Submission on Integration Policy to the Department of Justice and Equality
Age Action welcomes the forthcoming integration policy review and this opportunity to make a submission
to the review. The review fits well with Age Action’s current focus on issues related to integration and
older people.
There are two strands to our submission:
1 Issues related to the employment of workers from a migrant background in the
provision of care to older people.
11 Evolving needs related to the ageing of minority ethnic / people from a migrant
background in Ireland.
1 It is well documented that the proportion of workers from a migrant background engaged in the care of
older people, either as home care workers or in residential care centres, is very high in Ireland. This reflects
the global trend in care work migration. Recent research conducted by the Irish Centre for Social
Gerontology attached to NUIG (The Role of Migrant Workers in Ageing Societies 2009) and the Migrant
Rights Centre (Who Cares: the experience of Migrant Care Workers in Ireland 2012) indicated that at the
time of the research, between 27% and 30% of workers involved in residential and home care work with
older people are from a migrant background. The research also suggested that the high proportion of
workers from migrant backgrounds was likely to remain high given the nature of the work, its terms and
conditions and the consequent difficulty in recruiting Irish workers.
Both pieces of research highlighted significant levels of discrimination and racism experienced by migrant /
minority ethnic care workers. This came from employers, care recipients and relatives. African care staff
specifically raised the issue of racism and of verbal and physical abuse. As well as explicit racism to do with
skin colour and ethnic background, interviewees described incidents of more subtle forms of prejudice
such as selective recruitment, negative favouritism in relation to shift rostering and other duties,
workplace isolation. They also described incidents of prejudice and racism from residents of homes and
their relatives. Age Action currently works with about 21 residential homes in north Dublin, developing
residents’ councils within the homes as part of an Advocacy Programme. The Age Action experience in this
programme concurs with the findings of the research.
The research and the Age Action experience highlight other issues that not only have important
implications for the provision of care to older people but symmetrical implications for the integration of
migrant workers within Irish society. These issues could be broadly categorised as language and
communication issues. Proficiency in communication and understanding is clearly fundamental to the
delivery of person centred care with older clients. The research findings illustrate the universality of these
difficulties. There are obvious linguistic and comprehension differences even between people who were
raised as English speakers in different parts of the world. The difficulties for migrant workers, who are
struggling with these socio-linguistic differences, are further exacerbated by some of the communicative
impairments that older people can possess. Work practices can also be complicated in communication
difficulties with colleagues and with the families of care recipients.
At a broader level and of particular importance for the integration review, the ICSG research draws on its
own findings and the findings of other research to show how language and communication issues have
implications for labour market and social integration. For instance, difficulties in communication can affect
the recognition of qualifications, a mismatch between skill level and occupation and difficulties in job
mobility. With regard to social integration, communication deficiencies are an understandable restriction
to foreign nationals mixing outside the safety of their own ethnic and cultural groups.
The overall conclusions of the ICSG and the MRCI research are that, in spite of the challenges identified,
the involvement of workers from a minority ethnic / migrant background has been a positive experience
for the Irish elder care sector. Most employers and managers who participated in the research, praised this
cohort of workers for their strong work ethic, their willingness to learn and their commitment to providing
care for old people. Their presence has an additional added value in assisting the insertion of
interculturalism as a core value in service provision for older people.
A quote from the ICSG research is very pertinent - ‘when older people . . . have had to endure fragmented,
under resourced and inequitable care provision, the value we place on their care givers . . . also comes
under question’.
11 Evolving needs related to the ageing of minority ethnic / people from a migrant
background in Ireland.
Irish society has clearly become much more ethnically diverse in the last twenty years. In the last census,
12% of the population was found to be born outside Ireland. Most of the new migrants are still under the
age of 65 and not yet in need of services for older people. However the situation is rapidly changing. In the
2012 Census, there were 247 people from a Black ethnic group, 198 people of Chinese origin, 513 people
from other Asian backgrounds and 766 people of mixed ethnicity or from other minority ethnic groups
(CSO 2012). That amounts to a total population of 535,000 minority ethnic people over 65, or .3% of the
total population. The fact that in the 2006 census there were 147 African people aged over 65 and 247 in
the 2012 census indicates how these numbers are growing.
There has been no research to date in Ireland in relation to older migrants and their integration issues.
However there is evidence to suggest that the difficulties already described in Section 1 that affect all
migrants, eg the lack of status; language difficulties and problems in negotiating support services; lack of
recognition of overseas skills and qualifications are particularly pertinent for older people.
The ability to speak English reasonably well is of critical importance in participating in society. Research
indicates that the capacity to learn a new language becomes more difficult with age. The provision of
customised ESOL classes that meet the needs of older people and meet a social need also is clearly
important. Maintaining links with people from the same background is also important for all immigrants
but particularly so for older people. International research shows how important community engagement
both within their own ethnic group and with the wider community is for older immigrants or members of
the minority ethnic population. (Tiernan, C., et al Community Engagement: An essential component of
wellbeing in older African-American adults in International Journal of Ageing and Development)
Anecdotal evidence indicates that the small number of people who are approaching or already in that age
group, are living in isolated and vulnerable situations. There are also people amongst earlier groups of
refugees such as the Vietnamese community, who came to Ireland in the late 1970’s and the Bosnian
