is generally preferred, whereby people imply what they mean without saying it.
  • Loud tones and excessive gestures during conversation are usually considered rude.

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

  • Indirect eye contact tends to be preferred by Vietnamese, over direct eye contact.
  • When speaking with older or more superior people, Vietnamese people may bow their heads and avoid eye contact, as a sign of respect.
  • Overtly direct eye contact may be considered threatening or suspicious.

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

  • Vietnamese people, as with many other Asian cultures, may prefer limited or no physical contact.
  • Shoes should be removed before entering a Vietnamese home, place of worship, or hotel room.
  • It can be considered rude to beckon to another person by pointing. Instead, Vietnamese extend their arm whilst doing a scratching type of motion with their fingers.
  • It can be considered an insult to cross your legs and point your foot at another person.
  • Vietnamese people usually use two hands to pass or receive an object.

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

  • About an arm’s length of distance is appreciated when Vietnamese talk with other people, especially if the person is not well known.
  • Personal space when speaking with friends and close acquaintances may be closer.
  • Generally there is minimal touching during conversations, although there may some touch between friends and close acquaintances of the same sex.
  • Men and woman do not generally touch whilst conversing.

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

  • Vietnamese people are generally not punctual. Instead, they tend to practice flexibility with time.
  • Time is viewed in relaxed way by most Vietnamese with greater emphasis placed on people and relationships, rather than schedules and deadlines.

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

  • Vietnam has a male dominated society, and although constitutionally women are equal to men, there is more respect and greater opportunities provided to men.
  • Vietnamese women avoid wearing revealing clothing and avoid heavy makeup.

Global Gender Gap Index 2016 rankings

  • Vietnam ranked 65th on a global index measuring gender equality out of 144 countries. (World Economic Forum, Global Gender Gap Report 2016).

Marriage

  • Law gives men and women the same legal rights in marriage.
  • Unmarried people are forbidden to live together as husband and wife.
  • Women have equal rights to parental authority, however, men are traditionally the head of the household.

Inheritance

  • Vietnamese Civil Code indicated that men and women have equal opportunity to write a will or benefit as an heir, however there are still some inequalities. For example; if a person dies without a will, the custom is for the eldest Vietnamese son to inherit the parental home and largest amount of property. Other sons will receive some assets, whilst daughters may only receive small symbolic items.

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.

Vietnamese perceptions of dementia

  • The term ‘dementia’ and ‘Alzheimer’s disease’ are familiar amongst many of the younger Vietnamese community members, although knowledge on the disease is limited.
  • There is a common misunderstanding that dementia is a normal part of ageing, and is an unavoidable part of growing old.  However this is not true.
  • The perception that dementia may be brought on by excessive thinking and worrying also exists amongst some members of the Vietnamese community.
  • There is a concern of the negative perception of dementia, and this can create feelings of anger and defensiveness.
  • The perception of dementia is closely linked to religion and spirituality.
  • There is a common belief amongst some Asian cultures that illness and suffering are a part of life. This can cause delays in people seeking medical assistance both traditional and Western treatments.
  • Traditionally, mental illness is feared or denied and considered shameful within Vietnamese culture and families may hide away their ill family member until they are no longer able to provide care for them.

Attitudes towards counselling

  • Counselling is an unfamiliar term amongst many elderly Vietnamese people.
  • Vietnamese people often tend to talk to friends, relatives or religious leaders to seek their advice or alternatively, they try to cope on their own.
  • Whilst younger Vietnamese community members may be more willing to seek support, there is a common concern for confidentiality.

Communication of diagnosis/prognosis

  • Negative stigma may be associated with illnesses such as cancer. It may be believed that the person committed wrongdoing in a previous life to have brought on cancer. Others may believe that exposure to chemicals during the Vietnam War may have caused the disease.
  • Family members may wish to avoid their dying relative learning about their diagnosis and prognosis. This can stem from the idea that they may give up hope and the will to live.

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

Attitudes towards community care

  • Community care services do not exist in Vietnam so consequently many Vietnamese people are unfamiliar with the health service system in Australian or their rights.
  • The language barrier often prevents access to services for older Vietnamese people.
  • Community care services are generally accepted if they are delivered by Vietnamese speaking workers and this is often supplemented by family care.
  • Vietnamese carers are often reluctant to open up about the need for emotional support.

Attitudes towards residential care

  • Residential care is generally viewed in a negative manner and is only considered as a last resort.
  • Community options with care provided in a culturally appropriate manner are generally preferred, although residential care may become more accepted in the case of late stage dementia.
  • In Vietnam, residential care facilities are considered to be for those people whose family have deserted them.
  • Traditional expectations that family will care for the elderly contributes to the reluctance to seeking residential care placement. This expectation is shifting for Vietnamese in Australia as people are often required to work as well as care for their own children, which can mean that providing primary care to elderly parents is not always realistic.
  • Elderly Vietnamese people may feel abandoned or depressed if placed into a residential care facility.
  • Health professionals are generally well respected and their advice will not be questioned.
  • It may be considered bad luck for the family if a relative does not die at home, so if possible the family may wish to take their relative home for their final moments.

