Care needs of older migrants: What are older migrants’ expectations and experiences of the welfare state and how do they meet their care needs? Lessons from Norway Katrine Mellingen Bjerke University of Bergen
Research questions • How do older migrants from Poland and Pakistan address their care and assistance needs? • What are their attitudes towards and experiences of receiving public care in Norway? • How does the dialectics between a culture of familism in country of origin on one hand, and an emphasis on extensive public responsibility in Norway, on the other hand, influence the care practices developed amongst older migrants in Norway?
Background • Ageing of the population, an increasing number of migrants facing old age in Norway • Increased emphasis on differentiation of the elderly care services according to age, gender, social status, degree of assistance needs, sexuality and ethnic bakground
Theoretical perspectives Theories of transnationalism and culture • Focus on a development of a cultural syncretism, where migrants combine values from their country of origin and country of destination / settlement in different ways • Emphasis on how cultural values and practices are combined, and informs migrants’ attitudes towards and experiences of elderly care An intersectional perspective • The intersectionality perspective informs my approach as I explore how gender, age, degree of frailty, ethnic background and resources (education, bureaucratic competence, availability of family members etc) influences older migrants’ ways of adressing their assistance needs both formally (within the welfare state) and informally (within the family or network)
The institutional context • Scandinavian/social democratic welfare regime (Esping- Andersen årstall) • Universal provision of welfare to those in need (needs tested, not means tested) • The national health plan for Norway states that services of high quality should reach out to everyone regardless of their financial situation, social status, age, gender or ethnic background. • Among the Norwegian elderly there is an increasing preference for public elderly care rather than the reliance on family members • Dominant media discourses emphasize negative aspects such as low family solidarity, and inadequacies of public services
Elderly care • Institutional care services- only for the very old and frail • Home based care services - A home nurse comes to one’s house to give medical assistance (insulin injection, distribution of medicine, changing bandages, etc.) Or -A home helper comes to one’s house to help with cleaning, grocery shopping, etc)
Elderly care services • Undergone processes of increased bureaucratisation, taylorisation and user differentiation • These processes have paved the way for commercial providers - free user’s choice introduced (Oslo and Bergen) - A new view of the service recipients as active citizen consumers (rather than patients or clients) - A presumption that care recipients have the resources to exert influence on their own care
The study Initial study design My current empirical data Biographical interviews with 6 • 20 interviews: people from each gender in each national group who were • 8 pakistani men users of or had experiences • 3 pakistani women with any form of home based • 6 polish women care service • 3 polish men Within these group the plan • was to achieve a certain -Only a few of them had care distribution when it comes to needs, and only two received resources, family networks, help from public elderly care age and help needs -Ethnographic observation in Ethnographic observation in a • public arenas such as the selection of the interviewees’ polish church, ethnic homes to observe their daily communities for the elderly lives and encounters with care and the mosque providers
Total 50-66 67+ Women 67+ Men 67+ Pakistani 17,028 3,932 726 278 448 Polish 49,309 5,543 506 303 203
Cultural background Polish - tradition of familism and communism (which has led to considerable scepticism towards public institutions - Pre 1989 intergenerational living common due to scarcity of dwellings Pakistanis - Intergenerational living and family care is the ideal care arrangement - Norms of reciprocity
Case presentation • I shall now present to you some empirical data from my study • This is mostly information about different cases, and I have tried to keep the interpretations in abeyance After the presentation I would like your opinion on: 1) How to make sense of this 2) What are the experiences with elderly migrants in Britain?
General attitudes towards receiving care by the public Pakistani Polish «I have lived my life according to Allah so hopefully my health will be good and I won`t «You shouldn`t ask us need» (Tariq 72, manual worker and and what we need and get, teacher`s assistant, very religious) rather what we «It`s like I want to say that the system here in contribute with» Norway is fantastic the social system for (Piotr, 67, engineer) those who need it but to take advantage of the system I am against that» (Fehrooz 69, «I would be good to postalworker) know what is available «I would use it I am open to it the children just in case something have their responsbilities and since the happens» (Justyna 67, western way of living is in the way that we engineer) can`t decide much or right when it comes to our children they have to work out their own lives their own children so we can`t demand or force them to care for us so that`s fine with me and I think my wife agrees»
General interpretations • Pakistanis • Polish - Association with haram? -Fear of being labelled as a welfare parasite? - Breach of the norm of reciprocity? -Desire for knowledge about how the system - Fear of being labelled as works? a welfare parasite?
Older migrants in Norway How do they cover their needs?
Ashwariya (65) Came to Norway in 1976, family reunification • Worked in a family business but had to quit due to care • responsibilities for mother with dementia, received care wage at the time Describes this as an important sacrifice which she has had to make • Started working again after her mother passed away but had to • retire due to health problems Suffers from arthritis, asthma and had breast cancer • Has a son who is married to a Pakistani woman, they live in the • ground floor of the apartment Does not receive any help from home based care services but has • yearly checkups at the hospital and sees a physical therapist but relies heavily on her husband and daughter in law for daily care Describes her relation to her daughter in law as a reciprocal • exchange as she helps her daughter in law with learning norwegian and similar Describes herself as not wanting to be a load on the Norwegian • public and states that she prefers to manage on her own
Magdalena (73) • Grew up in a village outside of Krakow, educated maths teacher in Krakow • Moved to Norway in 1986 after she met and married a Norwegian man, but now lives alone • Worked as a teacher’s assistant but received a disability pension due to arthritis • Receives a home based practical assistance (1,5 hours a week) with cleaning and grocery shopping • Has a number of aids (an accomodated residence, hospital bed, wheel chairs and similar ) • Both her daughters live in Norway, but she doesn`t want to live near them. She doesn`t want them to feel obliged to visit or help her in her daily life
Noman (75) Came to Norway from a rural area of Punjab in 1971 • Previously worked in manual labour but had to retire due to • health problems Has heart problems, bad eyesight and general problems with • mobility Has four sons (three living in Norway) • Lives with his wife, son, and daughter in law • His everyday life consists of waking up early to have breakfast • prepared by his son or daughter in law, then he sits around watches TV until the son and daughter in law gets home from work to prepare dinner Compares his life to being «a caged bird» • Other than a TT card which is a public transportation card for • people who are frail, he doesn`t receive any publically provided care He states that he has applied, but mainly for more financial • assistance
Jelena (70) • Came to Norway to work as a musician in 1979 • Has as son who came to live with her in 1982 but now lives in California • Has arthritis, and has suffered a stroke • When she was in hospital she was advised to apply for practical assistance from the home based services • She decided not to because she felt the process of applying would be too exhausting and she had heard from a neighbour that she wouldn`t receive that much help anyways • Receives physical therapy • Has friends and neighbours who help her with cleaning
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