September 16, 2025 • 54 mins
How Language Matters in Transnational Care: A Conversation with Professor Loretta Baldassar
In this episode of the Care Matters podcast mini-series How Language Matters, Dr Jayanthi Lingham (Centre for Care, University of Sheffield) speaks with Professor Loretta Baldassar (Edith Cowan University, Australia) about the critical—but often overlooked—role of language in shaping care experiences among ageing migrant populations.
Drawing on comparative insights from Australia and the UK, the episode delves into:
- The demographic reality of ageing migrant populations and their unique care needs.
- Language as a barrier to accessing timely and adequate care services.
- The complex dynamics between migrant care recipients and migrant care workers—often both using English as a second language.
- How language intersects with digital literacy, class, and race in access to care.
The conversation is a vital listen for researchers, practitioners, and policymakers working at the intersection of migration, ageing, and care.
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Transcript
Episode Transcript
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(00:05):
The Care Matters podcast is
brought to youby the ESRC Centre for Care and CIRCLE,
the Centre for International Researchon Care, Labour
and Equalities.
In this series, our researcherswelcome experts in the field
and those giving or receiving careto discuss crucial issues in social care.
(00:27):
As we collectively attemptto make a positive difference to how care
is experienced and provided.
I am, Jayanthi Lingham
and I'm a research associatehere in the Centre for Care, Sheffield.
(00:50):
I'm really pleased to be here todaywith Professor Loretta Baldassar.
Loretta,I wonder if you could introduce yourself.
Thank you.I'm really delighted to be here.
I'm a visiting fellow
in the Department of Sociological Studiesat Sheffield University.
But I'm also affiliated with the centrefor care,
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particular working with Majella
Kilkey on the migration aspects.
The bordering, everyday bordering stream.
And I am from Edith Cowan University.
I have a new role at Edith CowanUniversity in Perth, Western Australia,
where I am Vice-Chancellor,Professorial Research Fellow
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and I head up, researchlab called the Sage Lab
Social Ageing Futures and also a tracksmigration research network.
And the reason that we have come togetherin this podcast is because,
I work with Majella Kilkeywithin a research group
(01:54):
that is called CareTrajectories and Constraints.
And within that I work on a researchstrand called Borders in Care,
which is looking at the careneeds and experiences of people
who have cross borders,and as part of that,
quite often may not have,English as a first language.
And in the co-production work,it's become apparent
(02:18):
that it's really important for usto think about the language that we use,
not just in relation to the Bordersand care study, but more broadly around
care when we're communicating our research
and when we're talkingwith potential research participants,
and that this is the reasonwhy we we've decided
to have this podcastmini series called How Language Matters,
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which is part of the centre for careCare Matters podcast series.
And this is the first episodein the mini series.
And we thought and it was a fantasticopportunity to think, much more about
how language matterswhen we're talking about research
and associated policy with in relation
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to ageing and care and migration.
And so actually,I think I wanted to start by asking you
some of the background,because your research is Australia based.
The research that we're doing here,and the centre is in the UK,
and it would be really usefulto know what the relationships between
(03:22):
migrationand ageing and care in Australia.
Thanks, Jay.
And those issues are really pertinent to,
the research I'm doing as well.
In fact, I think that language matters
and language issuescan provide a really interesting lens on
helping us to understand the migrationprocess for settlement process
(03:46):
service delivery and transnational issues.
But to answer your specific questionabout the relationship
between migration and care in Australia,
I suppose a couple of thingsI could start with to set the stage a bit.
1 in 3 olderpeople in Australia was born overseas.
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So by older peopleI mean people over the age of 65 years.
And so that'sa huge proportion of our population.
So diversity and migration in ageing
is a big and growing issue in Australia.
So waves of migration
can really clearlybe seen in the ageing profile.
(04:31):
So the big post-war influx,
which was a majorinflux of non-English-speaking
migrants from southern Europe,primarily Italy,
Greece, the former Yugoslavia, Malta,
these people are all now,you know, something like 75%
of the southern European born are over75 years of age.
(04:54):
So that's a big ageing issue.
And then in the 70s,we had the began to have
the influx from South Asia, SoutheastAsia.
These populations, you know, in their 50s
and heading towards ageing really quickly.
So ageingand diversity is a big issue for us.
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And it's up front and centrein our discussions about ageing.
The other point to make is that our care
workforce is also a migration issue.
So migration is a care.
She cares a migration issue.
And something like 40% of our careworkforce are migrants.
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And that percentage increasesas the skills level decreases.
So our lower skilled care
workers are oftenthe most recent migrants.
And these are very vulnerable, groups
who are in precarious jobsin the care workforce.
And all the issues
(05:59):
that I know are relevant tothe UK are relevant to Australia as well.
But what we have is a situationwhere that care workforce,
a very vulnerable population, is pairedwith the older
migrant population in the care setting,
who are also a vulnerable population,
but they're from different migrantbackgrounds with different languages,
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and everyone is speaking Englishas a second language.
So here we have two vulnerable populationsin that setting.
So language matters a big deal
actually for the care workerand for the care recipient.
It's really interesting and usefulto hear that background in in the UK.
I mean people have always migratedobviously with that
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with the history of the British Empireespecially.
But after World War two,there was active recruitment from across
the old empire for former coloniesof people to fill the labour force gaps.
And so people came as part of the
the empire as citizens and came here.
And in Sheffield in particular,for example, came to work in the heavy
(07:09):
industries.
And then later in the 70scame to work in the service
sector, setting up, you know,the takeaways, restaurants and everything.
You know, people always migrate,obviously for multiple complex reasons.
But then they've also been people fleeingpost-colonial conflict,
political situations and much more now,
(07:29):
climate crisis, economic crisis.
And so
we also have a very diverse populationin Sheffield across the UK.
And that's, part of the populationthat came many years ago
are also obviously it's similarto Australia,
in that situationwith differing language needs.
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So people, while they were part ofthe British Empire, will have learned
English very much and, and,and come here speaking very good English,
albeit in accents differentfrom what people might have expected.
But there are language needs, butalso the needs of a diverse population.
