Cultural Considerations in the Delivery of Homecare Services: "Beyond 2 kitchens and a disability/ più di due cucine e disabilità "

This study explored the experiences, interpretations and cultural beliefs of older Italian immigrants who were receiving culturally specific formal homecare services through an assisted living facility in Ontario, to examine how their identity and life history influenced their experiences of receiving care.The current study builds on the existing body of knowledge about Canada's older Italian immigrants, in particular their caregiving traditions and current need for formal care. This research study employed phenomenology to explore the subjective experiences of Canadian Italian older immigrants who were receiving formal homecare services to capture the personal meanings and interpretations of their immigration experiences, as they related to their need for formal homecare services. Interviews were conducted with 25 older Italian immigrants over the age of 75 that were receiving culturally specific homecare services. The participants shared their immigration stories, fears, work history, healthcare challenges and descriptions of arrival, family, losses, and life in Canada. The Life Course Framework was selected to guide this research study, to represent the process of aging and human development that continuously occurs across the life span. The Social Identity Theory was also used to provide additional guidance in understanding the social, cultural and historical influences of their life histories, as they related to their living arrangements in an assisted-living facility in Ontario and need for caregiving services. Three major themes emerged: 1. the importance of communication and relationship building in the provision of care and the barriers in accessing health care services, 2. retaining identity and control, and 3. facing an uncertain future. These themes reveal the importance of language, cultural practices and residential location. At the micro level, these findings demonstrate the importance individuals assign to their immigration history and cultural traditions. At a macro level, the findings reveal the need to provide cost-effective care that enhances the physical and mental well-being of individuals. These findings also reflect the importance assigned to the home environment and the need for workers to develop relationships with clients that are reflective of their cultural needs. Social workers have the ability to appreciate the historical context of Canada's immigrants; to develop policies in support of their cultural practices, traditions and acculturative interests, and the ability to appreciate the aging process and the associated need for formal services. As Canada's multicultural population continues to grow, social workers will be increasingly challenged to deliver culturally competent healthcare services. The findings are intended to offer additional guidance into the meaning of culture and its importance in furtherance of these goals.Ph.D