Dignity, care and support for older women from Black and Minority Ethnic (BME) backgrounds: Service providers’ perceptions - Report

A Report compiled as part of a larger Study: ‘In their own words’: Capturing the voices of older women from black and minority ethnic (BME) backgrounds in order to understand their perceptions of dignity, with a focus on care and support

The aim of this research was to explore service providers’ perceptions of how dignity could be enhanced or diminished, with a focus on care and support offered to community dwelling older people from black and minority ethnic (BME) backgrounds. A survey design was used to explore the following key areas of professional practice: the care of older women from minority ethnic backgrounds, the perceptions of the views held by these service users in respect to their care and support, barriers or areas of challenge in providing culturally responsive care, and lastly, the facilitators and enhancers of intercultural care that was responsive to ethnic and cultural difference. Data were collected between March and June 2012 via a purposely developed questionnaire, with 124 responses received. A telephone discussion on examples of effective practices and responsive services was conducted with 14 respondents after the survey. The majority of the respondents were female from a white background. A large proportion of respondents (n=54, 43.9%) worked in the third sector, followed by the public sector and the private sector. The largest numbers of respondents were involved in providing support (48.4%), followed by those managing services (35.5%), supervising others (23.4%), and delivering hands on care (17.7%). Respondents from a minority ethnic background comprised 18.6% of the sample, and the majority of them worked in the third sector.

Key Results
• Respect was mentioned most frequently with regards to dignity. Respect was strongly associated with dignity, and was communicated or manifested itself, through actions and behaviours.
• The majority of respondents perceived that older women from a BME background would think they were offered the opportunity and support to express their needs, but just under one quarter of the respondents (22%) thought they were seldom offered the opportunity, and 7.7% thought they were seldom offered support.
• Respondents perceived that older women from a BME background would think their physical needs were most often taken into account, whereas their cultural needs were least often taken into account.
• One quarter (25%) of the respondents perceived that older women from a BME background were seldom involved in decision-making about their own care, and 2.8% perceived that they were never involved.
• Close to one half of respondents (44.1%) perceived that older women from a BME background could seldom or never choose which language they wished to use to communicate, and 31.9% believed that this population group were seldom or never provided with information relevant to their ethnic or cultural background.
• The top five barriers which made it difficult to provide intercultural care with dignity were a lack of staff who can speak community language, a lack of interpretation services or limited access to interpreters, a lack of staff training, limited time and not recognising the culturally specific needs of older people.
• The top two barriers or challenges to providing responsive services were addressing the way local services were accessed, and not taking into account of older people’s culturally specific needs when designing services.
• With regard to key elements which might help respondents provide better care or support to older women from a BME background, staff training and recognition of and information tailored to older people’s needs were most frequently reported.
• Over 50% of respondents with a supervisory or managerial role reported managers as well as care plans, internal policy and best practice guidelines as sources of care information. Best practice guidelines were seen as a source of care information for over 50% of respondents who worked in the third sector.
• Over half of all respondents indicated they sourced external support and information from organisations that mainly work with older people. This was closely followed by organisations providing health and social care, and organisations mainly working with older people from a BME background, all of which were referred to by around half of all respondents. Equality organisations and cultural associations were referred to by around a third of the respondents.
• Other sources of information and support came from family members and friends of the person respondents provided care or support to (72.5%), the person they provided care or support for (67.5%) and by drawing on their own experiences (55%).
• Most respondents thought that older people from a BME background and their family members were often unaware of services especially mainstream services available for them. They also thought that a social support network was often not in place to facilitate access to relevant services on older people’s behalf.
• Lack of funding was frequently seen as a key factor that had hindered the development and adaptation of support and care; this was even more of a pressing concern for those based in third sector organisations.
• Among some respondents it was stressed that staff members tended to be constrained from learning about and responding to culturally appropriate care which often required more time and effort to plan and put into practice.
• Respondents reported that there were often few referrals of users from a BME background via social services or self-referrals. They felt unsure how and where to approach them and acknowledged difficulties in informing older people of newly developed programmes or service.