“Care from the heart”: older minoritised women's perceptions of dignity in care

Abstract

Purpose – Drawing findings from a large mixed-method study on perceptions of dignity, care expectations, and support in relation to older women from Black and minority-ethnic backgrounds, the purpose of this paper is to explore the interrelationships between life course events and the multiple roles adopted by women at different points in time that have shaped their perceptions of care and their care expectations in old age. Design/methodology/approach – In total, 32 semi-structured interviews were undertaken, allowing for the collection of data on the participants’ understanding of growing old, and the meaning and attributes of care and what care with dignity “looked and felt like”. The theoretical framework is guided by a life-course approach and grounded within an intersectionality perspective. The majority of the participants were migrants. Findings – Social markers such as ethnicity and cultural identity were found to influence the participants’ understanding and expectations of care with factors such as gender identity and integration in the local community also of importance. How women felt they were perceived and “recognised” by others in their everyday lives with particular focus at the time of old age with the increased potential of loss of dignity due to declining capabilities, raised the importance of the family involvement in care provision, and perceived differences in the attributes of paid and non-paid care. The notion of “care from the heart” emerged as a key attribute of care with dignity. Care with dignity was understood as a purposeful activity, undertaken with intent to show respect and to acknowledge the participants’ sense of worth and value. Practical implications – The implications of this study are relevant in the current debate taking place at the EU level about the lived experiences of ageing migrant groups and care expectations. Originality/value – The study highlights the importance of the social nature of dignity, how wider societal structures can impact and shape how care is understood for older women of migrant and minoritised backgrounds, and the need to explore migration and care across the life course.

Re-thinking health literacy: using a capabilities approach perspective towards realising social justice goals

“…MME groups have been consistently found to have low levels of health literacy, (7), poorer health outcomes and face inequalities in quality of care and barriers to healthcare access (4,22). Research has highlighted the role of migratory factors, ethnicity and cultural identity (23,24) as well as the quality of interactions with health providers (22,25) in shaping expectations and perceptions of care. Clinician attitudes and biases towards patients have been found to impact in negative ways on quality of care (22,26).…”

Older migrants’ access to healthcare: a thematic synthesis

“…Care by, and involvement of, family emerged as an important issue in older migrants’ access to, and use of, healthcare. Studies found that older migrants’ conceptions of family care are rooted in traditions that emphasise the reciprocity of care between children and parents (Oglak and Hussein, 2016; Saltus and Pithara, 2015). It was also perceived as a duty and obligation (Liu et al , 2017) and a cultural “golden rule” that they wished to uphold (Thyli et al , 2014).…”

“…The intergenerational reciprocity of caring was also associated with the idea of dignity in old age. For some, older age symbolized having a respectful position in the community and being cared for by children (Saltus and Pithara, 2015).…”

“…Practical support was provided in the form of assisting in transport, communication with health professionals (Liu et al , 2017; Thyli et al , 2014), providing information or knowledge (Doshani et al , 2007), advocacy and daily healthcare. Emotional support was provided by listening to worries or concerns (Lawrence et al , 2006), while providing a sense of security (Liu et al , 2017) and personalised altruistic care (Saltus and Pithara, 2015), as recounted by a research participant now living in Wales:I think it’s more about, um, the fact that, your family and friends, it’s not paid care, it’s, it’s love care, it’s care from the heart. So that does make a great deal of difference because professionals come in and it’s a job, you know, there is, you know, they come in, they do a job, they’ve got, there are time constraints and all those other things.Saltus and Pithara (2015)…”

“…In a study on hospital discharge in the UK, some older migrants expressed the wish for their family to be updated by healthcare professionals during the care process, and the lack of this could lead to distress (Ellins and Glasby, 2016). Family members were also considered to be better caretakers, with better knowledge and understanding of their practical and emotional needs (Saltus and Pithara, 2015) than what they could expected from formal care-givers.…”