Multiculturalism in social agencies for the aged

Conceptual framework

Literature review

There is a vast ‘ethnogerontological’ literature reflective of care for the aged from multi-racial and ethno-cultural backgrounds (Brotman, 2003), particularly those focusing on care of the aged in the residual liberal welfare model contexts. Nevertheless, few of these studies are concerned with how ethno-cultural diversity is portrayed on the websites of agencies providing social care for the aged. For example, Holland and Katz (2010) highlights cultural provision in extra care for the elderly Jewish community in United Kingdom. Rose and Cheung (2012) asserted that literature review of 54 articles published between 2001 and 2011 across countries advocated the need to combine ethnic, cultural and ‘gerontological’ issues into the diagnostic and statistical manual of mental disorders for accurate assessment of each client. Dockery’s (2010) empirical study highlighted the welfare link between race, ethnicity and culture among indigenous Australians. In the United States Longres (1997) expressed a similar view that the major goal for minorities is to gain access to the resources that allow for success, particularly the welfare industry, as a means to an end. Thus the crucial role ethnic identity (and diversity) can play in the promotion of health and care of the elderly as asserted by Lai (2012) is expressed by all the studies but none of them is concerned with how multiculturalism is strategically entrenched and portrayed by the agencies.

In addition several non-empirical studies have been concerned with culturally competent practice. For example, in a systematic academic review of literature on delivery of elderly care in the culturally and linguistically diverse backgrounds of Australia, Radermacher et al. (2008) asserted in their findings that culturally competent practice is required to deliver a responsive and effective community aged care system, a view akin to views expressed in related studies in the United States (Dong, 2012; Browne and Mokuau, 2008; Gutierrez et al., 1996), and in Sweden (Forssell and Torres, 2012). Their views confirmed Brotman’s (2003) earlier assertion though in the context of Canada that previous studies have been too focused on developing competency skills rather than on exposing and altering institutional structures and power relations dotted with racism.

Other studies have focused on a programmatic dimension to multiculturalism for social care of the aged in contemporary time. In California Chow et al. (2010) linked racial and ethnic variations to different services of support for adults of age 50 and above. Giunta et al. (2012) explored racial and ethnic diversity in senior centers in New York by comparing participants’ characteristics in more and less multicultural settings, and highlighted the importance of multicultural programming for senior centers as a result of demographic changes which seem bound to eliminate mono-cultural care centers for seniors. The focus of the study has also been directed towards composite factors of multiculturalism that are challenging care systems for the aged. Nguyen (2012) discovered English proficiency as the cause of access disparities to care services among Asian-American elderly immigrants to the United States. Bhattacharyya et al. (2012) also discovered that language and generational differences were some of the factors hindering effective service provision for the aged in the United Kingdom. The correlation between religion and ethnicity among African-American, Hispanic and White non-Hispanic was explored by Morano and King (2005), revealing the in-depth effects which multiculturalism factors can have on the care of the aged in culturally diverse settings. Also Alalauri and Hujala (2013) highlighted the growing importance of multiculturalism in the care profession by describing the discourses of multiculturalism on organizational culture and everyday life in care work community, including the elderly care contexts in Finland. However, agencies’ portrayal of multiculturalism on their websites is apparently out of focus in all these studies.

Nevertheless, few studies are conducted on multicultural dimension of care system structures but no information on how multiculturalism is portrayed by the agencies. In the United States, Torres-Gil and Moga (2001) compared senior center participants in an ethno-racially diversified setting with those in a non-diversified setting, and discovered that public policy responses could affect care system designs. This discovery is similar to Lum (2005) argument that most studies have neglected racial and ethnic differences in the structure and size of care giving networks in the United States. In the United Kingdom, the exploration of the mistreatment of black and minority ethnic groups by Bowes et al. (2012) uncovered structural and contextual factors to be more contributive than cultural factors for elderly care. Also, Health Service Executive (2005) structurally adopted a ‘Whole Organization Approach’ that embedded multicultural awareness, such as the usage of signage at the reception and public areas, to care for the languages of service users as a response to the challenges of ethno-cultural diversity in Ireland. Apparently none of these studies have considered their websites as a vital platform for disseminating multiculturalism strategically in view of its importance to social care delivery, even in culturally diverse settings.

