Background and Objectives By shedding light on the reasons why persons with a migration background (PwM) may take up the role of family caregiver of a person with dementia, and how this relates to gender norms, we aim to elucidate cultural and social dynamics that impede care sharing. Research Design and Methods A qualitative study of 12 PwM who provide care, or have recently provided care, for a family member with dementia was conducted through semi-structured interviews. Identified themes and patterns were analyzed with the help of Hochschild’s interpretive framework of framing and feeling rules. Findings Our findings illuminate how motivations to provide care are framed through two moral framing rules, reciprocal love and filial responsibility, and how these framing rules are accompanied by the feeling rule of moral superiority over non-caregiving family members. We show how shared dementia care is impeded though these moral framing and feeling rules, and how gender norms impact on an unequal distribution of care-tasks. Implications Healthcare practitioners should identify the moral dialectics of caregiving. This means that, on the one hand, they should be aware that moral framing rules may pressure women into exclusive caregiving, and that this can lead to health problems in the long term. On the other, healthcare practitioners should recognize that providing care can create a deep sense of pride and moral superiority. Therefore, showing acknowledgement of the caregiver contribution is a crucial step in creating trust between the caregiver and healthcare practitioner. Furthermore, asking for support should be normalized. Governmental advertisements on care–support can achieve this.

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Rationale, aims and objectives: Multimorbidity in deprived populations is associated with longer hospital stays, more avoidable admissions and complications, higher costs, and lower satisfaction with available services. While integrated care has been proposed as a solution, the expertise of professionals to deliver this type of care has received little attention. Our case study evaluates an intensive intervention in a deprived neighbourhood in the Netherlands, launched in 2008, to tackle multimorbidity and the expertise of health and social care professionals to cater to the population’s health needs.Methods: Mixed-methods evaluation. Between 2009-2012 semi-structured interviews (n= 11), field observations, conversations, dialogue sessions and documentary review. In 2012 and 2013 quantitative before-and-after study with web-based questionnaire in the intervention and two control neighbourhoods (n= 86 at t0 and n=117 at t1).Results: The intervention sought to develop professional expertise in population health orientation, generalism, and coaching. Activities were supported by management that emphasized learning by doing, working bottom-up with direct application in practice, and professionals enjoying discretion to experiment. The intervention’s widely supported mission brought cohesion to its activities. In the interviews, professionals reported becoming more adept at understanding the common causes behind patients’ complaints, unravelling their multiple problems, and encouraging them to be more active in addressing their own health and well-being. But this was not supported by the quantitative data measuring professionals’ attitudes.Conclusion and practice implications: Neighbourhood interventions can strengthen professionals’ expertise in population health orientation, generalism and coaching, and the communication and collaboration skills necessary to employ them. Whether they can lead to more adequate responses to multimorbidity and more effective integrated care arrangements needs to be further researched.

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