Cultural Profile Resource: The

A resource for aged care professionals

Birgit Heaney Dip. 19/06/2016

A resource for aged care professionals

Table of Contents

Introduction ...... 3 Location and Demographic ...... 4 Everyday Life ...... ……………5 Gender Roles and Statuses ...... 6 Family ...... 7 Personal Hygiene ...... 8 Leisure and Recreation ...... 9 Religion ...... 10 Food and Diet ...... 11 Health ...... 12 Death and Dying ...... 13 Language ...... 14 Cue Cards ...... 14 Disclaimer ...... 15 References ...... 15

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A resource for aged care professionals The Philippines Culture Profile

Introduction This profile of The Philippines cultural community is just one of the many projects undertaken by Quality Aging.

This project aims to provide relevant information for community groups and residential aged care providers to implement “best practice” strategies of care for the older individuals from diverse backgrounds.

This project is about ensuring the needs of older persons from a Filipino cultural background are met.

Population trends within Australia are increasingly characterized by a diversity of people, languages and culture. Together with this trend is an aging population, also with a rich diversity of languages and cultures.

Not surprisingly then, that residential aged care providers are faced with growing demands for culturally responsive facilities and care.

This profile aims to create a tool to provide aged care providers with

 An awareness of the cultural and linguistically diverse needs of older persons from a Filipino background.

 It also strives to enable the professional capability and progress of staff in the provision of culturally inclusive care; and

 The organisation’s compliance with the Residential Care Standards and National Care Standards as they pertain to the issue of cultural and linguistic needs.

The profile provides beneficial information about a variety of subjects and resources.

This is a guide only and is not intended to replace one stereotype of this culture with another; it is only intended to provide some insight into the culture. Nor does it reduce the importance of you establishing the individual cultural needs of each person as part of your care planning process.

In an effort to continue to provide you with updated information of this profile and improve its contents, we encourage readers to provide feedback by contacting Quality Aging at [email protected]

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A resource for aged care professionals Location and Demographic

The Republic of the Philippines, a nation of 7,107 islands with a total area of 111,830 square miles (307,055 square kilometers), is located on the Pacific Rim of Southeast Asia. Two thousand of its islands are inhabited. Luzon, the largest island with one-third of the land and half the population, is in the north. Mindanao, the second largest island, is in the south. The Philippines are 1,152 miles (1,854 kilometers) long from north to south. The width is 688 miles (1,107 kilometers). There are no land boundaries; the country is bordered on the west by the South Sea, on the east by the Philippine Sea, on the south by the Celebes Sea, and on the north by the Luzon Strait, which separates the country from its nearest neighbour, Taiwan. The closest nations to the south are Malaysia and Indonesia. Vietnam and China are the nearest neighbours on the mainland of Asia.

The islands are volcanic in origin. Mount Mayon in southern Luzon erupted in 2000. Mount Pinatubo in central Luzon erupted in 1991 and 1992. Both eruptions caused destruction of villages and farms and displaced thousands of people from their tribal homelands. Because the country is volcanic, the small islands have a mountainous center with coastal plains. Luzon has a broad central valley in the Northern provinces along the Cagayan River and plains in the midlands near , the capital. Mindanao and Panay also have central plains. Northern Luzon has two major mountain ranges: the Sierra Madres on the eastern coast and the Cordilleras in the center. The highest peak is Mount Apo in Mindanao at 9,689 feet (2,954 meters).

The weather is hot because of the country's closeness to the equator. The temperatures are constant except during typhoons. The dry season is from January to June; the wet season with monsoon rains is from July to December. Temperatures are cooler in November through January, dropping below 30 degrees Celsius (85 degrees Fahrenheit). The summer months of April and May have temperatures in excess of 39 degrees Celsius (100 degrees Fahrenheit). Typhoons occur from June through November.

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Everyday Life Life in the Philippines generally revolves around the extended family, including parents, grandparents, aunts, uncles, cousins (up to several times removed), and other relatives.

