Aged care services as facilitators of delayed inclusion – An analysis of institutional discourses on service provision for older migrants in Germany

Abstract

Background: Migration within and to Europe in the past decades has led to a growing diversity and a rising proportion of migrants in the older population. Germany has encouraged labour migration since the 1960s and many migrants who arrived for work in the past decades decided to stay and are now growing old in Germany. Health and social care institutions intend to acknowledge this change and adapt to the cultural diversity in aged care. This process can also be observed in the city of Munich, which is characterised by a high percentage of citizens with a migration background and an increasing population of older migrants. Methods: This study examines discourses on older migrants and their access to health and social care in Germany, associated challenges and proposed solutions. Problem-centred interviews were carried out with 18 professionals from public, welfare and charity organisations who develop, organise or provide aged care services for older migrants. The analysis examines the narratives of migrant representations, constructions of healthy ageng and phenomenal structures of services provision following the sociology of knowledge approach to discourse (SKAD) research programme. Results: The discourses on older migrants in public and social care institutions demonstrate how being defined as a migrant is related to cultural, socioeconomic and language difference and particularly stresses the structural challenges labour migrants experienced throughout and after employment. Thus, improving accessibility to health and social care is presented as a public responsibility, which aims to recognise the increasing diversity in older age and to create low threshold access to these services. Conclusions: Recognising the increasing diversity in older age by implementing diversity sensitive frameworks and improving accessibility to health and social care services could provide an opportunity for (delayed) inclusion in public services for older migrants.