https://www.mdu.se/

Purpose: The aim is to explore how family relations are affected by societal

changes in relation to informal and formal caregiving and self-determination

of older adults.

Design/methodology/approach: Care managers (CMs)/social workers (SWs)

(N = 124) participated in a comparative vignette study including Japan, South

Korea, and Sweden. Systems theory was used.

Findings: Japanese CMs/SWs clearly describe their efforts to create networks

in a relational way between formal and informal actors in the community. South

Korean CMs/SWs balance between suggesting interventions to support daily

life at home or a move to a nursing home, often acknowledging the family as the

main caregiver. In Sweden, CMs/SWs highlight the juridical element in meeting

the older adult and the interventions offered, and families primarily give social

support. Regarding self-determination, the Japanese priority is for CMs/SWs

to harmonize within the family and the community. South Korean CMs/SWs

express ambivalent attitudes to older adults’ capability for self-determination in

the intersection between formal and family care. Swedish CMs/SWs adhere to

the older adult’s self-determination, while acknowledging the role of the family

in persuading the older adult to accept interventions. The results suggest emerging

defamilialization in South Korea, while tendencies to refamilialization are

noticed in Japan and Sweden, albeit in different ways.

Research limitations/implications: In translation, nuances may be lost. A

focus on changing families shows that country-specific details in care services

have been reduced. For future research, perspectives of “care” need to be studied

on different levels.

Originality/value: Using one vignette in three countries with different welfare

regimes, discussing changing views on families’, communities’ and societal caregiving

is unique. This captures changes in policy, influencing re- and defamilialization.

The preferential form of living for the elderly in India is within the extended family. India is undergoing rapid economic development, an increase in mobility, and changes in gender norms due to an increase in women’s labour force participation, which places challenges on traditional intergenerational relationships. Ageing and the well-being of the elderly is a rising concern, especially considering that their proportion of the population is expected to grow rapidly in coming decades. There is a lack of universal state provision for the elderly’s basic needs, which is especially profound for elderly women, since most do not have an independent income. This leaves the elderly dependent upon the benevolence of their adult children’s families or other relatives. This paper explores, with help of narrative analysis and critical contributions from capability theory, elderly women’s agency freedoms and how this can be contextualised with their varying capability sets. With help of Spivak’s notion of the silent subaltern, the paper anchors elderly women’s abilities to voice to their agency freedom. The master narrative of the silent supportive wife and side-lined mother-in-law as well as three counter-narratives explore alternative agencies taken by elderly women.

This study sheds light on the value systems of the middle-class metropolitan older adults living alone, on the ageing self and the person's relationship to the surrounding society based on eight interviews. Ageing research has emphasized the traditional features of elderly care in India including its collectivist values rooted in filial piety and the extended family as well as embracement of disengagement influenced by the Hindu texts on two phases in later life: "hermit" and "renunciate". Increased social and geographical mobility, however, challenges traditional family systems. Using the example of the urban middle-class older adults living alone, this study explored whether living alone constitutes a challenge to the norms that previous research associated with Indian elderly care. Using abductive phenomenographic analysis the study found that the understandings of older adults in the study show great reflexivity concerning key aspects of their lives. Although the life conditions of older adults living alone deviated in many aspects from dominant traditional norms of filial piety and a care regime based on strong intergenerational interdependence, their responses and reflections mirrored assemblages of values deeply rooted in Hindu Vedic philosophy of the Ashramas and perceptions of independence, autonomy and self-reliance associated with Western "productive" aging.

 Background:  The cultural and social norms in India stipulate that family and preferably children of the older person, provide the support and care that is needed. In recent years, we have witnessed an overall upsurge in interest in informal care from all countries in the developed world considering their ageing populations. The older people living alone group is, especially interesting in this matter, since it seems to deviate from the expectations of extended family living.

 Objective:  The aim was to describe older persons' experiences of informal care when living alone in India.

 Methods:  The study has a hermeneutic design, analysing interviews of older persons living alone in India.

 Results:  Findings revealed informal care as the thematic patterns: Informal care as a fundamental human responsibility, an obligation and thereby a way to act in 'common sense'. It was a way of 'paying-back' care that they had received from others in their life history, motivated by governmental care was not presented as an option. Informal care also created safety by the provision of alert and actionable care by loved ones, including spatial safety. Most of the informants experienced themselves as informal caregivers assisting others in need even if they themselves were old and fragile. Providing self care was also seen as a part of informal care conducted by capable and worthy persons. They also pointed out their own obligation to seek informal care and even to listen to the suggestions of younger generations regarding the type and scope of care.

 Conclusions/implications for practice:  Informal care in India is not only dependent on having children who ensure that you receive the care you need. Extended family, neighbours and friends feel a basic human obligation to care for the older people in their environment. This responsibility is deeply rooted even within the older people who become fragile in old age.

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.

Assistant nurses caring for older adults with immigrant backgrounds are on the front lines of a practical, theoretical, and policy battlefield. They need to implement culturally sensitive care provision while not overstating the importance of culture, thereby, contributing to a negative picture of older immigrants as especially problematic. One proposed way to strike such a balance is the welfare theory of health (WTH). In this article, we let assistant nurses apply the WTH to a series of questions in four different vignettes representing the life stories of older persons who characterize typical dilemmas described by the theory. The results show that, through the lens of the WTH, assistant nurses looked for individual care preferences rather than stereotypical ideas about cultural characteristics. Further, the assistant nurses expressed a desire to get to know the persons more deeply to better interpret and understand their individual preferences. Thus, the theoretical framework is useful not only for exposing vulnerabilities to which some older adults with immigrant backgrounds may be exposed, but also for finding ways to mitigate the vulnerability by illuminating vital life goals and using them as a framework to organize care. This approach allows for mitigating the gap between the vital life goals and available resources to achieve a holistic state of health.

BackgroundInternational migration and aging populations make for important trends, challenging elderly care regimes in an increasingly globalized world. The situation calls for new ways of merging active aging strategy and cultural sensitivity. This study aim to illuminate the gap between cultural sensitivity and active aging to identify perceived thresholds by Swedish municipal officials in the understanding of older late-in-life-immigrants situation. MethodsDelphi methodology in three rounds. Twenty-three persons in municipal decision-making positions participated and generated 71 statements, of which 33 statements found consensus. ResultsThe 33 statements show that the decision makers prefer not to use cultural sensitivity as a concept in their work, but rather tailor interventions based on individual preferences that may or may not be present in a certain culture. However, as the complexity of care increases, emphasis drifts away from personal preferences toward text-book knowledge on cultures and activity.