Challenges in community health nursing of old migrant patients in Norway - an exploratory study

Old people of non-western minority backgrounds are an invisible group in Norway in several ways: in the national debate about the ageing population, in geriatric health care services, and in the general picture of ethnic minorities. There is a lack of knowledge about health and care amongst old migrants. This study aimed at exploring nurse managers' perceptions of the content of community health nursing care of older people from non-western countries of origin, and the challenges associated with caring for this group of patients. The study took place in a medium-sized Norwegian community, a mostly urban area with surrounding rural areas. The community health nursing system was organized in six districts with nurses in management positions, covering nursing homes, special housing and home-based care. Data were collected by a questionnaire with structured and open-ended questions answered by 18 nurse managers. The data provided scarce information, but indicated a lack of systematic cultural care assessments. Community health nursing of old non-western migrant patients was described as deficient and a demanding burden. The challenges were captured in four themes: language barriers, family involvement in care, deficiencies in cultural competency and the need for development. Increased competency, action and local responsibility were identified as propositions to manage the challenges. The lack of awareness and knowledge concerning cultural issues found in this study highlights the need for further development and research on this topic.