More broadly in the UK,some of those relate to what
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you might have expectedin terms of your care arrangements.
Moving from one placeto another place and, and perhaps,
having to navigate different families,structures and setups and having family
that, are in different placesoverseas and,
and you'll hearso all of those matters is still relevant.
(08:36):
And I think in the UK.
That that's another dimensionI could have added.
Actually, you're absolutely right.
There's also the case of migrants
living across borders,transnational families and migrants
working out how to care for family members
who are distant, living in another place.
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And all of the, issues
that that are relevant there.
But goinggoing back to the language issue,
you know, why does language matter,I suppose is the question here.
And, what we know very clearly
from Australian data is that
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migrant groups are more likely
to access services later.
And in poorer states of health,so they access them
laterin terms of their health trajectories.
And we know that one of the barriersis language
and another barrier is cultural, he said.
You know, where expectations about care.
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So, broadly speaking,it can be helpful to say, you know,
families, cultures that are usedto relying on the family for care,
you know, tend to leave it laterto access services provided by the state.
And we're seeing that in,in, in the care stats
and the health statsfor El Davis ageing populations.
(10:07):
So that's one way that we can seelanguage really does matter.
And actually there's somereally interesting work that's informed
my research anyway by, ElisabettaSantini and Tracy
Reynolds in the UK on those groupsthat you were describing.
He arrived in the post-war period.
And what they showed in their workwas that those groups that have
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what they called, I still I'mnot sure now what terminology they use.
They might have used the termcultural broker,
those communitiesthat have people within them
who are proficient in both languages,both the language, the host
country language, if you like, and thethe languages of the sending areas,
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and also proficientin the literacy of the health service
landscape, you know, and that todayalso includes digital literacy, right?
Because a lot of our serviceshave gone online.
So there's another kind of languageliteracy we need to to think about,
health literacy and health onlineliteracy.
Those communities that are well embedded and integrated
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usually have members within them, oftenthat what we call in
migration studies, the second generationor the 1.5 generation.
These are the members of the communitywho were born in the host country.
So they are really proficientin the host country language,
but also in the service landscape.
Whereas new and emerging communitiesor communities
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that might be more marginalisedfor other reasons, for other barriers,
who don't have that kind of
member, who has that
cultural competency set of competencies,
are even less likely to access servicesin a timely way.
I was just going to this chicken,actually, because it's so interesting
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hearing about the situation in Australia.
And obviously you've referredto research on the UK,
and it was making me think about the,some research that I was involved with
when I was at Warwick Universityworking with, Professor Sharon Rye,
and we were working on a studylooking at the experiences
of unpaid carers and unpaid carersand older people who need care,
(12:19):
specifically during Covid,
but that the matter of brokers,if you like, came up
and and exactly as you said
quite often second generationor younger generation
who were mostly literate, so could speakfluent, can speak fluently in English,
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but also navigate the health systemand also digitally literate end up having
to help not just their family members,but across the community.
And one of the things that came upwas that while
that ends up being kind of a linchpin,because that those resources are not there
when they need to be withinthe social care and health care system.
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But also there were risks of powerdynamics and difficulties and
and challenging household dynamics,kin dynamics, as we all have
across all of our communitiesand issues of people maybe
being taken advantage of and being chargedto use particular language support.
And so there's an extra layerof kind of vulnerability
(13:24):
that that comes in there when thosematters of language aren't addressed.
The other thing I wanted to bring upwas that you were saying, with newer waves
of migrant communities in Australia,there is, research that shows that
people reach health
services or don't access health servicesuntil much later.
And I think here in the UK,there was some research actually,
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from quite a long time agoby the Joseph Rowntree Foundation in 2007.
I think that was looking specificallyat the post 2004
migrationthat had happened after and countries
and joined the EUand when the UK was still in the EU.
So people came a lot of peoplecame as working migrants from, places
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like Poland and, were workingin much more precarious sectors
and also didn't have English and didn'taccess.
And, and now coming to the pointwhere they really need to access
health servicesbut never thought to access them
and that presenters or that did present
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as much more urgent issues when they dideventually reach those services.
Which is an issue for those peoplesin those communities,
health and needsand an issue for that system as well.
It's those, people that had
access services later in poorerstates of health that increased the
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the cost of health care as well,and also the impact on their
lifestyleand the, you know, their their capacity
to live meaningful lives in their laterages is also diminished.
So it costs the health care system
and the individual and the familyand the community when that's happening.
So it's somethingwe really need to address.
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And and your earlier point two links,both points together.
I think aroundwhat both countries are now are grappling
with in terms of interpreterand translation services.
So, you know,we've put a lot of effort in Australia
into developing a national translationinterpreter service,
which can be online or on the phoneto avoid those informal arrangements
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which were happening certainly beforethe service was available,
where a family member doesthe the translating and interpreting and
all those issues about power and gender
and the appropriateness, come into play.
And so we know thatthat's not best practice.
We know that that should be avoided.
Of course, it still happens informally.
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And, you know, I remember
because I've been working in the fieldfor 30 years,
you know, the cleaners were brought inbecause back in the post-war period,
the cleaners had a set of languagecompetencies
that matched these groups, not the care staff.
And they were brought in to, to beinformal interpreters and translators.
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What you find now with the smaller groups,even when you use the formal, service,
is that sometimes because of politicaland religious fractions,
they might not be the right person either.
So it's a really complex mattersin that language.
It really matters.And it's a really complex.
Yeah.
There's two things that I was thinkingas you were saying that,
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and I'm going to say the firstand I have to remember the successes,
and the first is when you were describingwere you were saying that in Australia
that there's the National TranslationInterpretation Service.
In theory there is that in the UK also.
So if you go to use the NHS,you have the right to request an
interpreter that's going to be there, thatbecause of underfunding under resourcing
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it doesn't.
I don't think it
necessarily always happensor happens to the extent that it's needed.
And the other thing is that
even when English is your first language
and you are supporting or
and you are going to the health serviceor social care service,
and you have particular care needsor emerging care needs,
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the system is again, so under resourced
now that the likelihood isyou'll only get your needs met
if you have a relative shoutingabout your needs
and articulating your needs,forget the language, you need that.
