Spotting good ageing: using welfare theory of health to frame the agency of older adults with immigrant backgrounds to attain good ageing

Abstract

Care providers for older immigrants in Sweden find themselves in a paradox. Individuals and associations call for culturally sensitive elderly care. However, implementing this comes at the risk of over-culturizing needs and behaviours, drawing a negative picture of 'the problem of immigrants' that needs to be solved with special interventions. To find a balance in this paradox, we applied the welfare theory of health to grasp a new understanding of the phenomena and draw a holistic picture of a person's needs and resources available to achieve good ageing, reaching beyond the cultural paradox. Semi-structured qualitative interviews were conducted with older adults with immigrant backgrounds in Sweden. The interviews were analysed using content analysis. Combining welfare theory of health with immaterial capital theories offered a holistic theoretical approach to good ageing. This took its departure from the agency of older adults, mitigating the gap between their vital life goals and available resources to reach these goals. Although informants wanted caring interventions from close family, we identified distinct responses to mitigate the diminished trust older adults had in the capability of welfare institutions to provide adequate elderly care.

Swedish experts' understanding of active aging from a culturally sensitive perspective – a Delphi study of organizational implementation thresholds and ways of development

“…This study draws its methodology from the Welfare Theory of Health (WTH) coined by Nordenfelt (1993) and focuses on the gap between cultural sensitivity and active aging. We take departure from the previous work of Johansson et al (2021).…”

“…We have in previous research (Johansson et al, 2021 ) proposed a theoretical framework for merging culturally sensitive and active aging that could depart from the so-called Welfare Theory of Health (WTH) coined by Nordenfelt ( 1993 ). The WTH frames health as the ability to realize what is important for a person to experience a minimal level of happiness, so-called Vital Life Goals (VLG).…”

“…Cultural capital is one such resource that shapes these preferences, making them embodied. Johansson et al ( 2021 ) has described how older adults with immigrant background uses the accumulated resources to reach their VLG's. And that the lack of resources makes for an agency gap that is stressful for an individual.…”

“…As expressed by Johansson et al ( 2021 ) “health promoting interventions would by necessity be more culturally sensitive if that lies within the scope of vital life goals for the older adult's minimum level of happiness” (p.4). However, WTH is a philosophical view of holistic health and is yet to be refined into a theory that is useful for practitioners.…”

“…When WTH was used as a theoretical foundation by Johansson et al ( 2021 ), it yielded both information on cultural preferences of the interviewed older adults, recommendations of how such culturally sensitive interventions would preferably be implemented, and what kind of personal resources can be mobilized to reach the VLG's of a person. The results of Johansson et al ( 2021 ) adds to the notion that the WTH can be used to move cultural sensitive care away from the realist approach, described by Houston ( 2002 ), and toward a more social constructivist view.…”