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ABSTRACT
Cultural diversities, histories, communities and nations are intricately intertwined with experiencing old age. Individual and/or household culture, norms and expectations precede the decision-making process for health-seeking behaviour that influences elderly people’s choice and use of health-care services. This study addresses the understanding of this issue among migrant Bangladeshi elderly women from culturally and linguistically diverse background, residing in North 24 Parganas, West Bengal, India. Accordingly, data were collected through purposive sampling from 104 elderly women, all aged above 65. Processed data highlighted inconvenience – related to (language) pronunciation, socio-economic status, traditional health beliefs, understandings and practices, and reliance on alternative medical amenities.
Disclosure statement
No potential conflict of interest was reported by the author.
Notes
1. India and Bangladesh share a 4,096 km-long international border, the fifth-longest land border in the world.
2. For more introduction of West Bengal, Undivided Bengal and formation of Bangladesh, see Harun-or-Rashid. ‘Partition of Bengal, 1947.’ Banglapedia. Asiatic Society of Bangladesh; Chatterji, ‘The spoils of partition: Bengal and India,’ 1947–1967, 277–79; Basu Raychaudhury, “Life After Partition,” Ch-1, “Nostalgia of “Desh”, Memories of Partition,” 5653–5660; Alexander, et al., The BengalDiaspora examines the combined historical, sociological and anthropological approaches to migration and diaspora. 1–286; and Samaddar, Transborder Migration, 1–227.
3. Basu and Amin, “Conditioning Factors for Fertility Decline in Bengal. Population and Development Review” gives an understanding of how the strong sense of language identity has facilitated mass mobilization more easily and intensely within two Bengals.
4. To gain a general understanding of Diaspora, and about particular cultures, and communities. See Ember, et al., ed, Encyclopedia of Diasporas.
5. To understand larger unmet language resource needs, see Runci, et al., “The Language Needs of Residents from Linguistically Diverse Backgrounds in Victorian Aged Care Facilities,” 195–8.
6. Pharr, et al., discusses older ethnic minority population’s expectations and experience of greater demand for family caregiving in “Culture, Caregiving, and Health,” 1–8.
7. To understand Cultural competence its fundamental relation with healthcare, see Capell et al., “Cultural Competence in Healthcare,” 30–7.
8. See Galanti, Caring for Patients from Different Cultures, 1–384. for Communication, cross-cultural misunderstandings in health care and understanding of the cultural differences.
9. To find the lingual barriers and lack of language proficiency that may bring about role disruptions, see Wooksoo and Keefe, “Barriers to Healthcare among Asian Americans,” 286–95.
10. Effective communication is important aspect of patient care; see Norouzinia, et al., “Communication Barriers Perceived by Nurses and Patients,” 65−74.
11. Maneze et al., “Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants,” 1–10. The article shows how inadequate host language skills are an important contributing factor to low levels of health-seeking behaviour.
12. Activities of daily living (ADLs), or basic ADLs, consist of the essential skills normally needed to accomplish basic physical needs, comprising of personal hygiene, dressing, toileting/continence, transferring and eating. However, Self-neglect affects an older person’s ability to attend to and carry out daily self-care tasks. Unique environmental and interpersonal factors also add to impairments in ADLs. Ageing impairs functional independence, impacts activities of daily living (ADLs) and reduces the quality of life. See Mlinac and Feng, “Assessment of Activities of Daily Living, Self-Care, and Independence,” 506–16.
13. Family involvement is a global phenomenon in the healthcare of older adults, see Gitlin, and Wolff, “Family Involvement in Care Transitions of Older Adults,” 31–64.
14. The perspective of communicating with outsiders and factors related to inaccurate and unfavourable stereotypes of members of other cultures and how it can cause misinterpretations of the messages received are explained in Gudykunst, Bridging Differences, 113–57.
15. To refer to how mutual understanding is jeopardized due to the lack of a common language, see Plejert et al. “Response Practices in Multilingual Interaction with an Older Persian Woman in a Swedish Residential Home,” 1–23.
16. Communication plays a prominent role in the work site – healthcare, see Jansson, Gunilla, “Bridging Language Barriers in Multilingual Care Encounters,” 201–32.
17. See, Omoniyi, and White, The Sociolinguistics of Identity, 1–239, for understanding the concepts of language and identity.
18. See Chew, “Metaphors of Change,” 156–90.
19. Reflections on the link between language and ethnic identity are reflected upon in the Introduction to the Handbook of Language and Ethnic Identity, by Fishman, 3–5; and García, “Languaging and ethnifying,” 519–34; contended that individuals construct and perform their identities through language in social interaction.