So in a way on top of that,then it need be used.
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Even if you can manage the interpreterand the translation
issues,you still need that relative there.
So that's a really, difficult thing.
I mean, advocacydefinitely is critical, isn't it?
In in accessing quality care.
That's very clear to me from my graphic
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research in the sector, advocacy matters.
And if you've got the additional barrierof language, it's an additional burden.
And there's some really troublingresearch, isn't there?
Especially from the US, about everydayforms
of racism, creating barrierswhere, you know, they actually advise
black people to take a white personwith them to the hospital.
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You know, you're actually going
to be considered more seriouslyand listened to more seriously.
If you just have a white person with you.
I mean, this is clearly visible
in their, research.
And I think we have shades of thatin both our countries as well.
And, and the cost that that's,
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that's another barrierthat's hard to quantifies.
And it, it's those everydayexperiences of marginalisation
which impact our wellbeingand our health and hard to pinpoint.
And the other reasonthat people access services later
in, in poorer states of health,which is related to language,
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is that they're not in their languagesand they're not appropriate
to their cultural expectationsand understandings of care.
So we don't have services that meettheir needs easily.
You're describing a situationin perpetual crisis.
I've heard people talk about it of,you know, everyone experiencing,
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and requiring, advocacyto get any sort of care.
So, yeah, we're talking about compounding,aren't we?
Barriers.
After, what,
over a decade of of economic austerityand funding cuts, severe
funding cuts to local serviceswhere social care
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is, is, is resourced,
where in a profound state of crisis,
as you were talking there,I was thinking about
what I think my second point was,which was that,
the needs of people who don't haveEnglish is the first language
on, related language,but relates to more complex
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things than just language, so particularcare arrangements and things.
And you describe that as cultural needs.
I, I always have, as we talked at,kind of be in my bonnet
about what we mean by culture and,and perhaps we can think about this
a little bit morebecause we have different acronyms
to refer to different groups, in Australia and in the UK.
(20:43):
And I think in Australia,you use this acronym called Kaldi,
which is cultural and.
Culturally and linguistically diverse.
So we do we could talk about called groups
and in the UK but had been.
Yeah, in the UK there's
there's a host of as if inadequatedescriptors or acronyms,
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but I suppose the most common onethat people might have heard is the,
which gets shortens to Bame,which throws up a whole other
set of issues, but which stands for blackand minority ethnic communities.
And I mean, we could tella whole other podcast
talking about the issues with that,but I guess straight off you can say that
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that kind of collapses togethera whole set of needs and,
trying to bring it back to language,for example.
I mean, we're talking about anyonewho is being me
is probably kindof a majority in the world.
And so how do you how do youhow do you encapsulate the needs,
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let alone the language and the usesof, people, those people, these people,
because that includes me, in that one acronym.
But on top of that,when you're navigating the system,
there are so many other social hierarchiesas well.
If you can talk in the right,if you can talk the language,
if you can navigate to social careor health care language.
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But on top of that,if you can talk a certain
kind of language, and this is where I sayclass issues come into it, if you
if you can talk with a certainkind of authority, if you can,
you know,if if you're from a certain backgrounds
and people will take you moreseriously and.
Age is another dimension, all of these
are, intersecting that may very rose.
(22:35):
But to.
So I guess I was just thinking neitherof those acronyms encapsulate though.
Yeah.
I wondered what that's you know,what the benefits are of cold.
And if you are having that therein the first place.
And and maybeif there are other particular pitfalls.
Look, I think that'sa really interesting question.
Why do we have these categoriesand other useful
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and and so that sort of leads me backto one of the first points
I made at the start actually, wasthat language is a interesting lens on
understanding the migration process,the settlement process
and and more contemporary
kind of conceptions of transnationalsocial fields and transnational ties.
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And, and that's where this language,
it needs to be contextuallyin, in Australian, migration history.
So if I can give a little potted historyand see what, see if that helps.
In general you could divide Australianmigration history.
And it has been by many commentatorsinto a number of broad periods.
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And for simplicity,I'll just talk about some main ones.
The first one is usually calledassimilationist
or assimilation ism,and that was from 1900 to about the 1950s.
So this is the period of the formationof the Australian nation state.
1901 was the Federationof Australian States.
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We had landmark policies
like the Immigration Restriction Act,
which is colloquially knownas the White Australia Policy.
And this was,you know, a period in Australian history
which is extremely formative
and the impacts of which are stillbeing felt today, where the charter group
or the group againstwhich all others were defined
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was the the British Protestantcolonialists.
And interestingly,
the Irish Catholicsjoined that group eventually
in that period, through their advocacy
and work in the Australian Labour Partyand the private school system.
That's a historywe could, I'll just break it out.
(24:44):
But we talk about the charter groupin the assimilationist
period as being Anglo Celtic,
from whichall other identities are defined, in
particular indigenous and ethnic groups,because we had two people,
what was considered a terra nullius,an, people land.
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And that was only
debunked, you
know, really quite recentlywith native title,
indigenous people didn't get citizenshipup until the late 60s,
and the Immigration Restriction Actwas not disbanded until the early 70s.
So this is a significant history.
And in that period,we were peopling Australia
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with a very carefully designedimmigration policy, which we continue
to have very carefully designed policiesthat work because we are an island nation.
So you can determine who gets inand who doesn't.
Anyway,let me get back to assimilation ism.
This period.
If we look at language and,social policy,
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it was about becoming Australian,a straight line thesis that,
you know, we wanted people to come,but they had to become Australian.
And what Australian was,nobody really defined.
But it was this Anglo Celtic centreand it was English speaking
and so all policy was gearedto assimilation ism.
And my grandmother, who arrived before
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the war, remembers this as everyoneneeding to become a new Australian,
and you were admonished publicly
if you were heardspeaking your first language.
It was not,thought to be a positive thing
to maintain the languagesfrom the sending areas.
It was consideredto, limit the capacity of someone
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to integrate and settleand to become a new Australian.
And it was considered to not help them,learn English.
Now that all fell apart
in the 50s, 60s and 70s.