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

  • Vietnamese people may use a combination of western and traditional medicines such as; herbal remedies, tonics and massage. Other treatments including; acupuncture, “cao gio” (rubbing oiled skin with a coin or a spoon) and cupping may also be used. Traditional methods may leave bruises or marks, which should not be confused as signs of abuse.

Attitudes to pain relief

  • Pain medication is usually accepted by Vietnamese people and self-medication is common.
  • Practices such as forcefully rubbing a coin on areas of the body, such as the shoulders or the chest are done by some, with the aim to clear ‘poison’ from the air.
  • Buddhists may use meditation to manage pain.
  • For some Vietnamese people, endurance and stoicism are considered indicators of strength of character.
  • Preserving harmony and not drawing attention to oneself is considered important and although pain or sadness may be experienced, it is often not displayed.
  • Pain behaviour studies suggest there is a need to be cautious of ethnic or cultural stereotypes. Therefore, even though there are findings of general cultural differences it is considered very important to evaluate the pain of each person individually.
  • Clinical recommendations regarding pain treatment are available in the “Attitudes to pain Resources” section of this app.

Tips

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

Resources

Generalist

  • The type of rituals that take place during the end of life depend on the religious affiliations of the dying person and their family.
  • Vietnamese Catholics pray to God and for their loved one to reach Heaven.
  • Vietnamese Buddhists seek consultation from Monks in preparation for the dying process.
  • The last minute of life is considered significant amongst many Vietnamese people, therefore relatives and friends will be present whenever possible.
  • It is believed that the body of the deceased should be at the home of the family for one day, otherwise the spirit will get lost and this will cause bad luck to the family.
  • Vietnamese people are generally not fearful of the use of words death, dying and cancer, however discussions of death and dying may be limited.

Buddhists

  • Death is not considered the end of life, but rather the end of the body that is inhabited. It is believed that the person’s spirit will exist in a new body.
  • Prior to death, the dying may wish to give away possessions and delegate responsibilities. This is considered important to allow them to ‘let go’ of this world and generate good karma.
  • The final moments of one’s life are for prayers and chanting (often facilitated by monks) to help the dying to let go of negative thoughts and reflect on the teachings of Buddha.
  • After the death of a Vietnamese person, it may be preferred that their body is not touched for 3-8 hours.
  • The family may wish to bathe the body with incense and spiced water.
  • White may be worn by family and friends at the funeral.
  • Cremation may be preferred as ashes are traditionally stored at Temples with a photograph of the deceased.
  • For the 49 days following the death, Buddhists pray to assist the transition of their loved one into the next life (as Buddhists believe in rebirth).
  • Buddhists often view stoicism as an indicator of strength of character and as such emotional displays of grief may be avoided.

Catholics

  • It is important that a Catholic family is offered the opportunity to have a priest to administer Communion and the Last Rites.
  • A funeral following Catholic Church protocols will often take place.
  • Following the funeral, a period of mourning will be observed.

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

  • It is considered taboo to touch or pass an object over a person’s head as Vietnamese consider the head to be a sacred part of the body.
  • It may be interpreted as a sign of anger to stand with hands on your hips or to stand with your arms crossed.
  • Many Vietnamese perceive crossing your index and middle fingers as an obscene gesture.
  • Touch is minimal in daily interactions with others. One should avoid touching someone on the shoulder, and especially avoid touching members of the opposite sex.
  • Items should be passed with both hands.

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 range of superstitions may be believed amongst the Vietnamese community. Some of these are listed below, however, it is important to note that beliefs vary between individuals.

  • It is considered bad luck to cut nails at night.
  • The hoot of an owl is considered an omen of impending death or illness.
  • One sneeze means that someone is talking ill of you, two sneezes indicates good things.
  • If an earlobe is scratched it means that whispers about you are being shared.
  • Wearing a white headband is symbolic of an upcoming death as Buddhists often wear white headbands after the death of family members.
  • Exchanging a toothpick with someone you love is thought to be symbolic of a growing rift between you.
  • Leaving rice in your bowl may lead to ill coming between wives and their husbands.