For Catholic families, godparents—those to whom care of children is entrusted should the parents die or otherwise be incapacitated—also figure prominently in the kinship network.

Members of extended families typically gather for major life events such as baptisms and confirmations (for Catholic ), circumcisions (for Muslim Filipinos), and marriages, as well as for major religious and other national holidays.

Etiquette

People believe that it is one's duty to keep things operating smoothly. It is very important not to lose face. Being corrected or correcting another person in public is not considered acceptable behaviour. People want to grant all requests, and so they often say yes when they mean no or maybe. Others understand when the request is not fulfilled because saying no might have caused the individual to lose face. When one is asked to join a family for a meal, the offer must be refused. If the invitation is extended a second time, it is permissible to accept. Time consciousness and time management are not important considerations. A planned meeting may take place later, much later, or never.

Filipinos walk hand in hand or arm in arm with relatives and friends of either sex as a sign of affection or friendship. Women are expected not to cross their legs or drink alcohol in public. Shorts are not common wear for women.

People pride themselves on hospitality. They readily go out of their way to help visitors or take them to their destination. It is of the highest importance to recognize the positions of others and use full titles and full names when introducing or referring to people. Non-verbal language, such as pointing to an object with one's lips, is a key element in communication. One greets friends by lifting the eyebrows. A longer lift can be used to ask a question

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Gender Roles and Statuses

Division of Labor by Gender

Traditional roles prevail in rural areas, where men cultivate the land but the entire family is involved in planting and harvesting the crops. Women work in gardens and care for the house and children as well as barnyard animals. In urban areas, men work in construction and machine upkeep and as drivers of passenger vehicles. Women work as teachers, clerks, owners of -sari stores, marketers of produce and health care providers. Occupational gender lines are blurred since men also work as nurses and teachers. In the professions, gender lines are less important. Women attorneys, doctors and lawyers are found in the provinces as well as in urban areas.

The Relative Status of Women and Men

While families desire male children, females are welcomed to supply help in the house and provide a home in the parents' old age. Women's rights to equality and to share the family inheritance with male siblings are firmly established and are not questioned. The oldest daughter is expected to become an OSW to provide money for the education of younger siblings and for the needs of aging family members. Women are the familial money managers. The wedding ceremony can include the gift of a coin from the groom to the bride to acknowledge this role.

Since personal relationships and wealth are considered the road to success, women have an equal opportunity to achieve. Winners of beauty pageants are likely to succeed in the business and professional world, especially if the pageant was at an international level.

6 A resource for aged care professionals Family

Values  The family is central to Filipino culture. Filipinos have a very wide definition of family, often including a large ‘extended family’.

 Family members are often involved in important decision-making processes.

 ‘Hiya’ encompasses feelings of ‘embarrassment’, ‘shame’ or ‘loss of face’. Filipino-born people may feel very sensitive to social slight and as a result are very careful of the feelings of others.

 Visitors to a Filipino home are traditionally offered food or refreshments. Filipino-born people may be offended by a refusal of this offer.

Concept of Shame  Hiya is shame and is a motivating factor behind behaviour.

 It is a sense of social propriety and conforming to societal norms of behaviour

 Filipinos believe they must live up to the accepted standards of behaviour and if they fail to do so they bring shame not only upon themselves, but also upon their family.

 One indication of this might be a willingness to spend more than they can afford on a party rather than be shamed by their economic circumstances.

 If someone is publicly embarrassed, criticized, or does not live up to expectations, they feel shame and lose self-esteem.

Attitudes to Residential Care

There is an expectation by older Filipino-born people that the family will care for the sick or elderly parents.

Filipinos generally seek their families to look after them when they are sick or when they are no longer able to live at home.

Separation from families at this time, in a hospital or residential care facility, is very difficult.

Visits by relatives, close friends and church friends are very important at this time.