And, sociolinguisticswas particularly useful in
helping us understandthat if you support L1 learning,
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that is your first language,you will have better outcomes in L2,
which is your second language,your new language in the host country.
So that revolutionised our thinking.
Unfortunately, that message isstill not out there in some areas,
and I know even in EuropeI lived in Italy.
So three years, about a decade ago,and they were still talking
(27:17):
about how L1 impacts negatively on L2,which is actually wrongheaded.
It's wrong thinking.
But in the UK, if you didn't speak Englishas a first language
at home, you were assumedwhen you started school to be backwards.
And so in a similar kind of practiceprevailed where you would have, you know,
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parents desperate for their childrento not be seems to be backwards.
And actually,I was just thinking a little bit earlier,
you you referred to,
host country in sending country.
And we don't use those terms in the UK.
And I think it relates to the languageand, and the assumptions from that
(28:00):
simulations, period.And I wondered if you could just explain.
Well, I
talk about sending areasinstead of home country
to avoid some of the essential izingthat can happen.
This is methodological nationalism, right?
This is Werner's critique ofof talking about peoples
as national groups, because we knowthey're very heterogeneous.
(28:23):
So language mattersalso in the way we conceptualise, write
and think about things.
And that's another layerthat we need to be really mindful of.
Yeah.
But during the assimilationist period,it was very much a straight line thesis.
And home countrieswere thought to be homogenous cultures,
and the host country was thought to be aand a homogenous culture that you could
(28:45):
assimilate into.
And so we were cold
calling new arrivals new Australians.
That's,it's it's emblematic in the language.
The language really is a windowon the social policy of the time.
And the conceptualisation
and migration itself was conceptualisedas a, as a process
where you left your homeland
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and you, you know, you forgot it.
And you then settled in the new country.
And we had a migration of settlementpolicy for most people, not all.
And that was reflectedalso in our social policy.
So migration policy, social policy,language policy, all of these aligned,
and they were revised in the 50s, 60s
(29:27):
and 70s with a more integrationist stance,which was beginning to recognise
that, no, people don't magically forgettheir homeland cultures
and they don't forget their language.
And these are really central.
And if you support them, you have,you know, healthier people.
And sociolinguisticswas really central to that work.
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So we started to build
the building blockswe needed for the very progressive
policies of multiculturalism,which came in the 1970s.
And I look back at those timesas really the heyday that the
they were my formative years.
I went to university in those years,and really it was very progressive.
(30:09):
We were even talkingabout structural forms of pluralism,
where we would deliver servicesin language for different groups.
We had language schools, we had schools,for different communities.
We had health servicesfor different communities
geared in language and attentive
(30:30):
to all of the intersectionsthat make up cultural ways of being.
And did it by then, didthat, did that period recognise
and accept that
Australia hadn't been a terror nucleus?
That and so werethose where those services
(30:50):
being designed to also supportthe people whose land had been
stolen occupied.
That's a really good question.
It's very interestingto look at the policy
and even research.
There have been very two distinct,distinct, separate silos of work,
(31:11):
one on Indigenous Australian historiesand one on white settler histories.
And the white settlerhistories is the migration stream,
which is the one I've been in,and the indigenous is a separate stream.
More recently they've been coming togetherand people have been asking questions,
about their intersectionsbecause, you know, migrants
(31:34):
and indigenouspeople are also, mixed families as well.
And mixed histories and,and points of intersection
in those histories,especially in regional Australia.
But for good policy reasons, actually,
they were kept separate because there werethey did have a different set of needs.
And this brings us to the pointabout called,
(31:55):
you know,this is a debate, an ongoing debate.
On the one hand,we it's useful to have a name
to talk about diversity,like cultural linguistic diversity,
because this is basedon the fundamental philosophy
which informs multiculturalism,which is to treat people equally.
We need to be awareand recognise their differences.
(32:19):
Whereas if we have the counterpointphilosophy,
which is to treat people equitably,we have to treat them all the same.
We're missing those differences.
The other side of that argument is thatit's inherently othering, racialised.
Another thing. Yeah.
So where and interestingly,cultural and linguistic
diversity in the Australian contextand the policy context doesn't
(32:43):
refer to English speakers,it just refers to non-English speakers.
And an earlier acronym was NSL, NASB,if I remember
correctly, non-English speaking languagebackground or something like that.
Then we moved to called
and you could do an analysisof the acronyms, and it would be a window
(33:04):
onto this shiftingunderstanding of culture and language,
different understanding aboutwhat's involved in the settlement process
and different understandingsabout migration.
But what multiculturalism
allowed us to consider
was multiple identities, intersections.
This these were the building blocksfor trans nationalism that came later,
(33:25):
which was to say, well, actually,and that became more visible with,
social uses of new technologies andthe revolution in poly media environments.
We can now talk about transnationalsocial fields when we talk about families
existing across distance, in ways
that really confound and critiquethe straight line thesis that you leave
(33:47):
your homeland and you don't,you know, you forget about it
and you settle in a new countrywith transnational frames of reference.
We talk about people inhabitingboth places simultaneously.
And that also seems to accountmuch better for
the fact that now there are, latergenerations of people
who are still connected to wherever it wasthat their parents and grandparents,
(34:11):
travel
from and also
connects to here, but in different waysfrom how you might be connected,
if you don't have that journey,that history of migration
and your family background.
And that is somethingI'm really interesting interested
in, actually, iswe still have research silos
about service delivery, which is reallya settlement focus and fraying.
(34:33):
And then transnational issues.
Yeah, be goodto bring them a bit together.
And and for understandable reasonsthey've been a bit siloed.
But now's the timeI think to to start talking
about service deliverythat embraces a transnational frame
because they have been quite separatein our even in our research.
So I tend to be a transnational familiesresearch scholar now,
(34:56):
but I did start out my careeras a more service provision person.
And I think language and these issues
help us again, are a window onto this.
Unfortunately, with 911
and the financial crisis and you know,
(35:17):
those things, if we remember back,
we had in Australia a very pointed
dismantling of multicultural,certainly structural
pluralism in service provisionand whether in fact it was more costly.
I don't know,we've ever done the homework on that.
