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The meaning of home care and caring for aging relatives at home : the Haitian Canadian primary caregivers’ perspectives Racine, Louise

Abstract

Providing nursing care in pluralist countries such as Canada remains a challenge for nurses. Little is known about the impact of 'race,' gender, and social class in mediating Haitian Canadian caregivers' ways of caring for aging relatives at home. This critical ethnography, informed by a postcolonial feminist theoretical approach, was directed at addressing two questions: What are the Haitian Canadian caregivers' ways of caring for an aging relative at home? and What are the contextual factors that might impinge on Haitian Canadian caregivers' access to public home care services? The study was carried out in Eastern Canada. A sample of convenience, composed of 16 Haitian Canadian primary caregivers, nineteen aging persons, and four home care nurses, was formed. Twelve out of sixteen participants were women - mostly daughters who were caring for aging mothers. Participant observation and open-ended interviews were used to collect data from primary caregivers. Fieldwork was carried out during two periods. The first part was from November 2000 to August 2001, during which, 21 interviews and 15 sessions o f participant observation at caregivers' home were conducted. The second part was from October 2001 to February 2002, during which, 3 validity interviews were conducted with some participants to map out the data analysis. A postcolonial feminist framework guided data collection and analysis. A thematic content analysis was conducted. Results indicated that ways of caring are enmeshed in a complex nexus of social relations where power, race, gender, social class come into play to permeate each level of the caring commitment. Caring is a process of reciprocal growth. Ways of caring are structured by Haitian values, gendering of caring activities, immigration, social 'Othering,' health care reform, and cultural misunderstanding of mainstream health practitioners. These factors explain why this community tends to underutilize public home care programs. The study points to designing culturally safe nursing interventions and revising current neocolonial home care policies. The findings underline the need to redirect nursing cultural research to address racial, gendered, and social discrimination that influence the economic accessibility to home care support programs for low-income immigrant families in Canada, creating social inequities in our health care system.

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