Thus almost all the literature reviewed emphasized the importance of multiculturalism to the wellbeing of people in ethno-culturally diverse settings from theoretical, empirical, programmatic, clinical and cultural competence approaches. However, with the exception of studies by Torres-Gil and Moga (2001), Health Service Executive (2005) and Bowes et al. (2012), no other studies made reference to strategic and structural display of multiculturalism by agencies, particularly on their websites, in the care of seniors, who need a more sensitive approach to accessing social care, in an age where internet has increasingly become the gateway to accessing social services. Hence the current inquiry into how multiculturalism is portrayed on the websites of agencies providing social care for the aged.

Results

Multiculturalism issues are entrenched in the agencies’ Strategic Planning Statements (SPSs) or texts, stating the reasons for the agencies existence and the social roles being performed in their respective countries of location. Organizational purposes, objectives, directions or long-range plans are referred to as SPSs (Bradford et al., 2000; Riggs, 1984), and in this study they are concerned with the statements of ‘mission, vision, goal, value, philosophy, aims and others’ , stipulating the essence of the agencies. And as portrayed in the Qualitative Analytic Matrix’s table, the SPSs exhibited similar multicultural sequences, patterns and frequencies that are categorized as multiculturalism of inclusion, diversity and individuality.

Firstly in the category of inclusion, the usage of the words: ‘all’ , ‘inclusivity’ and ‘everyone’ dominated all the texts, and featured in the following SPSs: mission, vision, value and others. This category is portrayed in nine cases located in South Africa, United Kingdom, United States, Canada and Australia, and five of the cases illustrated their textual referents with pictures of Africans, White Europeans, and people from Asia for emphases. Secondly, category of diversity is also filled with statements or texts referring to ‘cultural diversity’ , religion’ ‘independence’; and no discrimination on the basis of ‘nationality’ , ‘background’ color’ ‘race’ , ‘sex’ , and ‘age’ , as portrayed in six agencies – five in United States and one in Canada. These agencies also exhibited similar pictorial referents to Africans, White Europeans, and people from Asia. Lastly, the category of individuality featured ‘individuality’ in the value statements and statements of philosophy of two agencies located in the United States, with only one of the two exhibiting pictorial referents in addition to textual references as emphases of the multiculturalism issues within the agency.

As illustrated with the SPSs above, the pictures generally served as same equivalence of references for clarity and emphatic purposes across agencies and countries, but relative to the presence of particular ethnic groups in each agency’s location. Apart from being the concrete symbols of ethnic referents they also exhibited the same patterns across the categories of multiculturalism as used in this study. The pictures also served as the only medium of portraying multiculturalism in some cases, particularly as seen in one agency (Home Instead Senior Care) based in United States and operating on franchise to non-liberal welfare regimes.

Beyond the texts and pictures focus

Findings beyond the use of multimedia or ‘texts’ and ‘pictures’ are uncovered as in the following: firstly, the quantity and the spread of agencies that strategically provided for the multicultural care of the aged across countries supported the position of Longres (1997) who generally asserted that the wellbeing of people in diverse settings are improved through multiculturalism, and the position of Mayadas and Elliot (1997) who argued that 21^st century would be years of globalization, and multiculturalism. Thus due to the expansion of globalization in the midst of increasing social mobility, however, an increase in multicultural activities should also be expected across the world.

Secondly, the twenty four (n = 24) samples are associated with the concept of liberal ideology. The agencies are all located in countries with liberal welfare regimes and residual models of social welfare policy (Esping-Anderson 1990). In addition, through franchise the possibility of portraying liberal multiculturalism in other welfare regimes manifested, even when there are no such textual references in those countries’ social policy documents. This is seen in the agency called “Home Instead Senior Care” that operates on franchise from United States to South Africa, Hong Kong, Quebec, Singapore, Chile, China/Belgium, France, Greece, Spain, Italy/Denmark, Sweden, and Norway respectively in the framework. Apart from South Africa and Quebec in Canada, these are countries operating different forms of social welfare regime, hence the argument that multiculturalism is of the liberal ideology.