The latter are considered to be a part of the extended family. If this type of visiting could be facilitated by service providers it would be greatly appreciated.

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Personal Hygiene

Schedules and choices surrounding the following personal hygiene activities greatly affect the person’s sense of self, pride, dignity and confidence.

Bathing There are no particular customs in bathing; most Filipinos people prefer to shower daily.

Dress A significant portion of the Filipinos still retain their indigenous and traditional culture. Many Filipinos who live today in many foreign countries, commonly adopted the westernized style of dressing. Similarly this trend is also followed by the Filipinos living in Philippines who have the Austronesian descent.

The prominent ethnic groups of Philippines like Tagalog, Visayan, Bicolano and Moro have genuinely preserved a very traditional way of life and culture and even today they live with their folk heritage and traditional sport. In the traditional folk heritage of Philippines, the most spectacular feature is the traditional dress of Philippines.

The barong Tagalog or simply barong is a traditional attire from Philippines which is actually an embroidered formal garment used by both the Filipino men and women. Barong Tagalog is a very lightweight garment which is highly feasible outfit for the humid and tropic climate of Philippines. Filipinos wear Barong Tagalog not only for the formal dressing but also it is the most common traditional wedding costume in Philippines.

Barong Tagalog is stitched in a variety of fabrics in Pina fabric which is hand-loomed from leaf fibres. Barong Tagalog is also prepared with Jusi fabric which is mechanically woven and was once made from banana . Banana fabric is another sheer fabric used in formal occasions. Made and hand woven from banana fibre, it usually comes with geometric design details.

The Filipino women love to wear Baro at Saya, the Baro is the top blouse and the Saya is the skirt. Both of these Barong Tagalog & Baro at Saya are the unofficial national costume of Philippines. Baro at Saya was evolved with the passage of time as originally both the native sexes used to dress up with half-naked outfits. Gradually, the Filipino females started to cover the upper torso with short and sleeved blouses and it was later on named as Baro. Similarly, during the colonization era of almost 400 years in Philippines, a long and wrap around skirt was developed which was called as Saya. Traditionally Baro and Saya were made from sheer fabrics and today Baro at Saya comprises of highly expressed and skilfully . In modern times, Terno is another form of dress which has gained immense popularity among the Filipino women.

The traditional dress of Philippines like Barong Tagalog & Baro at Saya are real symbolic and allegorical in the cultural heritage of Philippines. Not only in day to day and formal usage, these traditional outfits are also worn by the folk performers in their diverse cultural appearances.

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A resource for aged care professionals Grooming Men and women look after themselves and are concerned about how they look. Women will prefer to wear makeup, jewellery, nail polish, perfume and have neat hair, that is be well groomed. Men tend to use cologne/aftershave, clipping nasal and ear hair and trimming nails etc.

It is important that the hygiene preferences of each person are established as part of the care planning process.

Leisure and Recreation

Dance is a mixture of Filipino and Spanish cultures. Professional dance troupes perform ballet, modern dance, and folk dance. Folk dances reflect a strong Spanish influence. Indigenous dances are used in historical pageants. An example is a bamboo dance relating a story about a bird moving among the reeds. People enjoy ballroom dancing for recreation. Barrio Fiesta Barrio Fiesta is a festivity being celebrated from region to region, according to their patron saint. Once again, this is predominantly put on by Catholic members of the community; however, everyone is welcome to join in the fun. Flores de Mayo Flores de Mayo, also called ‘Santo Crusan’, is held every year in the month of May. It is a religious celebration that honours the Blessed Virgin Mary through prayers, songs and offerings of flowers. Easter Sunday The Filipinos traditionally celebrate the occasion with family, usually after morning mass, and meet together as a large group. Families enjoy food sharing in the park and lots of activities for children. Misa de Gallo Misa de Gallo is a traditional 9 day pre-mass celebration before Christmas where a midnight mass is attended by families, followed by traditional midnight snack called Noche Buena.

