How do older people from ethnic minority backgrounds in the south of Glasgow identify themselves as candidates for services?
The older people who were contacted for this research all had prior contact with at least one service. Most of these attended day centres specifically designed for their needs. Others used drop¬in services focussing on people from BME backgrounds. In these cases, people identified themselves as requiring the service based on what they perceived as their own needs. People attending day centres reflected this in their comments:
People said they benefit from company, socialising, food, entertainment and physical exercise classes. Individuals also said the support they get from the staff and other service users is valuable. People appreciated the support they get with correspondence and letter writing from centre staff -Advocacy Connections Report (14)
If these centres weren’t here, I’d be so bored – an attendee at a day centre)
Access routes into the day centres contacted for this research were split. Two required referral through social work services and two operated via presentation at the centre and possible placement on a waiting list. Clearly, there will be many older people in south Glasgow who are eligible for the kinds of services described here who do not access them. Interviews with professionals working with people from ethnic minority backgrounds formed another layer of this research and this provided some insight into this group, as has previous work in this area.
Cultural expectations and influences play an important role in individuals’ perceptions of their own candidacy for services. Among the Asian predominantly Muslim population in the area the influence of culture and religion varies and is generally perceived to be slightly weaker among those whose families are now in their third and fourth generations since coming to the UK. Where the influence is strong, however, a marked difference exists in older people’s perception of themselves as candidates for services from those who are not from the Muslim tradition.
The role of the family of the older person is crucial to whether the older person pursues candidacy for services. In these cultures, in addition to a tradition of fundamental respect for their elders, care for the elderly is regarded as an honour which enriches the carer. Furthermore, “it is a matter of shame for most Muslims to hand over the responsibilities of elderly relatives to the state even if the state is willing to look after them.” (15). What emerges is a set of religio-cultural beliefs and traditions which directly impact on the issue of identity of candiditure for services.
Where older people are part of a strong family belief system that follows Muslim traditions, they will not perceive themselves as candidates for certain services, and nor will their families – they do not identify themselves as candidates for these services, no matter how they are presented.
The relationship between individual identification of candidacy and that individual’s need for the service is not a dependent one. Need can – and most certainly does – exist for those who do not identify themselves as candidates for services. It is how these needs are met that is in question. For many in this group and their families, state intervention to meet the need is not an option because care by the family at home complies more fully with their belief systems.
An important distinction needs to be made between those services that provide explicit, direct care to older people, particularly via direct state intervention – such as elderly care homes and most social services – and those which are seen as support mechanisms to enhance quality of life, such as many day centres where older people can gather sociably together and which tend to be perceived as social supports. These services appear to avoid the “shameful” stigmatisation of the more care related state interventions.
It is also important to highlight the diversity of opinion and tradition within the population of older people from ethnic minority backgrounds in south of Glasgow. The above description is typical only of a certain sector of this population. It was highlighted much more by professionals and those providing services than it was by the older people who were contacted during the research.
A further barrier to identification of candidacy which is specific to people from ethnic minority backgrounds relates to the issue of communication, which was a common theme throughout this research and which is an issue that also impacts in other areas of the candidacy framework.
Asian people often exhibited some apprehension about communicating their problems when no other Asian person was on hand. While there was little hostility expressed towards statutory welfare services, once their role had been explained, there was considerable support (59 per cent) for the employment of people from the local Asian community. Most felt this would help to reduce or avoid religious and cultural misunderstandings and reduce language barriers. Some 87 per cent also felt that translated material was very important to increase awareness and understanding. (16)
This study, coming some 24 years after the above report, identified an almost complete absence of people from ethnic minority backgrounds working in services in the south of Glasgow. One current worker in the area, who is white, identified this as a major issue affecting access to services for this group.
We need to build trust first. It would be far easier if there were more people from ethnic minority backgrounds working in the field in this area. People don’t come forward because they don’t trust us and we don’t speak their language. – Development worker in south of Glasgow
Systemic issues are seen as influencing the readiness of non-ethnic staff to interact effectively with people from ethnic minority backgrounds. These issues will further entrench a general perception of mistrust.
Research showed that even in areas of the city [of Glasgow] where the minority ethnic population is concentrated, relatively few were using the statutory services. Interviews with white staff revealed a lack of knowledge of the minority ethnic communities and difficulties were expressed by these white staff about approaching work with minorities; they spoke of being afraid to do the work, of not knowing how to approach it, and of their fear of offending. The training offered by the local authority appeared to have had a negative effect, raising concerns but failing to equip staff to deal with them. (17)
The perception of older people from ethnic minority backgrounds that they may not be understood, either in terms of basic language comprehension or in a more nuanced sense that relates to cultural understanding – their sense of cultural alignment with the service under consideration – impacts on their initial identification as candidates for services.
People also need to be aware of the existence of services in order to firstly identify themselves as possible candidates and then to access the service. There is significant evidence from this and other studies (McFarland et al, 1989) that awareness is limited. This will affect identification of candidacy. Issues relating to awareness of service are examined in detail under the “Navigation” dimension of candidacy.
(14) The experiences of accessing health and social care services for older people from Black and Minority Ethnic backgrounds in South Glasgow, Advocacy Connections, 2013
(16) Ethnic minority needs and service delivery: The barriers to access in a Glasgow inner‐city area, Elaine McFarland , Mike Dalton & Dave Walsh (1989) , Journal of Ethnic Migration Studies 15:3
(17) Researching Social Care for Minority Ethnic Older People: Implications of Some Scottish Research, AM Bowes, NS Dar (2000) BJSW: 30, 305-321