On one hand, the previous qualitative findings are confirmed by the quantitative table. Nineteen cases in the text column of the multicultural categories have twelve of the cases as textual referents, and they emphasized these referents with ‘pictures’ (multimedia). Thus the texts’ column represented the concrete social policies of the respective agencies, and each policy in the twelve cases is strongly emphasized by the supporting pictures. On the other hand, cases that used ethno-pictorial images ambiguously to portray multiculturalism are in the pictures’ column of the table. Among the eighteen uncategorized cases, where ‘pictures’ are the only referents to portray multiculturalism, there apparent ambiguity is uncovered as their references to liberal multiculturalism might have different meanings in non-liberal welfare regime countries. Hence those on franchise are seemingly used as extension of neo-liberalism to other types of welfare regimes, an apparent process of globalizing the liberal ideology, which would subsequently have multicultural implications. In other words, their usage can be subjected to ambiguous symbolic interpretations when there are no textual explanations of multiculturalism on their websites, or in their national social policy documents.

Therefore with this quantitative support for the preceding qualitative findings, this study empirically theorizes that the patterns and modes of portraying multiculturalism by social care agencies for the aged are similar. These agencies use texts that consist of multicultural categories of inclusion, diversity and individuality in their strategic plans; and emphasize their text referents through ethno-related pictures as universal equivalence symbols for ethno-cultural diversity. The non-text referents to pictorial images, however, are open to cultural and sociological relativities. And these modes of portraying multiculturalism are apparently rooted and originated from the liberal ideology.

Discussion

This section focuses on the commonality of the notion of multiculturalism across countries and continents; the implications of the study for social work practices; the minimal nature of the theory posited; and the need for further studies. Apart from discovering how social care agencies for the aged are portraying multiculturalism on their websites, the scope of the sampling technique used in this study helps to uncover multiculturalism as a global wide-spread notion vital to the wellbeing of the aged particularly among those in ethno-cultural diverse societies. Examples of studies expressing this view ranges from those conducted in the traditional countries of immigration and to others in non-traditional countries of immigration. Those in traditional countries of immigration include that of Dockery (2010) in Australia, Lai (2012) in Canada, and Torres-Gil and Moga (2001) in United States – these are the countries where majority of the samples used in this study are located. Those conducted in non-traditional countries of immigration include that of Holland and Katz (2010) in United Kingdom, Health Service Executive (2005) in Ireland, Alalauri and Hujala (2013) in Finland, and Forssell and Torres (2012) in Sweden. In addition, the notion was also expressed in a study conducted at a global level by Rose and Cheung (2012), hence the notion is a global phenomenon and the modes of portraying multiculturalism as demonstrated by the cases can be adapted globally.

The practice implication of the modes for portraying multiculturalism, first and foremost, is the use of multimedia (a combination of texts and pictures) as methods of communication by the agencies. It solves conceptual ambiguity in bi- or multi- lingual settings at ensuring welfare access and availability to all ethnic groups in both existing and emerging multicultural societies, and which can be adopted at national and global social policy levels. For example, the communication models justify the context in which the social care agencies from Canada are operating as it is a reflection of the demographic characteristics of the country given the assertion of Masi and Disman (1994) that prior to 1950, about 90% of immigrants to Canada came from Europe, and thereafter the percentage has decreased to less than 20%, and similarly argued by Lai (2012) that the percentage of people of color in Canada have increased from 4.7% in 1981 to 16.2% in 2006. Thus new Canadians now come from such diverse areas as East Africa, South East Asia, Central America, South America, and South Asia”.

Secondly, the modes are also of importance to social work practice, in the contexts of global interdependence of multi-ethnic populations, as an institutional multicultural structure of communication that has universally understood symbols of referents. Such communication models will contribute to the wellbeing of clients psychologically, in terms of confidence at accessing services and assurance of their availability for everyone. Therefore by using the communication models social work profession can further reject the double-jeopardy hypothesis attributed to cultural diversity (Lai 2012) which has been argued to be detrimental to the wellbeing of the aged in ethno-culturally diverse contexts.