A routine needs to be established with each individual relating to their personal preference.

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Religion Religious Beliefs. The Philippines is the only Christian nation in Asia. More than 85 percent of the people are Roman Catholic. The rosary is said in the home at 9 P.M. , just before the family retires for the night. Children are introduced to the statue of "Mama Mary" at a very early age. Protestant missionaries arrived in 1901 and followed the Catholic example of establishing hospitals, clinics, and private schools. The Church of the Latter Day Saints (Mormons) is currently the most active missionary group.

Sunni Muslims constitute the largest non-Christian group. They live in Mindanao and the Sulu Islands but have migrated to other provinces. Muslim provinces celebrate Islamic religious holidays as legal holidays. Mosques are located in large cities throughout the country. In smaller communities, Muslims gather in small buildings for services. Animism, a belief that natural objects have souls, is the oldest religion in the country, practiced by indigenous peoples in the mountains of Luzon.

Freedom of religion is guaranteed by the constitution. The disagreement between the Muslim population of the southern provinces and the federal government is not so much about religion as it is about political goals. Non-Catholics do not object to Catholic symbols or prayer in public venues.

Each barangay has a patron saint. The saint's day is celebrated by a fiesta that includes a religious ceremony. Large amounts of food are served at each house. Friends and relatives from other barangays are invited and go from house to house to enjoy the food. A talent show, beauty contest, and dance are part of the fun. Carnival rides and bingo games add to the festivities.

Religious Practitioners. Religious leaders are powerful figures. Business and political leaders court Cardinal Jaime Sin because of his influence with much of the population. Local priest and ministers are so highly respected that requests from them take on the power of mandates. A family considers having a son or daughter with a religious career as a high honour. Personal friendships with priests, ministers, and nuns are prized. Clerics take an active role in the secular world. An example is Brother Andrew Gonzales, the current secretary of DECS.

Faith healers cure illness by prayer or touch. "Psychic" healers operate without using scalpels or drawing blood. The several thousand healers are Christians. They believe that if they ask for a fee, their power will disappear. Patients are generous with gifts because healers are greatly respected.

Rituals and Holy Places. The major rituals are customary Christian or Muslim practices. Sites where miracles have taken place draw large crowds on Sundays and feast days. Easter is the most important Christian observance. On Easter weekend, the entire Christian area of the country is shut down from noon on Maundy Thursday until the morning of Black Saturday. International flights continue and hospitals are open, but national television broadcasts, church services, and shops and restaurants are closed and public transportation is sparse. People stay at home or go to church. Special events take place on Good Friday. There are religious processions such as a parade of the statues of saints throughout the community.

You need to establish each person’s religious preference and link them into a local minister of that religion.

Important cultural and religious days can be found in the Multi-Cultural Events Calendar

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Food and Diet Filipinos do not consider it a meal if rice is not served. Plain steamed rice is the basis of the diet. Three crops a year are harvested to provide enough rice for the population, and the government keeps surpluses stored for times of drought. Salt water and freshwater of fish and shellfish are eaten daily, served either fresh or salted. Fish, chicken and pork are usually fried, although people are becoming more health-conscious and often choose alternative methods of cooking.

Garlic is added to food because it is considered healthful. Filipino food is not spicy. All food is cooked on gas burners or wood or charcoal fires and is allowed to get cold before it is eaten. Rice is cooked first, since it takes longer. When it is ready, rice will be placed on the table while the next items of the meal are prepared and served.

Table knives are not used. Forks and spoons are used for dining. The food is eaten from a spoon. The traditional method of placing food on a banana leaf and eating with one's hands is also used throughout the country. It is acceptable to eat food with one's hands at restaurants as well as in the home.

Breakfast is served at 6 A.M. and consists of food left over from the night before. It is not reheated. Eggs and sausage are served on special occasions. Small buns called pan de sol may be purchased from vendors early in the morning.

