Female Pakistani carers’ views on future formal and informal care for their older relatives in Norway

Abstract

Background: The aging of Pakistani immigrants in Norway raises questions related to their increased need for care and help from relatives, as well as those concerning what future formal and informal care and healthcare accessibility for older immigrants may look like. The hidden nature of family caregiving means that the circumstances of carers, their views and their dilemmas related to future care are largely invisible. In this study, we explored female Pakistani carers' views of future care and healthcare accessibility for their older relatives in Norway. Methods: Our data included interviews with family carers between the ages of 23 and 40 years old, living in Oslo, Norway. We recruited ten family carers, out of which eight were daughters and two were daughters-in-law. Interviews were conducted by the first author in Urdu or English and were recorded and transcribed verbatim. Results: Our findings revealed several factors that influenced participants' perceptions about formal and informal caregiving, which can be organised into the following themes: 1) caring for family in Norway as in Pakistan, 2) worries about being 'dropped off' at a care home, 3) concerns about being cared for by outsiders, 4) questions about what other people might say and 5) adhering to society's expectations of a 'good' carer. Conclusion: Family carers' traditional views of filial piety do not entirely determine the use of or access to healthcare services of their older relatives. There is a need to develop culturally sensitive healthcare systems so that immigrant families and their carers have more options in choosing care in old age, which in turn will ease their families' care burden. Healthcare professionals and policymakers should not assume that immigrant families will take care of their own older members but should instead secure adequate support for older immigrants and their family carers.

Access to Long-Term Care for Minority Populations: A Systematic Review

“…We screened 191 studies at the full-text stage and selected 59 studies for inclusion. Of the 60 studies, 42 were conducted in the United States (Ahmed, Ali, Lefante, Mullick, & Kinney, 2006; Ahmed, Allman, & DeLong, 2003; Akamigbo, 2007; Akamigbo & Wolinsky, 2006, 2007; Andel, Hyer, & Slack, 2007; Angel, Angel, Aranda, & Miles, 2004; Angel, Douglas, & Angel, 2003; Angelelli, Grabowski, & Mor, 2006; Aykan, 2002; Baxter, Bryant, Scarbro, & Shetterly, 2001; Berridge & Mor, 2017; Cai, Salmon, & Rodgers, 2009; Duffy, Jackson, Schim, Ronis, & Fowler, 2006; Feng, Fennell, Tyler, Clark, & Mor, 2011; Friedman, Steinwachs, Rathouz, Burton, & Mukamel, 2005; Gandhi, Lim, Davis, & Chen, 2017; Gaugler, Kane, Kane, & Newcomer, 2006; Gaugler, Leach, Clay, & Newcomer, 2004; Goodwin, Howrey, Zhang, & Kuo, 2011; Harris, 2007; Harris & Cooper, 2006; Iwasaki, Pierson, Madison, & McCurry, 2016; Jackson, Johnson, & Roberts, 2008; Jang, Kim, Chiriboga, & Cho, 2008; Kersting, 2001a,b; Liu, Wissoker, & Swett, 2007; McCormick et al, 2002; McLaughlin, Elahi, Ciesielski, & Pomerantz, 2016; Miller, Schneider, & Rosenheck, 2011; Min, 2005; Putney, Keary, Hebert, Krinsky, & Halmo, 2018; Quigley, 2017; Riley, 2019; Rodriguez, 2004; Sharma, 2017; Spillman & Long, 2009; Stein, Beckerman, & Sherman, 2010; Stevens et al, 2004; Temple, Andel, & Dobbs, 2010; Yaffe et al, 2002), seven in Canada (Brotman, Ryan, & Cormier, 2003; Forgues, Doucet, & Noël, 2011; Gui & Koropeckyj-Cox, 2016; Kortes-Miller, Boulé, Wilson, & Stinchcombe, 2018; Lai, 2004; Metz, 2007; Qureshi et al, 2021), three in Norway (Arora, Rechel, Bergland, Straiton, & Debesay, 2020; Czapka & Sagbakken, 2020; Hanssen & Tran, 2018), two in Australia (Basic, Shanley, & Gonzales, 2017; Waling et al, 2019), two in Sweden (Heikkilä & Ekman, 2003; Innes, 2020), and one each in Belgium (Ahaddour, van den Branden, & Broeckaert, 2016…”