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

  • Vietnamese cuisine varies amongst the different regions and has Chinese, Cambodian (Khmer) and French influences.
  • A key staple food in Vietnam is rice.
  • Fermented fish sauce (called nuoc mam) is a widely used seasoning.
  • “Pho” is often claimed to be the “national dish” of Vietnam, and it is eaten at any time of the day (breakfast, lunch or dinner). This dish is a rice noodle soup, which includes thinly sliced meat.
  • Vietnamese cuisine includes; a range of salads, stir-fry, noodles, meat and seafood dishes, and a wide variety of fruit and vegetables.
  • Spring rolls, summer rolls/cold rolls (rice paper with fillings) and fried/steamed rolls are eaten across seasons as well as on special occasions.
  • Full moon cakes are made and eaten especially on Ancestor’s Day, which is also known as the Full Moon Festival.

Fasting

  • Catholics may fast on specific days such as; Good Friday and Ash Wednesday.
  • Buddhists may also fast on specific days.

Dining Etiquette

  • It is considered polite to bring either fruit, sweets, flowers, or incense to give to the Vietnamese host if invited for dinner.
  • Gifts to hosts should not include handkerchiefs, chrysanthemums, yellow flowers, or anything black due to superstition.

Table Manners

  • You should wait to be directed to a seat before sitting down.
  • The oldest person should be the first to sit.
  • Meals are usually served in a family style whereby each person will serve portions at the table.
  • Dishes should be passed with both hands.
  • Bowls are held close to the face when eating, especially when using chopsticks.
  • Chopsticks should be placed on the table or rest between mouthfuls to allow for a break to drink or speak.
  • Utensils usually include chopsticks and a flat spoon.
  • The spoon is generally held in the left hand for soup.
  • It is considered polite to finish everything on the plate.
  • To indicate that you have finished a meal, place the chopsticks on top of your rice bowl.
  • If using a toothpick, you should cover your mouth.

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. 
  • Commonly, people with dementia want to retain their independence for as long as possible and they rely on the community care system to help them achieve this.
  • Vietnamese people have great respect for their elderly and some families may feel advising their elderly member they have dementia is disrespectful as it may lead them to lose hope.
  • Whilst families and care recipients in Australia may both be told the diagnosis, families may prefer to keep this information from the care recipient.
  • Vietnamese people generally accept Western medicine for the treatment of dementia. This may be complimented with Chinese medicine such as herbs and acupuncture, as well as prayer.

Role of the family

  • As Vietnamese elderly are greatly respected, it is considered the duty of the children to care for their parents.
  • Traditionally, the caring role falls on the son, however, in Australia the care of parents is often shared by daughters and sons and it is also common for the role of carer to be taken on by the spouse of the person with dementia.

Role of health professionals/volunteers

  • Health professionals and volunteers are generally welcomed into the home to assist with care, however there is a preference for Vietnamese carers.
  • Vietnamese family carers may be hesitant to accept emotional support and services. Subtle offers of a ‘chat’ and practical help from counsellors and community services may effective and help avoid the home carer ‘losing face’.
  • Doctors are highly respected therefore volunteers and support services may be better adopted on the referral of the doctor.
  • Questions should be worded carefully to avoid affirmative responses when the person really means ‘no’.

Health Beliefs and Practices

  • Vietnamese people often manage their own medications.
  • Western medicines may be used in conjunction with more traditional remedies. For example; Chinese medicines such as tonics, herbal remedies and massage may be used.
  • The skin may also be rubbed with oils and then rubbed with the edge of a coin or spoon (known as cao gio), or cupped. These can create bruises or marks and should not be confused as a sign of abuse.

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

  • An important Vietnamese cultural value is respect for elders. Any insult to elders or ancestors is considered serious and can have consequences such as the loss of social ties.
  • Whilst traditional Vietnamese families have a patriarchal structure, the mother is responsible for family harmony, as well as taking care of budgets and schedules.
  • Another key cultural value is the importance of family and community, which comes before benefit to the individual.
  • Vietnamese people are very polite, reserved and they will avoid confrontation. To express disagreement they may be non-compliant or avoid answering a question.
  • Modesty and privacy are also values of the Vietnamese culture.

Confucianism

  • The position of an individual in Vietnamese society is influenced by Confucianism.
  • Confucianism emphases: duty, loyalty, honour, filial piety, respect for age and seniority, and sincerity.
  • This includes a system of behaviours and ethics as well as the obligations of people to one and other depending on their relationship. The relationships include:
    • Ruler: subject
    • Husband: wife
    • Parents: children
    • Brothers:  sisters
    • Friend: friend

Face

  • The concept of ‘face’ is important to Vietnamese people (as it is with many Asian cultures).
  • Face relates to a person’s reputation, dignity and prestige.
  • One can lose face, save face or give it to another.
  • Public humiliation can lead to a loss of face, whilst complimenting someone can give face.
  • Understanding the basic concept of face can be helpful in building and maintaining a positive relationship with people from cultures where it is considered important, such as the Vietnamese.