(35:37):
I don't think it wasbecause it had better outcomes.
If you think about prevention
and how we're living longerand in poorer states of health,
but that work wasn't donewhen we moved to post multiculturalism,
sometimes called mainstreaming,where the thesis is that all our services
deal with the diversity of our population,but in reality
(35:59):
it becomes a form of mainstream,which is monocultural.
And I wonder if that's actuallyalso what's happening in the UK
in these sort of post-racialBritain contexts.
I wonder where all that work
from the Birmingham school in,
you know, there ain't node
black in the Union Jack,which was very informative for Australia
(36:21):
and the development of cultural studiesand identity, identifying identity
politics in a where's that all gone toin this moment
when we look at service deliveryand diversity, as you say, you know,
people have said to me
here, there's so many issuesthat it just gets lower down the list.
But reallyI think it's integral, isn't it?
(36:44):
And it seems very peculiarto even entertain
the thought that we're post-racialin the UK.
When you think about all the kindof ongoing political issues
that have come up and, and the activismin the resistance against the racism
that that has been kind of uncoveredin our institutions and is ongoing.
At the same time, it's not a centralisingisn't it, because we're saying we are
(37:07):
we are diverse, we are super diverse,we are multicultural,
and we deal with it in our primaryservices, in our, you know, one service.
So that tensionreally needs some unpacking doesn't it?
And it's thatbut it's back to that philosophical point.
Do we do we need to recognise difference
in order to deliver equitableservices or not?
And how do we unpack that?
(37:29):
And bringing that to the questionof service delivery and service
provision in care?
We had in the centre for care a seminar
by one of our, one of the professorsworking with the Catherine Needham
and Patrick Hall, who presentedon their book Social Care in the UK
(37:49):
for Nations Between Two Paradigms,published by Bristol University Press.
And those two paradigms,
I think, which I was not at the seminar,but yeah, it.
Was a really great seminar.
I was so pleased to be there.
It really gave me a understanding of
UK history.
And, you know, it's interesting.
(38:10):
The title says Four Nations,
but those four nations arethe four nations of the United Kingdom.
And within that it sort of implicitlyshows heterogeneity, right?
Doesn't it?
And there's language issuesin those four nations with Welsh and,
Gaelic and so on.
But the other diversitiesof the migrant histories,
(38:32):
just seem to disappear a bit.
And we talked about that
at the end of the seminar,and I think people are really interested.
And because I have comewith an Australian frame,
where we've had a Royal commission into aged care quality, health and standards.
And even in that, I have to say,
(38:52):
diversity issues were not key, but,you know, they were mentioned using
the nomenclature of called and indigenousculture and linguistic diversity.
And there were mentions of it.
And we havehad as a result, recommendations
about how to provideethno specific services.
(39:14):
And this brings me to, the seminar
and, and this work. So
should we support ethno specific services,
which are a form of structural pluralism,where we're using service
delivery and languageand recognising cultural needs.
(39:35):
And I suppose if we map that onto the two,
the tensions between the two paradigms in,
Catherine Needham and PatrickHall's work,
they called the two paradigms,I think, differentiated and standardised.
So the standardised is that approach
which is regulated, consistent,
(39:58):
you know, considers safety issues,institutionalised,
centralised, triesto treat everyone equally.
So this is standardised care.
On the one hand, the one paradigm.
And those are the kind of, the benefitsor advantages of standardising that care.
So you have a certain levelof at security,
(40:20):
of knowing that you, you have the rightto get access to all of that.
Schenker. Exactly, exactly.
Whereas the other paradigm was,I think they called it differentiated,
which was personcentred, micro commissioned, asset based,
more flexible,responsive to individual needs.
(40:41):
And this could be more likewhere you would find ethno specific.
But what happens thereis that with all that
flexibility, are we,
sort of sacrificing consistency.
And are wethen challenging safety and standards and,
(41:01):
and so the royal Commission in Australiakind of said looked at ethno specific,
which is from that differentiated,paradigm and said, well,
yes, it is the best care for
to deal with cultural differencesand language differences,
but we need to standardise itso that we meet certain standards.
And so now you need to employat least this many language speakers,
(41:26):
and you need to do this, this and this,which is good at one level.
But what it's resulted inis a lot of ethno specific providers
have said we just can't meet that.
So we've sort of sacrificedthe really good programs
that I could see were continuing thatreally did try and manage those things.
And where you sort of see it, and my workis mainly qualitative and micro.
(41:49):
Okay.
So I'm going to go to some of my moremicro studies is in is in dementia care.
You know, you've got
someone who's lived in Australiafor 50 years.
They're now in their 80s.
They've got progressive cognitive decline.
It days Apache.
They're reverting to their first language,
(42:09):
which is something that happenswith cognitive decline.
Maybe no one in their familyspeaks that language fluently
because it's really their first language,like a dialect from their home country.
People might still, in their familyhave standardised forms of the language
but not know that dialect.
So they become increasinglysocially isolated.
Their personhood is at risk because
(42:32):
it's difficult to co narrate their life.
And I think narrative methodologiesare really helpful to understand dementia
because you find in couples, for example,
that the spouse without dementiawill co narrate the person's life
and ability to participateand in social engagements
(42:53):
by kind of filling in the gapsin their attempts to speak.
It's a beautiful kind of theoryand method.
And what happens in care settings,institutional care settings in particular,
if there's no one that has that languageor even those cultural understandings
about touch and, what the care ways,
(43:13):
that person can becomevery shut down and isolated.
And I've seen it,I've seen the person very withdrawn.
And then it's very difficult to interprettheir care needs.
And, and there's, you know,increasing use of chemical restraint
because of problematic behaviours.
And sometimes what's the root ofthis is communication issues sometimes.
(43:37):
And I'm not an expert on dementia, but
I had seen these things unfold.
And I think we need more researchand we need to look at this.
And I think language matters here.
So I think the Royal Commissionis right to say language is a key here.
And let's let's have some standards aroundcare delivery and language in language.
(43:57):
But then I think if we make the
the standards too high to
achieve,we're also undermining what's possible.
And maybe we need to think more creativelyabout how to deliver those needs.
