Background: The aging of Pakistani immigrants in Norway raises questions related to their increased need for care and help from relatives, as well as those concerning what future formal and informal care and healthcare accessibility for older immigrants may look like. The hidden nature of family caregiving means that the circumstances of carers, their views and their dilemmas related to future care are largely invisible. In this study, we explored female Pakistani carers' views of future care and healthcare accessibility for their older relatives in Norway. Methods: Our data included interviews with family carers between the ages of 23 and 40 years old, living in Oslo, Norway. We recruited ten family carers, out of which eight were daughters and two were daughters-in-law. Interviews were conducted by the first author in Urdu or English and were recorded and transcribed verbatim. Results: Our findings revealed several factors that influenced participants' perceptions about formal and informal caregiving, which can be organised into the following themes: 1) caring for family in Norway as in Pakistan, 2) worries about being 'dropped off' at a care home, 3) concerns about being cared for by outsiders, 4) questions about what other people might say and 5) adhering to society's expectations of a 'good' carer. Conclusion: Family carers' traditional views of filial piety do not entirely determine the use of or access to healthcare services of their older relatives. There is a need to develop culturally sensitive healthcare systems so that immigrant families and their carers have more options in choosing care in old age, which in turn will ease their families' care burden. Healthcare professionals and policymakers should not assume that immigrant families will take care of their own older members but should instead secure adequate support for older immigrants and their family carers.

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Increase and diversification of the migrant population can have significant implications for the Norwegian Health Plan's commitment towards equitable access. Despite the generous nature of the welfare state in Norway and emphasis on culturally sensitive care, it is important to consider the various impediments that some migrants may experience in accessing and consuming healthcare services. We conducted a scoping review aimed to shed light on the extent of healthcare utilization and the socioeconomic barriers experienced by migrants. Our review illustrates that migrants' overall consumption of different forms of healthcare services is lower than that of the general population but varies between different migrant groups. Financial affordability has been found to influence use of services that more or less fall out of the publicly covered healthcare benefits, such as dental care, physiotherapy and private specialists' care. However, there is lack of information on how affordability influences use of primary healthcare, somatic specialist care, nursing homes and mental healthcare. While there is evidence of socioeconomic barriers at the patient level for utilization of primary healthcare services, including both pre-migration aspects and factors in the host country, the question of affordability often becomes subordinate in the context of the welfare state. Our review suggests further examination of pro-rich inequity in healthcare services, given the rising income inequality in Norway, and with migrants usually having lower incomes than the rest of the population. Furthermore, research needs to take into account different groups of migrants such as undocumented refugees, migrants awaiting residency and labour migrants in order to examine barriers encountered both in everyday experiences as well as structural barriers to healthcare consumption.

Purpose The purpose of this paper is to synthesise data from the existent literature on the experiences of non-western older migrants in Europe in accessing and using healthcare services. Design/methodology/approach In total, 1,606 records were reviewed and 12 studies were selected. A thematic synthesis using Thomas and Harden’s approach was conducted. Findings The findings resulted in the three overarching themes: traditional discourses under new circumstances; predisposed vulnerabilities of older migrants and the healthcare system; and the conceptualization of health and the roles of healthcare professionals. The authors found that older migrants’ experience of accessing healthcare is influenced by many factors, such as health literacy, differences in healthcare beliefs and language barriers, and is not limited to cultural and traditional discourses of care. Findings reveal that there is a limited body of knowledge on barriers experienced by older migrant women. Research limitations/implications The geographical scope of the study and subsequent type of healthcare systems should be taken into account while understanding barriers to care. Another limitation is that although we studied different migrant groups, the authors synthesised barriers experienced by all. Future research could study migrants as separate groups to better understand how previous experiences with healthcare in their home country and specific social, cultural and economic circumstances shape them. Originality/value This paper provides a synthesis of the experiences of migrants from non-western countries who moved to a host country with a very different language, culture and healthcare system.

Background The population of Europe is ageing and becoming more ethnically diverse due to migration. Finding suitable long-term caring arrangements for older immigrants in Europe has been one of healthcare policymakers’ concerns in the last decade. However, relatively few older people with an immigrant background live in long-term care facilities, and many prefer to be cared for by their family members. Little is known about immigrant family caregivers’ experiences of caring for older family members and the support they need while providing care. This study aims to synthesize the qualitative literature exploring the experiences of individuals caring for older family members with immigrant backgrounds from Africa, Asia and South America living in Europe. Methods We searched the electronic databases Medline Ovid, Embase Ovid, PsycInfo Ovid, SocIndex EBSCOhost, CINAHL EBSCOhost, Scopus, Social Care Online, ASSIA ProQuest, and Google Scholar for original, peer reviewed research articles, published in English from 2011 to 2022. The seven-step interpretive methodology in meta-ethnography developed by Noblit and Hare (1988) was followed for qualitative synthesis. Results After assessing 4155 studies for eligibility criteria, 11 peer-reviewed articles were included in this review. The qualitative synthesis of these included articles resulted in four main themes: strong care norms for parents, the moral dilemma of continuing care, uneven care sharing, and the use of formal care services. Conclusions Caregiving dynamics are changing, both in terms of motivations and approaches to caregiving. Furthermore, there are gender disparities in the distribution of caregiving duties, particularly with women carrying the more significant burden of care. The care burden is further exacerbated by the lack of culturally sensitive formal services complementing the care needs of the ageing immigrants and their family caregivers. Therefore, those searching for alternatives to informal care should be met with appropriate health and care services in terms of language, culture, religion, and lifestyle, delivered in a non-judgmental way.