At midmorning and in the afternoon, people eat merienda. Since Filipinos are fond of sweet foods, a mixture of instant coffee, evaporated milk, and sugar may be served. Coca-Cola is very popular. Sweet rolls, doughnuts, or a noodle dish may be available. Lunch is a light meal with rice and one other dish, often a fish or meat stew. Fish, pork, or chicken is served at dinner with a soup made of lentils or vegetables. Fatty pork is a favorite. Portions of small cubes of browned pork fat are considered a special dish.

Fruits are abundant all year. Several kinds of banana are eaten, including red and green varieties. Mangoes, the national fruit, are sweet and juicy. A fruit salad with condensed milk and coconut milk is very popular on special occasions.

Vegetables are included as part of a soup or stew. Green beans and potatoes are commonly eaten foods. The leaves of camote, a sweet potato, are used as a salad and soup ingredient. Ube, a bland bright purple potato, is used as a colorful ingredient in cakes and ice cream. Halo-halo, which means "mixture," is a popular dessert that consists of layers of corn kernels, ice cream, small gelatine pieces, cornflakes and shaved ice. Patis, a very salty fish sauce, is placed on the table to be added to any of the dishes.

Fast food has become part of the culture, with national and international chains in many towns. All meals at fast-food restaurant include rice, although French fries also tend to be on the menu. Banana ketchup is preferred, although the international chains serve tomato ketchup. A national chain, Jollibee, has entered the U.S. market with a restaurant in California, where many Filipino immigrants live. The company plans to expand to other cities with Filipino populations.

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Food Customs at Ceremonial Occasions

Léchon, a suckling pig that has been roasted until the skin forms a hard brown crust, is served at important occasions. The inside is very fatty. Strips of the skin with attached fat are considered the best pieces. The importance of the host and the occasion are measured by the amount of léchon.served. Blood drained from the pig is used to make dinuguan

Sticky rice prepared with coconut milk and sugarcane syrup is wrapped in banana leaves. Glutinous rice is grown especially for use in this traditional dessert.

Gin and beer are available for men and are accompanied by balut, a duck egg with an embryo. Dog meat is a delicacy throughout the country. It is now illegal to sell dog meat at markets because cases of rabies have occurred when the brains were eaten.

Health

Life expectancy is seventy years for females and sixty-four years for males. The Health Care Law of

1995 provides citizens with basic health care at no cost through subsidies. The working poor are given financial assistance when necessary. Children receive inoculations at no cost. The World Health Organization (WHO) declared the Philippines to be polio-free in 2000. It is the first nation in the world to be recognized for the elimination of polio.

Regional public hospitals provide service to everyone. People who live far away ride a bus for hours to reach the hospital. Funds for ambulances are raised by lotteries within each barangay or are provided by congressmen and are used only for the people who live in that area. Private hospitals are considered superior to public hospitals. Paying patients are not discharged from hospitals until the bill is paid in full. Patients have kasamas (companions) who remain with them during the hospital stay. Kasamas assist with nursing chores by giving baths, getting food trays, taking samples to the nurses' station and questioning the doctor. A bed but no food is provided for the kasama in the hospital room.

The infant mortality rate is 48.9 percent, and one-third of the children are malnourished. Over 13 percent of preschool and elementary school children are underweight. A government program provides nutritious food for impoverished pupils at the midmorning break. This is only offered to schools in the poorest areas. National test scores are examined to see if improvement has occurred. If the scores are better, the program is expanded.

The most prevalent health problem is "high blood" (hypertension). One in ten persons over the age of fifteen has high blood pressure. Tuberculosis is another health concern; the country has the fourth highest mortality rate in the world from that disease. Malaria and dengue fever are prevalent because there is no effective program for mosquito control. The number of deaths attributed to dengue increased in the late 1990s.

