Background: The recent studies conducted among the health professionals representing long term care have shown that working with the elderly immigrants involves a range of challenges. One of the typical challenges is to adjust care service to the individual needs so that it maintains the patient’s integrity and dignity. The Norwegian health care system is built on the principles of equal access, equal quality and equal health outcomes. At the same time, it requires that health care takes into account that people are different and have different needs, with other words those with unequal needs should receive unequal treatment. The challenges related to the individual adjustment of care service, however, may give various implications and negatively affect the equity objectives and thereby prevent health care from being fair and equitable.
Objective: This master thesis aims to explore the challenges the health professionals at nursing homes face while seeking to provide equitable care services for the elderly immigrants. Based on the empirical findings, this paper also discusses to what extent the principles of equity in health care are fulfilled.
Method: A qualitative study, using semi-structured in-depth interviews. Study has been conducted from the health care professionals’ perspective. The sample size includes eight respondents. The key informants are nurses and caregivers from two different nursing homes in Oslo area. The informants represent both somatic and psychiatric wards. The selection criterion is availability of working experience with elderly immigrants from non-Western countries.
Results: A range of challenges that affect work of the care personnel has been revealed. Health professionals reported that the challenges they faced include problems related to language barriers, unrealistic expectations from health care, lack of health literacy, intentions to maintain traditions, problems related to hygiene, religion and food habits. It takes more time to assist patients with ethnic minority background than their Norwegian counterparts. Of all the above-mentioned obstacles language barriers, cooperation with patients’ families, unrealistic expectations seem to be most significant. These factors prevent health personnel from successful adjustment of long term services to the individual needs. The significance of other challenges such as hygiene, food or religion is not diminished, but they are rather results of the intention to maintain traditions. The analysis of the findings also indicates that there is a wide span in implementation of the equity policy. The underuse of long term care by the aged immigrants may be a sign of the horizontal inequity. Uneven adjustment of health care to the individual needs may imply vertical inequity in the distribution of heath care.