While the debate on multiculturalism – a socially complex dynamism – is still raging, nevertheless multiculturalism is found in the everyday life of people across the globe. It has remained a powerful force in modern societies (Banting and Kymlicka, 2006), particularly in the cases of national minorities and indigenous people in traditional countries of immigration (Kymlicka, 2007; Scheffer, 2011) as evidenced in the United States, Canada, and Australia. Multiculturalism has neither been limited to scholarly philosophical debates, nor to policy issues in the political arena, but manifested in everyday social practices in both traditional and non-traditional countries of immigration all over the world.
One of such social practices is the social work profession, particularly international social work. In social work profession generally, Sue (2006) devoted a seemingly classic multicultural social work textbook to calling for organizational change in social work education and practices that would reflect not only traditional therapeutic practices, but also an emphatic focus on rebalancing clients in their familial and community contexts by means of treatment practices aimed at freeing them from cultural oppression. Similarly, Gutierrez (2001) reviewed scientific literature at developing an Ethno Conscious Perspective that focused on equity, equality and fairness and a social development agenda (a departure from the individualistic approach) in order to change the low status of ethnic minorities communities, refugees, and people of color in the United States. The reality of multiculturalism in the social work profession is asserted further by Longres (1997) who posited that multiculturalism is arguably the most important issue in providing for the wellbeing of people in ethno-culturally diverse settings. Thus multiculturalism works for social justice – a key principle in social work’s international definition (Adams et al., 2009). It encompasses social welfare for everyone. And in particular, Mayadas and Elliot (1997), p. 176 emphasized that 21st century international social work has as its core values “globalization, transculturalism, multiculturalism, democracy, diversity, socio-cultural and ethnic exchange”. They apparently synthesized multiculturalism and international social work with the international communities and institutions; the globalization of the social work profession; identification with international institutions; and advocacy for local problems originating from the global system (Healy, 2001; Lyons et al., 2006; Cox and Pawar, 2006; and Hugman, 2010).
Within the seemingly wide scope of multiculturalism, the focus of this study is on agencies’ social care of the aged, in which the administration of agencies is contemporarily being affected by what Torres-Gil and Moga (2001), p. 14 described as the “growth of minority populations, continued immigration, increase in longevity, the aging of the baby boomer and public policy responses…”. Hence, the question arises of whether social care agencies for the aged have ever strategically reflected multiculturalism on their websites, either in the past, or contemporarily, as internet has increasingly become the gateway to social life, and as a response to increasing global social mobility. In a seemingly first attempt at providing answers to the question, due to the dearth of literature on this type of research, this study empirically explores how multiculturalism is being displayed on the websites of agencies providing social care for the aged. This is done towards a better understanding and advancement of international social practice of caring for the aged in ethno-cultural diverse settings, as well as in contexts resemblance of (hypothetical) Banal Nationalism “in which public institutions and public space are imprinted with a particular national identity” (Kymlicka, 2007, p. 64) thus depicting an illusion of ethno-cultural homogeneity that is immunized against social mobility.
Consequently, this study primarily uncovers the nature and pattern of how multiculturalism is portrayed by agencies providing social care for the aged, for replication and possible improvement. In addition, the study explores the commonality of a notion that meeting the needs specific to cultural identity (a strong factor in multiculturalism) is an indispensable factor for the wellbeing of the aged (Lai 2012), when organizing and strategizing social services for older people in ethno-cultural diverse settings. At achieving these goals, the background sub-sections illustrate further how the study has systematically used both the concepts of multiculturalism and that of agency for the aged, thereafter followed by literature review concerning the area of focus. The sections on results and discussion contain the empirical discoveries and their implications for international social work practices and social policies. The concluding section contains the limitation on the scope of the theory generated as well as recommendations for further studies, while the techniques deployed in the study are described in the section for methods.
Conceptual framework
Multiculturalism
The concept of multiculturalism is apparently complex in meaning. Cumulative knowledge about human nature has shown that no two human beings are completely the same or different, and human societies are however made up of these differences. Their developments into a complex reality of socio-cultural environment is no longer under debate, as social research has revealed the world to be a composite of social evolution called multiculturalism, and the global interdependence of these socio-cultural composites is contemporarily being called ‘globalization’ (Dominelli, 2009). Nevertheless, Torres-Gil and Moga (2001), p. 16 asserted that the concept as used in social work “appears to reference the value and even desirability of encouraging racial and ethnic groups to maintain their group self-identities”. This is also the concept’s referent in major scholarly texts such as Banting and Kymlicka (2006) and Kymlicka (2007), but Sue (2006) added ‘feminism’ to the grouped referred to, and Jay (2002) also referred to ‘sexual orientation’. However, due to the varied meaning of multiculturalism there is the need to delve into the evolution of the concept so as to illustrate its usage in this study.
