Activity and Social Responsibility in the Discourse on Health Care, Long-Term Care and Welfare Services for Older Immigrants

Table 1

Phenomenal structure and subject potions of older immigrants.

Interpretative pattern	Social responsibilities of older immigrants are a resource for self-supporting ethnic networks	Social responsibilities of older immigrants are a resource for society
Subject position	(i) Older immigrants are traditional and family-oriented; therefore, activity and social engagement take place in extended families and within extensive ethnic networks.; (ii) Because of cultural differences, older immigrants age differently.	(i) Older immigrants are a heterogeneous group (culturally, ethnically, economically), often having experienced socioeconomically challenging and discriminatory living conditions.; (ii) Their social networks include the (extended) family, migrant organisation, and the municipality.
Values	(i) Family values are based on intergenerational cohesion, i.e., care in the family is best; recognition for delivering care within the families.; (i) Traditional or cultural values provide as a sense of belonging (“identity anchor” ([47], 5))	(i) Promoting responsibility for and participation in the community.; (ii) Achieving independent living in old age.; (iii) Overcoming a deficit perspective on older migrants and strengthening potentials.
Perceived problems and causation	(i) Increased health risks compared to the nonmigrant older population due to low-paid and high-risk employment, short time in employment, and financial insecurity.; (ii) Changing family structures challenge the provision of care by family members.
	(i) Migration leads to disadvantaging living situations (migration as a risk factor, e.g., due to psychosocial stress).; (ii) Lack of knowledge on services and authorities in the health and social sector as well as language barriers.; (iii) Previous expectation that older immigrants will migrate back to the country of origin in old age.; (iv) Ethnic networks are not accessible, segregated from society.	(i) Older immigrants live predominantly in discriminatory and low-resource socioeconomic circumstances.; (ii) Municipalities and their health and social services are not adapted to cater for older immigrants; care, health promotion and social services are underutilised.; (iii) Experiences with discrimination in public service institutions.; (iv) Lack of accessibility of existing social/health structures due to language barriers, limited integration, and information deficits.
Older immigrants’ responsibilities	(i) Family is a central resource for support and care.; (ii) Important services are carried out in the (ethnic) communities.; (iii) Older immigrants need to familiarise themselves with state services.	(i) Social involvement in the municipalities is expected.; (ii) Migrant organisations need to be opened and accessible to society.; (iii) Immigrants can fulfill bridging positions between ethnic/private networks, migrant organisations, and municipal services.
Public/municipal responsibilities	(i) Support of family and extrafamily networks and expansion of support services.; (ii) Assistance for long-term care in families with outpatient care.; (iii) Developing intercultural or culturally sensitive approaches in health, care, and welfare services.	(i) Improving access to public/municipal services (i.e., health promotion, ambulatory, and stationary long-term care).; (ii) Developing intercultural approaches in institutions such as culturally sensitive care; avoiding parallel structures of migrant/nonmigrant clientele.; (iii) Better networking of existing actors, resources, and services; connecting private and public services; recognising informal work of older immigrants; and providing support for independent living.