As I said at an earlier pointin our conversation, the migrant care
workers have different languagebackgrounds to the older population.
(44:20):
At some point,these are going to line up better,
and so I'm hopeful about,
the future as well.
But at the moment,that's an area that needs more research.
It's really useful to hearsome of the complexities that came out
in, in the researchthat you were describing, with people
(44:40):
with dementia as well,because I was thinking then
that's an added layer of complexity,where because of the condition of dementia
and the progressive natureof dementia, communication is so, so key.
And then when then you also need to takeinto account people's language needs.
When English or the dominant languageof wherever they are,
(45:01):
is not the first language.
In addition and I thinkwhen when we outside of this podcast
talked about this,I was quite fixated on the fact that,
anyway, there are lots of issueswith meeting people's communication
needs and dementia and lots of,there's lots of pre judgements or,
(45:21):
inaccurate judgements and understandingsabout dementia that we need much more.
We need to become much better at in, in
service delivery and just in meetingthe care needs of people with dementia.
However, I then went and looked back at,at a WhatsApp conversation
that I'd had with the family memberabout supporting a family member who,
(45:41):
had dementiaand had gone back to their first language.
And I realised that the the exchangethat I'd had with this family member
was about respite care for this person.
And, and I had put in that, I'm so relieved that there's someone there
that is going to be speakingthat that first language.
So it's, itit is a really significant thing.
(46:03):
And you're absolutely right.
It's it's about being ableto hear the language,
understanding how you might communicatein, in, in whatever that language is,
regardless of whether there's
a perfect understanding of dementiaby the person that is providing that care.
So and it's it's even more subtle,I think, in those really,
(46:26):
intimate momentsin, in, in, in meaningful
living in, in institutional settingswhere,
you know, I've seen this many timeswhere the person living with
dementia is finding it difficultto communicate in any language, really.
But the if their carer has familiarity
(46:48):
with the cultural waysand ways of being and
and they can often more easilypredict or interpret
what language that is offeredor is available.
And oftenthis is around simple things like food.
Food is so powerful.
I mean, really?
And why?
I mean, the Royal Commission in Australiauncovered just some desperately
(47:09):
inadequate situationswhere, you know, for,
too little was being spent on food,and food was being used as medicine,
where everybody was just given laxativesbecause they weren't moving enough.
So we'll just start giving them anyway.
And, you know, people becoming incontinentafter a respite period
(47:31):
because they're not gettingthe mobility they need and they're getting
laxatives in their food.
I mean, all this stuffis critically important,
and I can't even remember where I beganbecause I've got a funny side track now.
That I was, I was absorbed in your very,
rich and disturbingbut very important description about it.
(47:53):
Food.
So, you know, I've had,
Italian residents in aged carejust say we don't really want much.
We just want fresh ingredients andingredients that we recognise as our food.
You know, could we have some pastaand some good parmesan cheese
(48:14):
and some fresh tomatoes and basil?
It's not hard and it's not expensive.
And, and the other thing they say iscould we prepare it?
But, you know, it's this whole dignity
of risk issue about standards and safety.
(48:34):
And this is all about cultureand language as well.
And when we get down to the nitty gritty
in those
micro ethnographic encountersthat I do my research
on, it is about what mattersand what's meaningful.
And this is often around food, language
(48:55):
and ways of being touch these kinds of,
aspects of communication more broadly.
Is, is about meeting people's
just human social happiness, you know,
and I guess thinking back to thinking backto Catherine and Patrick's book
(49:16):
and those the tensionsbetween that standardised care and their
differentiated care, which I think is
also called person centred care.
I can absolutely see the
and potentially the importanceof being able to meet,
(49:38):
you know, diverse needs,lots of different needs and to also,
well, send to the personand send to the person's
the person, family or community and say,you know what it is that you need.
And it might be something like food,it might be particular communication
and in particular languages,I guess I also in the UK
at least worry that the risk is
(50:00):
that then takes the kind of onus off
the state and local authoritiesto to even think about those things
and just say, okay, the family knows best,the hassle knows best
or that person knows best,and then it kind of becomes cost cutting,
or corner cutting exercisewhere costs can be saved.
(50:21):
And, and that's not a bad thing,
but the actual costs are still thereand they just fall much more heavily
on unpaid carers and on on householdswho are already so under resourced.
It is it's, it's it's fraught isn't it.
And, and I did like the conclusionactually which was we made something
like clumsy and good enough solutionsthat promote learning and feedback.
(50:45):
And I think,I think that's a really positive note to,
to mention,which was the conclusion of their work.
And I think it is about that.
It's about now moving forward andand naming
the tensions between those paradigmsand working through them.
And I think part ofthe answer is messy ness
(51:06):
and what you're describing thereabout the inherent risks
of the person centred,which I would call, relation centred.
I think that's a better wordbecause you immediately added community.
And I think the person centredmodel is quite medicalized
and looks at the possessed personas the disease.
Whereas I think if we talk aboutrelationship centred, we have a broader
(51:28):
perspective that social relational,which is what is essentially
the best definition of care,I think, and personhood.
And if we think about those risks,
we're also sort of tendingto see what happens in Australia.
Is the migrant communityas a deficit model.
(51:49):
But actually there's enormous resourcesthere as well.
If we can facilitate them and support themand not take advantage of them.
So I think there'ssomething about an answer there as well.
How can we facilitate community
as resource rich models without
further burdening
(52:10):
the care burden dimensionwhich you've raised?
I think there is some answers therethat we need to work out,
and I think that'swhere my research is heading.
And, I think this book kind of pointsto that direction as well.
It sounds like they're saying that we needto be having these conversations,
which is the starting point,which is absolutely true.
(52:35):
And I'd also like the next chapter
of the book to bring diversity inand to do a bit of what
we've been doing today in our podcast,which is what is the history of language
policy and migrationand settlement policy in service delivery,
and where have we got to and
(52:55):
why has this point of diversityseemingly disappeared a bit?
And how do we bring it back?
And and how does that history map on tothe care needs
and the care experiences of peoplewho have lived that history and are here?
And, and, and where does that take us interms of policy?
