Australia and Canada are often treated as comparable, or perhaps family have migrated from Pakistan to India, or Denmark to Sweden. From the outside, they can appear that way. Growing older in a foreign country, I have become more acutely aware of how differently their systems are experienced from the inside, and how much everyday life depends on familiarity that policy rarely names.
When routines, shared reference points, and unspoken understanding are thinner, ordinary interactions require more effort. This is not simply a question of migration. It is about what happens when people grow older in places that are not the cultural ground that first shaped them.
When Continuity Becomes Fragile
As people age, continuity and familiarity matter more. Knowing how systems work, who to trust, and how to make oneself understood becomes more consequential.
When familiarity is absent, everyday interactions require more effort and carry higher stakes.
In Australia, this complexity is often gathered under the label “culturally and linguistically diverse.” The term is intended to flag difference and tailor support, but it also collapses very different lives into a single category. Language, health literacy, migration history, and time spent navigating Australian systems vary widely, yet the label treats them as equivalent.
In Canada, the language is different, but the move is similar. Older adults are described as having “limited English proficiency,” or grouped as immigrant or newcomer seniors. These terms identify a service need, but they also frame people primarily by what they lack. Long histories, professional lives, and deep social roles are reduced to a problem of language or navigation.
In the UK, the needs of older migrants are often viewed through the lens of ethnicity, deprivation, or access barriers. Again, the categories differ, but the effect is familiar. Difference becomes something to manage administratively, rather than a lived condition shaped by time, ageing, and place.
The Quiet Pressures That Accumulate
One of the first experiences many people have as they grow older in a foreign land is the quiet collapse of the relationships that hold memory and identity over time. There is a disruption of the long social line that carries a person across time: friends who remember your childhood, neighbours who know your habits, family who understand your humour without explanation.
Some people maintain strong ties back home. Others lose them gradually, through distance, cost, illness, death, and time. What remains is not only fewer relationships, but fewer people who can recognise you without effort. Familiarity thins, and with it the quiet dignity of being known.
Another pressure emerges in healthcare, where navigation and misrecognition often converge. Knowing what to ask for, when to ask, and how much insistence is acceptable is rarely acknowledged. Consent may be given without full understanding, or people may withdraw rather than ask again. A healthcare system may record “non-compliance” when the real story is fatigue, fear, or uncertainty.
Status loss introduces another quiet burden. In the country of origin, someone’s competence was assumed, yet in the host country they may be referred to as a “newcomer” or “LEP.” An accent becomes shorthand for capability. Silence is interpreted as consent. Authority becomes conditional.
Family life can also become more complex over time. Many families carry love across cultures but learning how things work here does not unfold evenly. As needs increase, some people feel they belong fully neither back home nor here.
Across these experiences runs a longer pattern. Over time, the cumulative work of adjustment, repeated navigation, and ongoing misrecognition has consequences.
When Labels Replace Recognition
So what, then, is the problem with labels?
It is not that systems should never classify. Systems require structure. The problem arises when classification becomes a substitute for recognition. Labels like CALD and their equivalents can make institutions appear progressive while leaving a person’s actual life untouched. They turn belonging into a service feature rather than a human requirement.
If we are serious about dignity, we have to treat ageing in a foreign land as a lived condition, not a demographic descriptor.
Not “hard to reach.”
Not “LEP.”
Not “CALD.”
But a person whose life has already required more translation than most, now facing systems that ask for even more, at the very moment the body and mind are asking for rest.
I've often thought of this when negotiating the health system. What if I had to do this in another country, and I didnt speak the language? Is there a need for more people familar with the system to be available as "cultural translaters/pathfinders" to help people negotiate their way. I know some hospitals have volunteers to do this.
Dear Jane,
Thank you for your thoughtful and deeply resonant piece, "Growing Older Without Familiar Ground." Your reflections on how ageing in a place distant from one's original cultural and social moorings demands relentless "translation" of self—precisely when the body and mind crave rest—strike at the heart of a universal human experience. While your essay focuses on international migration in settler societies like Australia, Canada, and the UK, India offers a vast, living mirror of these same global realities, unfolding over generations through massive internal migration from rural to urban areas, across regions, languages, and cultures.
In India, this isn't a recent phenomenon tied to globalization—it's been happening for decades, even centuries, driven by economic necessity, land pressures, and aspirations for better opportunities. Millions migrated from villages in Bihar, Uttar Pradesh, Rajasthan, Odisha, or Tamil Nadu to the bustling metropolises of Mumbai, Delhi, Bengaluru, or Kolkata when they were young (or their parents did). Today, those same individuals are ageing in places that were once destinations of hope but now feel like limbo: neither fully here nor there.
The impacts on older people manifest at multiple, intersecting levels, creating a profound sense of void that echoes your description of thinned familiarity, status loss, and accumulated quiet pressures.
1. The "Left-Behind" in Villages: The Empty Nest on a Massive Scale. When adult children (especially sons, traditionally the primary caregivers under norms of seva or filial duty) migrate for work, elderly parents remain in rural homes, often alone or as couples. Research from the Longitudinal Ageing Study in India (LASI) and other studies shows that around 35-36% of older adults are "empty-nesters," with many reporting higher rates of poor self-rated health, chronic ailments, psychological distress, loneliness, and depression compared to those with co-resident children. Parents of migrant sons face elevated risks: about 18% rate their health as poor, with increased chronic morbidity and emotional isolation. The traditional joint-family safety net frays—daily chores intensify, land may lie fallow, and emotional support arrives only sporadically via remittances or rare visits. This creates a rural "void": the house echoes with absence, community ties weaken as younger people leave, and dignity erodes in the quiet collapse of long-held roles.
2. Ageing in the Place of Migration: Urban Limbo and Belonging Nowhere. Conversely, many who migrated decades ago now grow old in the cities they once came to for opportunity. They live in informal settlements, chawls, or slums, far from native linguistic roots, kinship networks, and cultural references. Accents mark them as perpetual "outsiders"; status once held in the village diminishes (a respected farmer reduced to a daily wage laborer), and navigating urban healthcare, bureaucracy, or even neighborly interactions demands exhausting effort. Studies highlight higher depressive symptoms, poorer successful ageing outcomes, and amplified vulnerabilities (especially with functional limitations) among older migrants compared to non-migrants. They belong neither to the fast-changing city—where they remain "migrants" despite 30-40 years of residence—nor to the village, now distant, altered, and without the daily presence of family.
In both scenarios—left behind in villages or ageing in urban exile—India illustrates your core insight on a continental scale: migration creates dual voids for the elderly. Systems rarely name this lived condition; labels like "rural elderly" or "interstate migrant" reduce profound human experiences to administrative categories. Yet the cumulative toll—eroded relationships that once carried identity without explanation, status loss, healthcare misrecognition, and the extra labor of adaptation when rest is most needed—is immense.
Your call to treat ageing away from one's ground as a human condition..., deserving dignity, not just service provision, feels urgently relevant here as well. India, with its internal diversity mirroring global divides, reminds us that these challenges are not marginal but central to how societies age in an era of mobility. Thank you again for shining light on this fragile continuity. It helps us all see more clearly.
With warm regards and deep appreciation,
Himanshu Rath
agewellfoundation.org