Hierarchy

  • Hierarchy is followed in Vietnam. This is derived from Confucianism which highlights social order.
  • Everyone has a role and place within society, both within their family and their workplace.
  • The oldest person in a group is considered to be of the highest social order and should be greeted and served first.
  • The head of the family is usually the oldest male, and he is responsible for making decisions and giving approval for marriages.

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

  • Vietnamese people do not generally celebrate Easter, unless they are Christian.
  • Catholics usually hold Easter celebrations from Thursday to Saturday, concluding with a family gathering on Saturday night.

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 Vietnam.
  • Christmas Eve is often more important the Christmas day.
  • Christianity is not the major religion in Vietnam, however, many Christians will gather in the centre of Ho Chi Minh City (formerly Saigon) at a Catholic Cathedral on Christmas Eve.
  • Historically, Vietnam used to be part of the French Empire and some French influences such as Christmas traditions can still be seen in Vietnam.
  • Large department stores and hotels usually display Christmas decorations and lights.
  • Catholic churches often have nativity displays.
  • The city streets on Christmas Eve are often full of people enjoying the Christmas displays, enjoying food and taking photographs.

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

  • Tet (New Year) is celebrated in Vietnam at the beginning of the lunar calendar (on the 1st day of the 1st month).
  • This celebration usually this falls in late January, or sometimes in early February, of the Gregorian calendar.
  • Tet is a significant holiday in Vietnam. Each New Year is considered a clean slate with new opportunities for success.
  • Vietnamese people make preparations for Tet such as; thoroughly cleaning and decorating their houses, and purchasing new outfits.
  • Festive foods such as “banh chung” and “banh”, (which contains rice with meat or bean fillings wrapped in leaves), are very popular.

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

  • For exact dates of some Vietnamese special days and holidays, refer to the lunar calendar.

1st day of 1st month - the Tet Nguyen Dan (or Tet)

  • Tet is the celebration of Vietnamese (and Chinese) New Year, as well as remembrance of ancestors. It is the largest and most popular festival of the year. Celebrations can last up to seven days. Many people believe that Tet will set the omen for the course of the rest of the year, so if one eats a lot during Tet, there will be plenty of food for them for the rest of the year.

8th day of the 4th month – Buddha’s birthday

  • Public holiday to commemorate the death of the Buddha as well as to celebrate the birth and enlightenment.

30 April – Reunification Day

  • Commemorates the fall of Saigon and ending of the Vietnam War.

1 May – Labour Day

  • A public holiday in Vietnam to celebrate workers

19 May - Ho Chi Minh's birthday

  • A public holiday in Vietnam to commemorate an outstanding politician that greatly assisted with the independence of the country.

June – Doan Ngu

  • Marks the opening of summer solstice.

15th day of the 7th Month – Wandering Souls Day

  • Souls of the dead are believed to wander into homes of their families. Buddhists pray for the souls of the dead and families spread food around their homes and burn fake money in their honour.

15th day of the 8th Month - Tet Trung Thu (Mid-Autumn Festival)

  • This festival honours the harvest and family. During this time it is a custom to give Banh Trung Thu or moon cakes which are filled with lotus seeds, ground beans, orange peels and a bright yolk in the centre. The festival is celebrated for an entire month.

2-3 Sept - National Day

  • A day that includes festivities such as parades, speeches and fireworks to celebrate the independence of Vietnam.

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

  • Types of activities Vietnamese seniors may enjoy include; tai chi, light exercises, group activities/games, gardening, cooking, crafts, painting and getting together to enjoy special occasions.

Reminiscence:

  • Smell or taste - Using smell kits, different cultural foods. Suggestions include; Vietnamese Coriander, Mint, Thai Basil, Lemongrass, Dill, Lime and Mango.
  • Sight - Cultural Photographs, Slides, Films, Painting pictures, looking at objects. (Refer to the “Cultural activities resources” section for some visual ideas). 
  • Touch - Touching cultural objects, feeling textures, painting and pottery. Pampering, massage hands, 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

  • Vietnamese music is diverse and combines traditional and foreign influences such as those from China, Korea, Mongolia, and Japan.
  • Champa, the former Indochinese kingdom, also influenced traditional Vietnamese music.
  • A range of musical compositions arose from the Vietnam War and the plight of Vietnamese refugees. Many are considered “classical anthems” in Vietnam and overseas.
  • Key musical writers include; Trịnh Công Sơn and Phạm Duy and, and popular singers include; Khánh Ly and Lệ Thu.
  • Composers in the North of Vietnam were influential in Vietnamese revolutionary songs known as “nhạc đỏ” or “Red Music”.
  • Vietnamese Buddhists may avoid music that stimulated unsavoury thoughts and prefer to listen to chanting.

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