Barriers in access to home care services among ethnic minority and Dutch elderly--a qualitative study

Background: Ethnic minority elderly have a high prevalence of functional limitations and chronic conditions compared to Dutch elderly. However, their use of home care services is low compared to Dutch elderly.

Objectives: Explore the barriers to access to home care services for Turkish, Moroccan Surinamese and ethnic Dutch elderly.

Design: Qualitative semi-structured group interviews and individual interviews.

Setting: The Netherlands.

Participants: Seven group interviews (n=50) followed by individual interviews (n=5) were conducted, in the preferred language of the participants.

Methods: Results were ordered and reported according to a framework of access to health care services. This framework describes five dimensions of accessibility to generate access to health care services, from the perspective of the users: ability to perceive health needs, ability to seek health care, ability to reach, ability to pay and ability to engage.

Results: This study shows that while barriers are common among all groups, several specific barriers in access to home care services exist for ethnic minority elderly. Language and communication barriers as well as limited networks and a preference for informal care seem to mutually enforce each other, resulting in many barriers during the navigation process to home care.

Conclusion: In order to provide equal access to home care for all who need it, the language and communication barriers should be tackled by home care services and home care nurses.