Table 3 Illustrative quotes from community focus group discussions, by theme and gender

Knowledge and access to information: “Here, we just convey the message to one another. All of us receive social welfare, so if I hear something I just tell the other person. The departments don’t come here. Only if one of us visits their office and something new comes up then that person comes and tell us.”

Disability: “My main problem is my physical health, especially my legs. … This makes it hard for me to go and receive my social welfare assistance – food voucher.”

“For the older people that are sick, they can hardly work now and go to the farms. They are unable to gather food and earn money by selling crops.”

“I had my leg amputated and I must use crutches and I paid $200 for the pair. Hospital never gave anything.”

Family capacity: “Taking care of older people is not an easy task. We need perseverance and a good heart to care for older people. There isn’t a lot of assistance from Government …”

Knowledge and access to information: “It is best the information is conveyed through the CHW.”

Disability: “I used to go frequently to the farm, but I cannot do that now because I get short of breath whenever I do rigorous work. I thought it was asthma, but the doctor says my heart is weak.” “I must take a lot of medications and the side effects of the medications is a problem for me. It makes me drowsy and I get tired easily […] So, I cannot go out to visit friends.”

“We have been working in the mines for a very long time, all of us here today. When you look at the two gentlemen here they are using canes due to wearing clogged shoes under the mines every day, every year. As for me my heart muscles are affected due to lifting heavy loads underground and it has affected me now on a long-term basis.”

Mental health: “In good health means sleep well, eat sensibly, drink lots of water and have a lot of rest.”

“It means eating good and nutritious food to stay healthy”

Family capacity: “I wish I was stronger so I can care for myself. I live with my son and his family. They look after me well but sometimes they cannot go for holidays because they worry about who will look after me.” “In families where their fathers are missing and [the fathers] are supposed to be earning for their families: these families usually have difficulties caring for their elderly relatives.”

“Usually the women care for the elderly that are bedridden. They bathe and feed them. The women in the house do the most work.” “Okay, just imagine if in a family there is a young man in his twenties, and he is given the responsibility of looking after his elderly father, uncle or grandfather. This young man would not know how to responsibly care for him. He would need to cook and care for the elderly man and then go to his farm and try and earn a living off the farm. It is quite difficult.”

Respect/ values: “The issue now is that people are more focused on work and earning money. […] I feel that neglecting our cultural obligation to care for our elderly is becoming more apparent as the years go by.

Fear of ageing: “I see that if an older person doesn’t have money and did not have a good job when he [sic] was younger, their family will feel it’s a burden to look after them.” “For me I stay with my mother we sit down and share stories. Her only fear is being alone, now that she sees us around, she feels better.” “Yes, I worry about my health. And if I do get sick, who will look after me? I cannot always rely on my family. They also have their own lives to live.”

Dissatisfaction with the process of seeking care: “[It would be better] if the elderly can avoid the queue altogether. It’s alright for those of us that are still fit, we can hold our stomachs and wait, but the elderly is not the same as us.”

“They should attend to us first. We cannot wait for long. They treat us equally with other younger people that are not so sick. We are old, we cannot wait for long. When we come in and there are no chairs, none of the younger people stand so that we can sit and wait.”

Respect/ values: “In this village, the elderly is respected. It is against our culture to have younger people mistreat the elderly. We try as much as possible to ensure that this occurs.”

Fear of ageing: “We sometimes worry that some of our children tend to neglect us due to our age.”

Dissatisfaction with the process of seeking care: “We aren’t as strong and fit as before to be able to stand for long hours and wait to consult a doctor”.

.“So, we get tired and frustrated when we wait long hours and when we do finally get seen, our sugars are high and our pressure is high so the doctors then change our medication dosages and what not.”

Family / Community attitudes: “Before, families would collectively care for one another, but as people have moved to urban areas like Suva, they have tended to be less caring for everyone and become more individualistic.”

Health worker attitudes: I think they should learn to treat older patients more appropriately. The care they provide is good but it’s just the way they approach us. Maybe they are busy or tired.

Transport: “In this community, bus services are irregular and so we wait for a long time for a bus.” “Most times, the ambulance is also unavailable and when it does come, we must pay for it. There is a fee to use the ambulance.”

Social welfare: “When it started food voucher was $50 and till now it is still $50. There’s no change but things are getting expensive.”

I rely on my social welfare money especially if I have to go for clinic, so if my clinic time does not coincide with the day I receive my social welfare money I end up not going to the hospital.

Family / Community attitudes: “I don’t think we should see the care of our elderly as a burden. Many young people have begun to see it that way. With modern ideas we have started to lose focus on our culture and traditions of caring for the elderly.”

Health worker attitudes: “Some are good, and some are rude. I don’t want to sound like I’m being critical but there are some nurses that are very unfriendly and treat us harshly when we come to hospital.” “The older citizens are seen last, after normal rounds, [...] But we need rest.”

Transport: “Transportation is a problem and whenever the road is flooded it is very difficult for us to travel across.” “If you miss the 6:30 am bus, the next one is at 9:30 am and by the time you reach the hospital, your clinic time is over.”

Access to medicines: “Sometimes they just tell us to go the private pharmacy since they don’t have any of our medication at the hospital. We have to pay for our medications and not like before where we have access to free medication at the hospital pharmacy.” “We want quality medications that should be available all the time.”