Where does that take us in termsof what we need.
(53:16):
For this policy?
Addressing the challengethat the book ends with, you know,
clumsy and good enough solutionsthat promote learning and feedback.
You know, I think I think there'ssomething in that direction.
Yeah, we've ended up doingquite a good mini review of the book.
And I think, I think your languagematters.
(53:37):
Podcasts really does matter.
And part of it is trying to work outwhat the questions are actually.
But I think you're on tosomething really important.
Yeah.
Because as you were saying earlieron there social level,
there's the level that we've talkedabout language and care needs of people
who, who, who we're thinking aboutwithin the centre for care.
And then there's alwayshow also how we talk about masses
(54:01):
and care and issues of care.
And that also matters.
So I think as hopefully as we go throughthe podcast
series will untangle, untangle,some of that matters.
A bit moreand I wish you well, more power to you.
Thank you very much.
The Care Matters podcast is
brought to youby the ESRC Centre for Care and CIRCLE,
the Centre for International Researchon Care, Labour
and Equalities.
In this series, our researcherswelcome experts in the field
and those giving or receiving careto discuss crucial issues in social care.
(00:27):
As we collectively attemptto make a positive difference to how care
is experienced and provided.
I am, Jayanthi Lingham
and I'm a research associatehere in the Centre for Care, Sheffield.
(00:50):
I'm really pleased to be here todaywith Professor Loretta Baldassar.
Loretta,I wonder if you could introduce yourself.
Thank you.I'm really delighted to be here.
I'm a visiting fellow
in the Department of Sociological Studiesat Sheffield University.
But I'm also affiliated with the centrefor care,
(01:12):
particular working with Majella
Kilkey on the migration aspects.
The bordering, everyday bordering stream.
And I am from Edith Cowan University.
I have a new role at Edith CowanUniversity in Perth, Western Australia,
where I am Vice-Chancellor,Professorial Research Fellow
(01:34):
and I head up, researchlab called the Sage Lab
Social Ageing Futures and also a tracksmigration research network.
And the reason that we have come togetherin this podcast is because,
I work with Majella Kilkeywithin a research group
(01:54):
that is called CareTrajectories and Constraints.
And within that I work on a researchstrand called Borders in Care,
which is looking at the careneeds and experiences of people
who have cross borders,and as part of that,
quite often may not have,English as a first language.
And in the co-production work,it's become apparent
(02:18):
that it's really important for usto think about the language that we use,
not just in relation to the Bordersand care study, but more broadly around
care when we're communicating our research
and when we're talkingwith potential research participants,
and that this is the reasonwhy we we've decided
to have this podcastmini series called How Language Matters,
(02:39):
which is part of the centre for careCare Matters podcast series.
And this is the first episodein the mini series.
And we thought and it was a fantasticopportunity to think, much more about
how language matterswhen we're talking about research
and associated policy with in relation
(03:02):
to ageing and care and migration.
And so actually,I think I wanted to start by asking you
some of the background,because your research is Australia based.
The research that we're doing here,and the centre is in the UK,
and it would be really usefulto know what the relationships between
(03:22):
migrationand ageing and care in Australia.
Thanks, Jay.
And those issues are really pertinent to,
the research I'm doing as well.
In fact, I think that language matters
and language issuescan provide a really interesting lens on
helping us to understand the migrationprocess for settlement process
(03:46):
service delivery and transnational issues.
But to answer your specific questionabout the relationship
between migration and care in Australia,
I suppose a couple of thingsI could start with to set the stage a bit.
1 in 3 olderpeople in Australia was born overseas.
(04:07):
So by older peopleI mean people over the age of 65 years.
And so that'sa huge proportion of our population.
So diversity and migration in ageing
is a big and growing issue in Australia.
So waves of migration
can really clearlybe seen in the ageing profile.
(04:31):
So the big post-war influx,
which was a majorinflux of non-English-speaking
migrants from southern Europe,primarily Italy,
Greece, the former Yugoslavia, Malta,
these people are all now,you know, something like 75%
of the southern European born are over75 years of age.
(04:54):
So that's a big ageing issue.
And then in the 70s,we had the began to have
the influx from South Asia, SoutheastAsia.
These populations, you know, in their 50s
and heading towards ageing really quickly.
So ageingand diversity is a big issue for us.
(05:15):
And it's up front and centrein our discussions about ageing.
The other point to make is that our care
workforce is also a migration issue.
So migration is a care.
She cares a migration issue.
And something like 40% of our careworkforce are migrants.
(05:39):
And that percentage increasesas the skills level decreases.
So our lower skilled care
workers are oftenthe most recent migrants.
And these are very vulnerable, groups
who are in precarious jobsin the care workforce.
And all the issues
(05:59):
that I know are relevant tothe UK are relevant to Australia as well.
But what we have is a situationwhere that care workforce,
a very vulnerable population, is pairedwith the older
migrant population in the care setting,
who are also a vulnerable population,
but they're from different migrantbackgrounds with different languages,
(06:23):
and everyone is speaking Englishas a second language.
So here we have two vulnerable populationsin that setting.
So language matters a big deal
actually for the care workerand for the care recipient.
It's really interesting and usefulto hear that background in in the UK.
I mean people have always migratedobviously with that
(06:45):
with the history of the British Empireespecially.
But after World War two,there was active recruitment from across
the old empire for former coloniesof people to fill the labour force gaps.
And so people came as part of the
the empire as citizens and came here.
And in Sheffield in particular,for example, came to work in the heavy
(07:09):
industries.
And then later in the 70scame to work in the service
sector, setting up, you know,the takeaways, restaurants and everything.
You know, people always migrate,obviously for multiple complex reasons.
But then they've also been people fleeingpost-colonial conflict,
political situations and much more now,
(07:29):
climate crisis, economic crisis.
And so
we also have a very diverse populationin Sheffield across the UK.
And that's, part of the populationthat came many years ago
are also obviously it's similarto Australia,
in that situationwith differing language needs.
(07:52):
So people, while they were part ofthe British Empire, will have learned
English very much and, and,and come here speaking very good English,
albeit in accents differentfrom what people might have expected.
