sou · GLB376 · 1998-01-01 00:00:00 — The one was quantitative and used a questionnaire which was answered by 141 persons from thirty different countries. The other was qualitatively based encompassing long interviews with sixteen persons from nine different countries. The interviews were held in the interviewed persons mother tongue (unless he or she expressed a wish to speak Swedish) and took place mainly at the homes of the interviewed persons. This was done in order to create an interview situation which was comfortable and secure for those who participated. The report begins with a survey of relevant Swedish and international literature on ageing, ethnicity, health and encoun- ters. Then follows a critical examination of the political- administrative concept older immigrants from linguistical, statistical and social-psychological perspectives. The main problems are to grasp who and what is actually covered by the term older immigrants since the group is very heterogeneous. Another problem is that individuals can relate in many ways to the group to which they are considered to belong. Many of the foreign-born elderly belonged to minorities in their country of origin. A third problem is that the concept lends itself to a negative stereotype of elderly from foreign cultures as being placed in much jeopardy since they are assumed to be poorer, sicker and less socially integrated than Swedes in general. From different macro- and microsociological perspectives seven hypotheses could be formulated for testing on the collected materials. They are (in shortened form): 1.Some who come from other cultures will have difficulty in assimilating to the Swedish and care structures and will prefer the ways of their home country. 2.Some who come from other countries will appreciate and prefer the Swedish health service and its ways of encountering patients. 3.Elders coming from the nearest neighbouring countries will find it easier than non-European immigrants to place demands on and to make changes in the health and care services. 4.Elders will try to figure out the rules in order to adjust their behaviour to the existing ways of Swedish care environ- ments. 5.The ability to adjust behaviour varies. Those who came from neighbouring countries will find it more easy, others must invent strategies for coping with unusual and unexpec- ted situations. 6.The experience of encounters in the and care services can be similar for both Swedes and immigrants, thus they react over the same conditions. However, the way they react may differ. 7.Many professionals have a definite idea of what they perceive to be older immigrants. Immigrants who can communicate in Swedish will be treated differently than those who need interpreters. The collected material verifies (although in different degrees) these hypotheses, but with one exception. Persons who came from cultures where the health system was very different from the Swedish did not express difficulty in accepting the new Swedish ways. Of course there were some persons who travelled back to their home countries for care, but they did so first after many years of difficult negotiation with the Swedish health service. Usually these problems concerned difficulty in making a diagnosis for persons who had diffuse symptoms and who came from . On the whole the older immigrants were satisfied with the encounters they had with care and old age care. The questionnaire answers are overwhelmingly positive, with only a few individuals expressing any criticism. The judgements in the interviews are also positive, but they do contain criticism of particular details. Examples of criticism: being encountered in an infantilizing ; many and women from countries in the Middle East told of difficulties they had in accepting examinations by male doctors; many complained that the staff have too time to talk; that services were hard to reach by telephone; that the rate of staff turn-over is so high; that carers can be rigid and unwilling to listen to the wishes of the elderly person; some tell of malpractice. Some persons from the Nordic countries and Eastern Europe have been successful in complaining about and changing or old age care. But none of the non-European elderly had even attempted to complain. Many of these say that they would never raise a complaint regardless of what their children and families thought. Instead some of them had travelled back to seek care in their home countries. The report ends with some recommendations about planning of service directed towards older persons from other countries, the educational needs of the staff and the need for continued research. Keywords: age care, care, immigration, refugees, encounters, communication, ethnicity, social geronto- logy. Utredningen om bemötande av äldre (S 1995:15) () publicerade skrifter: 1.Rätt att flytta - en fråga om bemötande av äldre (SO U 1996:161) 2.Brister i omsorg - en fråga om bemötande av äldre (SO U 1997:51) Omsorg med kunskap och inlevelse - en fråga om bemötand e av äldre (SOU 1997:52) Invandrare i vård och omsorg - en fråga om bemötande av äldr e (SOU 1997:76) kan beställas från: 106 47 , orderfax , ordertel. Kvalitetsutveckling i vård och omsorg om äldre - Exempel från kommuner och landsting (Utredningen om bemötande av äldre , ). Stencil enligt ovan samt delbetänkanden och rapporter på kassett, i lättläst sammanfattning och i punktskrift för personer med olika funktionshinder kan beställas från Utredningen om bemötande av äldre, , 103 33 , (fax ) eller från utredningssekretariatet, , tel. .