Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature

Abstract

As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved.

Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English

“…With Spanish and Portuguese being 2 of the most spoken languages in our catchment area, patients who spoke those languages may have benefited from our hospitals’ more robust infrastructure to serve their needs: Spanish and Portuguese are the only 2 languages available via video equipment located in our inpatient areas, in addition to phone and in‐person PMI modalities that are available for other languages 35. Although we do not have data on patients being accompanied by others during their care, being married or partnered may have been a proxy for patients having greater social support during their hospitalization that in turn could have resulted in patients’ linguistic needs being more effectively understood and met 36, 37…”

Formal and Informal Long-Term Care in the Community: Interlocking or Incoherent Systems?

“…-determinant of who receives help. Our first set of models, therefore, includes a range of indicators of need as predictors of receiving any help (types of impairment, number of types of impairment, self-reported health status and age: details in Appendix The top section of Table 1 repeats the indicators of need discussed above and reported in Appendix Greenwood et al, 2014).…”

The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups

“…Informal carers from BME groups provide more unpaid care and experience worse health outcomes than majority White populations [29] yet are less likely to access formal health and social care services [30,31]. They are also more likely to describe their experiences of services as less satisfactory than White British service users [32].…”

“…Stereotyped assumptions about minority ethnic groups preferring to care for disabled relatives within the family have been widely discredited in favour of more complex and diverse interpretations of informal caring [33,34]. For example, in addition to the importance of family and cultural beliefs, barriers to engaging with statutory care services may include perceptions of need, individual coping styles, poor information and concerns about the quality of care services [31].…”

“…Language and culture are cited as important barriers to access, particularly where older people (and /or their family carers) are not fluent in English [38] and may have difficulties reading, writing or using the telephone [31]. In some respects carers from BME groups share features of carers of people with aphasia, where 6 communication difficulties exacerbate difficulties experienced by carers of stroke survivors in general [39], for example, accessing information, training and support [24,40].…”