community who came to Ireland in the mid-1990’s, who are entering that older age group. Further
anecdotal evidence from care home staff about people from minority ethnic backgrounds who have
entered their care homes indicates that care staff have often been at a loss about how best to meet the
needs of people from minority ethnic backgrounds and relate to them in a culturally sensitive way.
A significant factor when considering the issues facing older immigrants / members of the minority ethnic
population is that they may have different views on growing older and the ageing process. Research shows
that the impact of ageing (in terms of health and support needs) happens at a comparatively younger age
in many minority ethnic communities thereby calling into question the need for customised services at a
younger age than generally considered for the majority ethnic population.
Recommendations
The recommendations outlined in Irish Centre for Social Gerontology are comprehensive and very clearly
set out. Age Action concurs with these and has added some additional recommendations:
1 The lack of prioritisation of the older adult health and social care sector underlies and exacerbates many
of the issues concerning migrant health and social care workers in ageing societies. Older people have not
been a priority in Ireland and resource allocation has not been adequate. Any debate on migrant care
workers within the system must take account of that fact.
2 The National Intercultural Health Strategy 2007-2012 recognised the need for a focus on migrant carers
in Ireland. We would add that there must be a coherent strategy to address these issues in particular
contexts, including the elder care sector. The personal nature of health and social care provision makes it
essential that respect for racial and cultural differences are understood to encompass both the providers
and recipients of care. Older residents and their families need to be made aware of cultural changes taking
place within care organisations, particularly with respect to the ethnic and cultural mix of staff, and must
be assisted in making the necessary transition that allows for harmonious and mutually beneficial
relationships to evolve. Likewise residential and home care providers and providers of social services for
older people need to take account of the increasing ethnic diversity of the population.
3. The migrant care workforce is not receiving sufficient levels of support to negotiate current and future
challenges in the older adult health and social care sector. Increased support and training structures for
migrant carers and other staff are essential for staff development e.g. language, social care skills and
approaches to care), orientation and integration purposes e.g. cultural awareness programmes and cross
cultural learning. To ensure their effectiveness and to accommodate staff changes, these training and
awareness programmes need to be part of staff continuing development programmes. Ideally they should
be developed in collaboration with mainstream education providers such as VEC’s, FETAC.
4 Customised and accessible English as a Second Language classes that meet the integration needs of older
adults should be made in geographical centres such as north Dublin, Ennis where there are significant
numbers of older adults.
4. Interculturalism and cultural competence need to be included as core modules within nursing and social
care education programmes for all students. Interculturalism and cultural competence modules also need
to be included in continuing professional development programmes for all staff.
5. Stronger regulations governing worker discrimination in care environments – including home care
settings – are necessary. Appropriate structures for the reporting of racial abuse and labour exploitation,
wherever it occurs, should be put in place at organisational, regional and national levels.
6 The present channels for information provision on migrant’s rights and entitlements are not effective,
resulting in migrant carers not always being fully informed with respect to what constitutes rights
violations in the Irish labour market. A reform of existing processes is necessary to address the current
deficiencies in information.
7. Existing employment and immigration regulations negatively impact on the effectiveness of older adult
health and social care, increase the vulnerability of carers, and threaten the stability of the migrant care
workforce with respect to decisions to remain in the sector and to stay in Ireland. There needs to be a
more coordinated and integrated approach to policy development across the ageing, migration and
employment domains, particularly in relation to long-term residency, family reunification, efficiency of the
permit system, and the conceptualisation of care skill level.
8 The potential for migrant workers to be marginalised within a host country, through discriminatory
practices, weak regulatory structures and poor policies, is substantial. Working in the older adult health
and social care sector, which has largely been under funded, increases that potential for marginalisation,
and in effect frames the experiences of migrant carers in the labour market. Significant public investment
in older adult care is required to provide the physical infrastructure and human capital necessary for high
quality care.
--------------------------------------------------------------------------Inspired by its own experience and by these research findings, Age Action decided to apply for and has
been granted funding through the European Integration Fund to implement a project based on the
research findings and recommendations. The overall project aim is, in acknowledgement of the
complementary strands of a multi-cultural nature of the care staff and the growing needs of an ageing
migrant population, to embed interculturalism within residential care homes in north Dublin. The project
will begin by conducting a needs assessment in a number of residential care homes in the north Dublin
region to update the previous research. Drawing on the learning from the research and from the needs
assessment, the project plan is to complete three other pieces of work:

design a set of training and awareness programmes customised respectively to the needs of
management, staff and residents of nursing homes and aimed at promoting intercultural
communication and understanding within participating homes;

assist participating homes in developing a resource (eg a leaflet, poster or DVD) that acknowledges
the intercultural ethos of the home;

assist participating homes to develop an anti-racism / anti-discriminatory code of practice;

develop an accessible reporting mechanism for staff who experience racism or discrimination.
Age Action will work closely key stakeholders such as the HSE, Nursing Homes Ireland, and the Migrant
Rights Centre to promote the wider use of these materials, with the ultimate aim of inserting
interculturalism within the provision of services for older people in Ireland. We would welcome the
opportunity of an ongoing dialogue with the Office for the Promotion of Migrant Integration as the project
unfolds.