The quest for cultural sensitivity : how cultural sensitivity can be practised while mitigating othering in Swedish eldercare

Abstract: The need to provide culturally sensitive care for older adults with immigrant backgrounds has been expressed by care professionals. Meanwhile there is a lack of consensus about how this should be done, and critical perspectives in research highlight the danger of causing this group to be viewed as problem bearers. This thesis explores the possibility of using the welfare theory of health to achieve cultural sensitivity while limiting the risk of othering. It uses a goal-oriented perspective of health that could be useful in an active ageing context. Study I used a mixed-methods design and the Delphi method. Study II used a quantitative design and survey method. Study III used a qualitative design and semi-structured interviews. Study IV used a qualitative design and vignette method.Study I showed that municipal decision-makers in eldercare find it hard to agree on what cultural sensitivity entails. They prefer to consider individual preferences in less complex cases, but look for fixed cultural categories in more complex cases. Study II showed that the welfare theory of health can be used as a viable, personal, holistic approach to health among older adults, and that it can be measured with the HACT questionnaire. Study III built on the questionnaire in Study II, expanding it to include immaterial capital theory. It elucidated how immaterial resources of older adults with immigrant backgrounds, such as social capital, influence their goals related to good ageing. Study IV showed that assistant nurses could use the welfare theory of health to increase cultural sensitivity in their work. However, like the decision makers, they looked for fixed cultural categories in more complex cases.The thesis shows how the welfare theory of health can be used to conceptualize cultural sensitive care with a starting point in the personal goals of older adults with immigrant backgrounds. With the help of immaterial capital theory, the thesis can shed light on the importance of immaterial resources, such as social capital, both in forming those goals and as resources to achieve them. With this knowledge, decisions and practices aiming to provide culturally sensitive care could be based on assessments of needs and resources without relying on preconceived and fixed ideas about other cultures.