Herbal remedies are used alone or in conjunction with prescribed medications. A dog bite treated with antibiotics and rabies shots also may be treated with garlic applied to the puncture. The study of herbal remedies is part of the school health curriculum. Many elementary schools have herb gardens that are planted and cared for by the students.

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Health Beliefs and Practices

Filipino-born people may use western medicines concurrently with traditional, herbal and religious healing practices.

Some Filipino-born people may associate bathing with the draining of strength from the body, particularly for those who are ill.

Devotion to Saints and other religious practices may be seen as an important part of the healing process.

This may mean YOU shouldn’t perceive a Filipino-born person who questions a doctor or health professional as being difficult. Nor should you consider the person as ‘being difficult’ should he/she want a second opinion or to access complementary medicines or some type.

Death and Dying

Funeral practices and burial customs in the Philippines encompass a wide range of personal, cultural, and traditional beliefs and practices which Filipinos observe in relation to death, bereavement, and the proper honouring, interment, and remembrance of the dead. These practises have been vastly shaped by the variety of religions and cultures that entered the Philippines throughout its complex history.

Most present-day Filipinos, like their ancestors, believe in some form of an afterlife and give considerable attention to honouring the dead. Except amongst Filipino Muslims (who are obliged to bury a corpse less than 24 hours after death), a wake is generally held from three days to a week. Wakes in rural areas are usually held in the home, while in urban settings the dead is typically displayed in a funeral home. Apart from spreading the news about someone’s death verbally, obituaries are also published in newspapers. Although the majority of the Filipino people are Christians, they have retained some traditional indigenous beliefs concerning death.

Death and burial rights include a broad range of practices among Filipinos. Friends will come together at varying times over several days until the eve of the funeral to make the wake a most memorable one. Viewings are acceptable to some families, but not all. The families and friends look for emotional support at this time from all who are around them, including staff in facilities. Priests and Ministers of religion are important parts of these rites of passage as are church services, prayers and masses for the departed.

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Language Most Filipinos speak Filipino, the national language; and English, the language for commercial and legal transactions. The Philippines is the world’s third largest English speaking country, after the and the United Kingdom. Literacy rate is a high 96%. Approximately 111 languages and dialects are spoken in the country and most Manilenos speak at least one other dialect besides Filipino. Tagalog (pronunciation: [tɐˈgaːlog]) Tagalog is one of the major languages of the Republic of the Philippines. It is the largest of the in terms of the number of speakers. Tagalog, as its de facto standardized counterpart, Filipino, is the principal language of the National News media, media in the Philippines. It is the primary language of public education.

YOU need to be aware that just because they could once speak English, does not mean a) They necessarily spoke it fluently or extensively OR b) They have retained these skills as he/she aged OR c) That it is their preferred language.

Speaking English can be tiring to the elderly – as they are engaging in a translation-type of process. Many elderly people revert back to their native language as they aged.

Cue Cards Quality Aging has cue cards that you may find useful and assist you in communicating with a person that speaks a language other than English.

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Disclaimer The information herein is a synthesis of information from a range of sources believed to be reliable. Quality Aging gives no warranty that the said base sources are correct, and accepts no responsibility for any resultant errors contained herein or for decisions and actions taken as a result and any damage from these decisions or actions.

References

http://miceastmelb.com.au/wp-content/uploads/2016/03/FilipinoCulturalProfile2011.pdf

http://www.mccsa.org.au/site/wp‐content/uploads/2014/08/Guide‐to‐Working‐Cross‐ Culturally.pdf

http://www.diversicare.com.au/wp‐content/uploads/2015/10/Philippino.pdf

http://www.commisceo‐global.com/country‐guides/phillippines‐guide

http://www.everyculture.com/No‐Sa/The‐Philippines.html

https://en.wikipedia.org/wiki/Funeral_practices_and_burial_customs_in_the_Philippines

https://en.wikipedia.org/wiki/Philippines

https://en.wikipedia.org/wiki/Philippines#Culture

https://en.wikipedia.org/wiki/Filipino_values

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