“…Of the 60 studies, 33 studies were rated as being of excellent quality (Akamigbo, 2007; Akamigbo & Wolinsky, 2006, 2007; Arora et al, 2020; Basic et al, 2017; Berridge & Mor, 2017; Brotman et al, 2003; Cai et al, 2009; Chui et al, 2019; Chung et al, 2008; Czapka & Sagbakken, 2020; Friedman et al, 2005; Gandhi et al, 2017; Gaugler et al, 2006; Gui & Koropeckyj-Cox, 2016; Harris, 2007; Harris & Cooper, 2006; Heikkilä & Ekman, 2003; Liu et al, 2007; McCormick et al, 2002; Metz, 2007; Miller et al, 2011; Min, 2005; Putney et al, 2018; Quigley, 2017; Qureshi et al, 2021; Riley, 2019; Rodriguez, 2004; Sharma, 2017; Spillman & Long, 2009; Stein et al, 2010; Stevens et al, 2004; Yaffe et al, 2002), 22 were rated good quality (Ahmed et al, 2003, 2006; Andel et al, 2007; Angel et al, 2003, 2004; Aykan, 2002; Forgues et al, 2011; Gaugler et al, 2004; Goodwin et al, 2011; Hanssen & Tran, 2018; Herat-Gunaratne et al, 2020; Iwasaki et al, 2016; Jackson et al, 2008; Jenkins Morales & Robert, 2020; Kersting, 2001a,b; Kortes-Miller et al, 2018; Lai, 2004; McLaughlin et al, 2016; Tenand et al, 2020; Travers, Hirschman, & Naylor, 2020; Waling et al, 2019), and 5 were rated fair quality (Appendix 6) (Ahaddour et al, 2016; Innes, 2020; Jang et al, 2008; Lehnert, Heuchert, Hussain, & König, 2019; Mahieu, Cavolo, & Gastmans, 2019).…”

“…Of the 60 studies, 33 studies were rated as being of excellent quality (Akamigbo, 2007;Akamigbo & Wolinsky, 2006Arora et al, 2020;Basic et al, 2017;Berridge & Mor, 2017;Brotman et al, 2003;Cai et al, 2009;Chui et al, 2019;Chung et al, 2008;Czapka & Sagbakken, 2020;Friedman et al, 2005;Gandhi et al, 2017;Gaugler et al, 2006;Gui & Koropeckyj-Cox, 2016;Harris, 2007;Harris & Cooper, 2006;Heikkilä & Ekman, 2003;Liu et al, 2007;McCormick et al, 2002;Metz, 2007;Miller et al, 2011;Min, 2005;Putney et al, 2018;Quigley, 2017;Qureshi et al, 2021;Riley, 2019;Rodriguez, 2004;Sharma, 2017;Spillman & Long, 2009;Stein et al, 2010;Stevens et al, 2004;Yaffe et al, 2002), 22 were rated good quality (Ahmed et al, 2003(Ahmed et al, , 2006Andel et al, 2007;Angel et al, 2003Angel et al, , 2004Aykan, 2002;Forgues et al, 2011;Gaugler et al, 2004;Goodwin et al, 2011;…”

“…Twenty-seven studies evaluated expectations and preferences of different populations with regards to future long-term care placement (Table 3) (Ahaddour et al, 2016;Akamigbo & Wolinsky, 2006;Arora et al, 2020;Chui et al, 2019;Chung et al, 2008;Czapka & Sagbakken, 2020;Duffy et al, 2006;Forgues et al, 2011;Gui & Koropeckyj-Cox, 2016;Hanssen & Tran, 2018;Heikkilä & Ekman, 2003;Herat-Gunaratne et al, 2020;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;Kortes-Miller et al, 2018;Lai, 2004;McCormick et al, 2002;McLaughlin et al, 2016;Metz, 2007;Min, 2005;Putney et al, 2018;Quigley, 2017;Rodriguez, 2004;Stein et al, 2010;Travers et al, 2020;Waling et al, 2019). Fourteen studies were conducted in the United States (Akamigbo & Wolinsky, 2006;Duffy et al, 2006;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;McCormick et al, 2002;McLaughlin et al, 2016;Min, 2005;Putney et al, 2018;Quigley, 2017;Riley, 2019;…”

“…Fourteen studies were conducted in the United States (Akamigbo & Wolinsky, 2006;Duffy et al, 2006;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;McCormick et al, 2002;McLaughlin et al, 2016;Min, 2005;Putney et al, 2018;Quigley, 2017;Riley, 2019;Rodriguez, 2004;Stein et al, 2010;Travers et al, 2020), six in Canada (Brotman et al, 2003;Forgues et al, 2011;Gui & Koropeckyj-Cox, 2016;Kortes-Miller et al, 2018;Lai, 2004;Metz, 2007), three in Norway (Arora et al, 2020;Czapka & Sagbakken, 2020;Hanssen & Tran, 2018) and one each in Australia (Waling et al, 2019), Belgium (Ahaddour et al, 2016), Hong Kong (Chui et al, 2019), Sweden (Heikkilä & Ekman, 2003), Taiwan (Chung et al, 2008), and the United Kingdom, England (Herat-Gunaratne et al, 2020). Eleven studies used quantitative analyses (i.e., surveys or questionnaires) (Akamigbo & Wolinsky, 2006;Chung et al, 2008;Iwasaki et al, 2016;Jackson et al, 2008;Jang et al, 2008;Kortes-Miller et al, 2018;Lai, 2004;McCormick et al, 2002;McLaughlin et al, 2016;…”