20. For Role of Communication and a carers’ perspective, see Valentina, 9–60.
21. To understand holistic communication skills during interactions with older adults. See William and James, “Incorporating Peplau’s Theory of Interpersonal Relations to Promote Holistic Communication between Older Adults and Nursing Students,” 35–41.
22. Good communication and elderly care relations, see Yorkston, et al., “Communication and Aging,” 309–19.
23. The role language plays in constructing barriers to healthcare is grave. The health-care structures are facing an increasing array of cultural and linguistic diversity. Migrant minority groups are increasing and thus language divergences are resulting in amplified psychosomatic stress and therapeutically noteworthy communication mistakes as studied in Meuter et al., “Overcoming Language Barriers in Healthcare,” 2–5.
24. For self-treatment and self-drug-use; and Poverty as a major determinant of health-seeking behaviour in Asian countries, see Adhikari and Rijal, “Factors Affecting Health Seeking Behaviour of Senior Citizen of Dharan,” 50–7.
25. Self-medication is a global phenomenon. This aids to conceal perilous and unsafe illness, causing complications and hefty financial consequences or death. Inferior drugs, inadequate amount and intervals, deficient awareness of protections and allied diseases can be dangerous, see Nagarajaiah, et al., “Prevalence and Pattern of Self-Medication Practices among Population of Three Districts of South Karnataka,” 296–300.
26. Patients think that if a treatment helped a purpose previously, it will do so again. Analgesics are the best example here because the general public are often inclined to address pain as soon as it arises. A natural inclination to keep old prescriptions that helped in the past for use later on, particularly if the future purchase involves problem or expense is common. Another obvious concern is that patients take unused prescription drugs that remain after use in homes and are misused for re-use, used unsuitably for self-medication of future illnesses or consumed unintentionally. See Kvarnström, et al., “Barriers and Facilitators to Medication Adherence,” 1–8. While there is a deficiency in patient-centred communication; overall, non-adherence is a complex process and more understanding is needed. See Sidorkiewicz, “Discordance between Drug Adherence as Reported by Patients and Drug Importance as Assessed by Physicians,” 415–21.
27. The elderly do not seek any type of treatment, they prefer self-medication and traditional methods, to understand the situation in Indian context, see Kumar et al., “Health Status and Health Seeking Behaviour in Varanasi,” 1711–14; Fishman and García, “A Cross-Sectional Study of Health-Seeking Behaviour of Elderly Individuals,” 3–485; and Shukla, et al., “A Study in Barabanki of Eastern Uttar Pradesh,” 15–8.
28. For understanding Socio-economic status and how it determines health-seeking behaviour, see “Health Impact Assessment (HIA), The Determinants of Health.” For the Indian perspective on Healthcare-Seeking Behaviour and their determinants, see Kanungo, et al., “Perceived Morbidity, Healthcare-Seeking Behaviour and Their Determinants in a Poor-Resource Setting,” 1–21; and Rupali, and Gautam Khakse, “Health-Seeking Behaviour of Elderly Individuals,” 181–4.
29. Internal locus of control communicates about the qualities and features that can be controlled by individuals and how they have more control over their lives. People with an external locus of control are prone to mental ailment patterns as compared with an internal locus of control people. Hence, it can be said that locus of control is an indicative variable that shows a person’s view of the role and influence of a person in successful events and failures in life, see Pourhoseinzadeh, 397–407.
30. How the medical practitioner accepted the fees, i.e., payment was an important factor in seeking help from the doctor. To understand the same, see the study by Hakmaosa, et al., 162–66 is important.
31. Evidences on social determinants of health have come of age, see Braverman, 381–98; and WHO, 1–40.
32. In the book Disease Control Priorities in Developing Countries; 2nd edition; Chapter 10, 195–210. “Gender Differentials in Health.” Buvinić, et al., Argued How Sex and Gender Characteristics are Accepted as Useful Factors for Research and Action in the Health Sector. In what way the behavioural dissimilarities are assigning a critical role to women in relation to health.
33. Explanations on culture care diversity, respecting the cultural values and family beliefs conceives the existence of social and cultural forces that exert important influences on human beings and consequently, on the process of care, see Couto et al., “Family caregiver of older adults and Cultural Care in nursing care”. 959–66.
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Sudeshna Basu Mukherjee
Sudeshna Basu Mukherjee is a Professor of Sociology at the University of Calcutta, West Bengal, India. She obtained her M.A. & Ph.D. from the University of Calcutta. Her research concerns have examined the Aged in Multicultural Environment along the Care Continuums, and the Stress of Sandwich generation. She has completed a major research project on Population Ageing in West Bengal in 2013, funded by University Grants Commission. Her other research projects underway are Women Empowerment in Diverse Cultures and Sustainable Economic, Social and Political Empowerment of Women in South East Asia.