Ageing in Contexts of Migration

Ute Karl, Sandra Torres, Ute Karl, Sandra Torres

• Publisher: Routledge
• Year: 2015
• eBook ISBN: 9781317814184
• Edition: 1
• Topic: Sozialwissenschaften
• Subtopic: Soziologie

Population ageing and the globalisation of international migration are challenging the research agendas of social scientists around the world, and posing numerous challenges for policy makers and practitioners whose goal is to formulate and design high-quality and user-friendly policies and services. Both of these phenomena have brought, for example, attention to the fact that more and more people around the world are ageing in countries other than those where they were born. The fact that elderly care sectors around the world need to recruit staff if they are to handle the growing number of older people that will need their services is also something that has been discussed when population ageing and the globalisation of international migration have been debated. The elderly care sector's reliance on people with migrant backgrounds has namely increased as a result of these phenomena.

This collection is therefore situated at the intersection of ageing and migration studies and takes into account the various issues with which this intersection is concerned. The chapters in this volume are written by established researchers in the field of ageing and migration around the world. The collection explores these issues in three sections:

• Elderly care regimes and migration regimes: national perspectives
• Ageing in contexts of migration: a multifaceted phenomenon
• Elderly care and migration.

The expert contributions in this volume address the array of issues associated with the study of ageing, old age and elderly care in contexts of migration.

Part 1 Elderly care regimes and migration regimes

National perspectives

DOI: 10.4324/9781315817606-1

1 At the intersection between an elderly care regime and a migration regime

The Swedish case as an example

Sandra Torres

DOI: 10.4324/9781315817606-2

Introduction

Inspired by Kilkey et al.’s (2010) assertion that there is a need for research that elucidates the relationship between care regimes and migration regimes, this chapter presents the Swedish case and gives glimpses of research on older immigrants and care workers with immigrant backgrounds. In doing so, the chapter focuses on the context of care – a context that gives us insight into society’s moral and political life (Tronto, 2010) as well as its relationship with ‘Others’ (Narayan, 1995).

The chapter is organised as follows. First, insights into Sweden’s elderly care regime and migration regimes are offered in separate sections in order to present the ambitious policies surrounding the terrain that is the elderly care sector. Next, demographics are presented for contextualisation purposes. And finally, a section that sheds light on the debate and the realities of migrants in the Swedish elderly care sector is presented, with concluding remarks meant to problematise the difference between policy ambitions and everyday realities.

The Swedish elderly care regime

The notion of care regimes stems from the feminist critique of Esping-Andersen’s (1990) book on several welfare states, and draws attention to the implications that the organisation of care services in different welfare regimes has on gendered power orders (e.g. Anttonen and Sipilä, 1996; Pfau-Effinger, 2005). The idea is that care regimes can be differentiated on the basis of the mixture of formal versus informal care provision, the care expectations that are implicitly placed on families as a result of this mixture and the ways in which the care sector is organised. Focusing on social services, Anttonen and Sipilä (1996) have found, for example, two distinct care regimes: a Scandinavian regime characterised by a strong formal sector, and a southern European regime characterised by strong reliance on the family. Along the same lines – but focusing on the mixture of formal versus informal care – Bettio and Plantenga (2004) distinguish between countries that expect the family to assume responsibility for care (e.g. Italy, Greece and Spain); countries that place care responsibility on the family, but that have different strategies for childcare and elderly care (e.g. Great Britain and the Netherlands); countries that expect a great deal of the family but that provide formal compensation for this (e.g. Austria and Germany); and, finally, countries which allocate a comparatively large amount of resources to the formal care sector (e.g. the Nordic countries).

Thus, although there is no consensus as to which factors should be used to categorise care regimes, and some question whether we can in fact speak of distinctive welfare regimes (e.g. Kasza, 2002), there is some agreement that the Nordic countries have – comparatively speaking at least – a distinct care regime of their own. The notions of universalism and de-familialisation as well as the broad range of public care provisions that are available to large segments of the population are some of the characteristics of this care regime (Bettio and Plantenga, 2004). However, there are some (e.g. Rauch, 2007) who question whether Sweden does in fact qualify as an example of the Scandinavian care regime since there is no elderly care guarantee in this country and restrictive admission tests are actually widely used. Thus, although the Swedish elderly care regime was considered to be a fine example of the kind of egalitarian welfare services that developed in highly industrialised European societies after World War II, the period that started in the mid-1980s brought about dramatic changes in the generosity of the system that gave the Scandinavian care regime its reputation. Korpi (1995) argues that these changes were characterised not only by stagnation of the development of care for the elderly in this country but also by a decrease in the quality as well as the scope of this care regime. Blomberg et al. (2000) describe, in turn, the stagnation that has occurred in elderly care specifically as an example of the withdrawal of the welfare state.

