A Study on Diversity-Mainstreaming of Elderly Care in the Netherlands

Written by Hanna Carlsson

In the Netherlands, like many other immigration countries, diversity-mainstreaming policies have become common. The goal of diversity-mainstreaming policies is that health and social care services are inclusive to people from all cultural, ethnic, and religious backgrounds. While the idea behind policies can be good, the question is how they impact people in practice. Therefore, ENIEC member Hanna Carlsson decided to research how the implementation of diversity-mainstreaming in the elderly care sector affects older migrants?

To answer this question Hanna and her co-author Dr. Roos Pijpers interviewed people working with care provision and policy issues related to older migrants in Nijmegen and the Hague. They also looked at policy documents on the topic of health and social care and older people.

They found that although national policy discourages services targeting minorities, and there was less support for these services in the Hague than in Nijmegen, they still found many day care, home care and residential care services targeting different older minorities in both municipalities. The persistence of targeted services can be explained by the vagueness of the term ‘diversity’. ‘Diversity’ was interpreted by policy makers in many ways. Some interpreted ‘diversity’ as supportive of services targeting minorities. Others interpreted the term as a call to only provide services for all older people, rather than for specific groups. This is a problem if it leads to unequal access to culturally appropriate services between municipalities.

When diversity was interpreted to support targeted services, these services were framed as a solution to the temporary problem that many older labor migrants speak little to no Dutch. Hanna and Roos argue that this is an issue for two reasons. Firstly, seeing older migrants’ low access to care as a temporary issue undermines continued investment in intercultural and culturally sensitive services, services that currently are successful in reaching the group. Secondly, by reducing older migrants care needs to language problems, there is little attention to older migrants’ other care preferences and needs for belonging.

Research by ENIEC members Elżbieta Czapka, Mette Sagbakken and Saloua Chaouni Berdai has shown that culturally appropriate services are needed to address older migrants low use of aged care services (Chaouni Berdai, Smetcoren and De Donder 2020, Czapka and Sagbakken 2020). We suggest that policymakers take a more positive approach to the diverse cultural, linguistic, and ethnic preferences of older people. Instead of pitting culturally sensitive and intercultural services against services that are targeting all older people, we argue that a combination of both is the best way to give individual older migrant and minorities access to the care that fits their needs.

If you want to read the full article, it is available open access on: https://www.tandfonline.com/doi/full/10.1080/1369183X.2020.1857231

Chaouni Berdai, Saloua, An-Sofie Smetcoren and Liesbeth De Donder. 2020. “Caring for Migrant Older Moroccans with Dementia in Belgium as a Complex and Dynamic Transnational Network of Informal and Professional Care: A Qualitative Study.” International Journal of Nursing Studies 101:103413. doi: https://doi.org/10.1016/j.ijnurstu.2019.103413.

Czapka, Elżbieta Anna and Mette Sagbakken. 2020. ““It Is Always Me against the Norwegian System.” Barriers and Facilitators in Accessing and Using Dementia Care by Minority Ethnic Groups in Norway: A Qualitative Study.” BMC Health Services Research 20(1):954. doi: 10.1186/s12913-020-05801-6.