‘Multiculturalism’ shares conceptual complexity with its parent word – ‘culture’. Culture has been defined from the perspectives of three senses: as artistic or intellectual work by the humanities scholars; as a way of life by anthropologists and sociologists; and as a development process of historical documents and methods by historians (Baldwin et al., 1999). Similarly, the term ‘multi-culture’ became ‘multiculturalism’ for Dewing and Leman (2006), who argued that the concept has its origin, from Canadian government policy of 1965 and 1971. And also for Koleth (2010), pp 4 who asserted that it was used in Australia in 1973 “as the basis for migrant settlement, welfare and social-cultural policy”, hence multiculturalism has been seen from different perspectives: firstly as a political prescription (or ideology) that aims at legitimizing the incorporation of racial and ethno-cultural diversity in the general structure of any society; and secondly as a social reality that describes racial and ethno-cultural diversity as a phenomenon (Kallen, 1982). These perspectives fit into what Taylor et al. (1994) have viewed as ‘the politics of recognition’ in his understanding of multiculturalism. In agreement with these lines of thought, Raihanah (2009) summarizes that multiculturalism has become a wide raging concept which can be used to describe an ideology, a social policy or aspects of public structure. Thus it can be inferred that within the discussion of ethno-racial relationships, particularly among the classical countries of immigration, the dominant argument is the political aim and agenda for integration.
In addition, Jay (2002) argued for the need to understand multiculturalism from different national historical perspectives, invariably it can also be inferred that the concept is a product of cultural diffusion that collocates with its variant models in state policies such as ‘social integration’ , ‘ethno-cultural diversity’ , ‘assimilation’ , ‘acculturation’ (Kallen, 1982; Torres-Gil and Moga, 2001; Kymlicka, 2007) and ‘cultural pluralism’, ‘melting-point’ , ‘race-relations’ , ‘identity politics’ (Jay, 2002), paving the way for, as much as embedded in, the theoretical arguments of cultural and sociological relativities. Therefore, from these perspectives this study defines multiculturalism as the evolving multi-racial and ethno-cultural inclusion, diversity and individuality in everyday interactions that have effects on how social institutions are organized. The definition is used in this study as the main theoretical framework giving focus and direction, and informs what to look for in the text contents of organizational strategies on the websites of sampled agencies.
Social care agencies for the aged
The word ‘aged’ generally refers to individuals in the final stage of their life-span (Johnson et al., 1997). Everyone, irrespective of the population group of belonging may contend with health-related problems, but the probability of developing health problems becomes more pronounced as one comes to the later stage of life (Heffernan et al., 1988). Hence agency care for the aged is becoming complex in most societies, particularly in the advanced countries, owing to changes in family types, urbanization and high social mobility. Adding to these complexities is the changing racial and ethno-cultural demography of the elderly, which is one of the practice fields in which social workers play important helping roles globally.
Consequently, different models of service delivery and partnership are emerging as multipurpose senior centers in a seemingly new model of services for older people. This is an abridged form of the ‘social science models’ and the ‘bio-medical models’ (Payne, 2009) with emerging multicultural trends as portrayed in sample data, and are called here the ‘Multi-Racial & Ethno-Cultural Models’ of social care for the aged. They include social services, in which professional social workers assist the aged to make healthy and happy adjustments by solving social problems, thereby serving as advocates (particularly in residential care) and liaising between family members of clients and staff. That is, social workers ethically serve as client companions all the time, with a multi-racial and ethno-cultural approach. Other services are therapeutic services, which may be physical or recreational, (some in the domain of clinical social workers); nursing services; medical services, which include physicians, clinical specialists, dentists, podiatrists and ophthalmologists; and lastly ancillary services such as pharmacy, radiology, or clinical laboratory services.
Therefore, the concepts of agency social care for the aged are as simple as the social and medical models, and as complex as the emerging multi-racial and ethno-cultural models illustrated above, and together with the concept of multiculturalism as defined previously, serve as the conceptual and contextual frameworks for searching for relevant literature review, and for data gathering techniques in this study.
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.