Irrespective of whether or not the Swedish elderly care regime is a good example of the Scandinavian social service model, elderly care is – comparatively speaking at least – largely publicly funded in this country. The overall responsibility for care of the elderly in Sweden rests with the state and not with the family, as is the case in some European countries. However, in this regard it must be noted that this does not mean that older people in Sweden have all their care needs met by the state. As Sundström and Johansson (2005) have pointed out: ‘informal care is the most common form of assistance that older people in Sweden receive; few rely solely on public services’ (p. 8). All older people in Sweden who have permanent residency and are in need of help and support in activities of daily life can, however, apply for assistance from the elderly care sector. The decision on whether or not care services are made available to them is determined after completion of an individual needs assessment process, which is carried out by care managers. This is why Rauch (2007) refers to Sweden’s admission tests when questioning the universality of this regime. It is worth noting that in contrast to needs assessment practices in the UK, which give the relatives of older people applying for services the opportunity to have their own needs assessed during this process, the needs assessment process in Sweden focuses only on the older person’s needs. This presents challenges when dealing with older people who cannot verbalise their needs, as is often the case when one has immigrated late-in-life, comes from a culture that differs greatly from the Swedish culture, and has not mastered the Swedish language yet (Forssell et al., 2015).

The work of care managers in Sweden is guided by legislation but also by organisational and municipal prerequisites (Dunér and Nordström, 2006). The legal foundations for needs assessment are found in the Social Services Act (SFS no. 2001: 453), which is a framework legislation that emphasises the right of the individual to receive municipal services. This legislation does not specify exactly what this right entails, which is why Rauch (2007) has argued that ‘though on a rhetorical level the Swedish Social Services Act (SoL) contains an individual service right, in reality elderly care guarantee is absent’ (p. 260). The legislation states that care for older people should be aimed at promoting a life with dignity and a feeling of well-being, but it is up to local municipalities to decide how resources are to be allocated. The legislation also clearly states that only those individuals whose needs cannot be met in any other way can access services, which is why access to elderly care in Sweden is a strongly conditioned right. The discretionary power that care managers in Sweden have has been shown to be particularly challenging when assessing the needs of older people with immigrant backgrounds who express needs that the sector does not always recognise as reasonable (Forssell et al., 2015) and/or have expectations that are not always deemed appropriate (Forssell et al., 2014). This is one of the reasons why welfare scholars question whether Sweden’s elderly care regime is in fact as egalitarian and universalistic as its reputation. Research shows that the ‘differences in what people are provided with are connected with differences in ethnic background, social class, gender, and the community in which a person resides’ (Blomberg et al., 2000, p. 162). Treating Sweden’s elderly care regime as a prime example of the Scandinavian social care model or the Nordic elderly care regime is therefore problematic these days.

The Swedish migration regime

Hammar (1985) defines immigrant policy as ‘the conditions provided to resident immigrants’ (p. 9), while immigration policy regulates who gets to migrate to a country (i.e. the entry categories that a country’s immigration policy relies on) and how non-citizens are to be controlled. The conditions that determine whether immigrants are included or excluded from the society that hosts them are often regarded as a country’s immigration policy regime (Faist, 1995). A combined look at Sweden’s welfare regime and immigration regime shows that although the social democratic regime that characterises this country’s welfare regime accords rights on the basis of citizenship, the immigration policy regime is actually far more inclusive since Swedish immigrant policy accords rights on the basis...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Table of Contents
• List of figures
• List of tables
• Notes on contributors
• A migration lens on inquiries into ageing, old age and elderly care: carving a space while assessing the state of affairs
• Part I Elderly care regimes and migration regimes: national perspectives
• Part II Ageing in the context of migration: a multifaceted phenomenon
• Part III Elderly care in the context of migration
• Index