But there are language needs, butalso the needs of a diverse population.
More broadly in the UK,some of those relate to what
(08:16):
you might have expectedin terms of your care arrangements.
Moving from one placeto another place and, and perhaps,
having to navigate different families,structures and setups and having family
that, are in different placesoverseas and,
and you'll hearso all of those matters is still relevant.
(08:36):
And I think in the UK.
That that's another dimensionI could have added.
Actually, you're absolutely right.
There's also the case of migrants
living across borders,transnational families and migrants
working out how to care for family members
who are distant, living in another place.
(08:59):
And all of the, issues
that that are relevant there.
But goinggoing back to the language issue,
you know, why does language matter,I suppose is the question here.
And, what we know very clearly
from Australian data is that
(09:21):
migrant groups are more likely
to access services later.
And in poorer states of health,so they access them
laterin terms of their health trajectories.
And we know that one of the barriersis language
and another barrier is cultural, he said.
You know, where expectations about care.
(09:42):
So, broadly speaking,it can be helpful to say, you know,
families, cultures that are usedto relying on the family for care,
you know, tend to leave it laterto access services provided by the state.
And we're seeing that in,in, in the care stats
and the health statsfor El Davis ageing populations.
(10:07):
So that's one way that we can seelanguage really does matter.
And actually there's somereally interesting work that's informed
my research anyway by, ElisabettaSantini and Tracy
Reynolds in the UK on those groupsthat you were describing.
He arrived in the post-war period.
And what they showed in their workwas that those groups that have
(10:29):
what they called, I still I'mnot sure now what terminology they use.
They might have used the termcultural broker,
those communitiesthat have people within them
who are proficient in both languages,both the language, the host
country language, if you like, and thethe languages of the sending areas,
(10:49):
and also proficientin the literacy of the health service
landscape, you know, and that todayalso includes digital literacy, right?
Because a lot of our serviceshave gone online.
So there's another kind of languageliteracy we need to to think about,
health literacy and health onlineliteracy.
Those communities that are well embedded and integrated
(11:12):
usually have members within them, oftenthat what we call in
migration studies, the second generationor the 1.5 generation.
These are the members of the communitywho were born in the host country.
So they are really proficientin the host country language,
but also in the service landscape.
Whereas new and emerging communitiesor communities
(11:36):
that might be more marginalisedfor other reasons, for other barriers,
who don't have that kind of
member, who has that
cultural competency set of competencies,
are even less likely to access servicesin a timely way.
I was just going to this chicken,actually, because it's so interesting
(11:58):
hearing about the situation in Australia.
And obviously you've referredto research on the UK,
and it was making me think about the,some research that I was involved with
when I was at Warwick Universityworking with, Professor Sharon Rye,
and we were working on a studylooking at the experiences
of unpaid carers and unpaid carersand older people who need care,
(12:19):
specifically during Covid,
but that the matter of brokers,if you like, came up
and and exactly as you said
quite often second generationor younger generation
who were mostly literate, so could speakfluent, can speak fluently in English,
(12:41):
but also navigate the health systemand also digitally literate end up having
to help not just their family members,but across the community.
And one of the things that came upwas that while
that ends up being kind of a linchpin,because that those resources are not there
when they need to be withinthe social care and health care system.
(13:01):
But also there were risks of powerdynamics and difficulties and
and challenging household dynamics,kin dynamics, as we all have
across all of our communitiesand issues of people maybe
being taken advantage of and being chargedto use particular language support.
And so there's an extra layerof kind of vulnerability
(13:24):
that that comes in there when thosematters of language aren't addressed.
The other thing I wanted to bring upwas that you were saying, with newer waves
of migrant communities in Australia,there is, research that shows that
people reach health
services or don't access health servicesuntil much later.
And I think here in the UK,there was some research actually,
(13:46):
from quite a long time agoby the Joseph Rowntree Foundation in 2007.
I think that was looking specificallyat the post 2004
migrationthat had happened after and countries
and joined the EUand when the UK was still in the EU.
So people came a lot of peoplecame as working migrants from, places
(14:08):
like Poland and, were workingin much more precarious sectors
and also didn't have English and didn'taccess.
And, and now coming to the pointwhere they really need to access
health servicesbut never thought to access them
and that presenters or that did present
(14:29):
as much more urgent issues when they dideventually reach those services.
Which is an issue for those peoplesin those communities,
health and needsand an issue for that system as well.
It's those, people that had
access services later in poorerstates of health that increased the
(14:50):
the cost of health care as well,and also the impact on their
lifestyleand the, you know, their their capacity
to live meaningful lives in their laterages is also diminished.
So it costs the health care system
and the individual and the familyand the community when that's happening.
So it's somethingwe really need to address.
(15:10):
And and your earlier point two links,both points together.
I think aroundwhat both countries are now are grappling
with in terms of interpreterand translation services.
So, you know,we've put a lot of effort in Australia
into developing a national translationinterpreter service,
which can be online or on the phoneto avoid those informal arrangements
(15:35):
which were happening certainly beforethe service was available,
where a family member doesthe the translating and interpreting and
all those issues about power and gender
and the appropriateness, come into play.
And so we know thatthat's not best practice.
We know that that should be avoided.
Of course, it still happens informally.
(15:56):
And, you know, I remember
because I've been working in the fieldfor 30 years,
you know, the cleaners were brought inbecause back in the post-war period,
the cleaners had a set of languagecompetencies
that matched these groups, not the care staff.
And they were brought in to, to beinformal interpreters and translators.
(16:17):
What you find now with the smaller groups,even when you use the formal, service,
is that sometimes because of politicaland religious fractions,
they might not be the right person either.
So it's a really complex mattersin that language.
It really matters.And it's a really complex.
Yeah.
There's two things that I was thinkingas you were saying that,
(16:38):
and I'm going to say the firstand I have to remember the successes,
and the first is when you were describingwere you were saying that in Australia
that there's the National TranslationInterpretation Service.
In theory there is that in the UK also.
So if you go to use the NHS,you have the right to request an
interpreter that's going to be there, thatbecause of underfunding under resourcing
(17:03):
it doesn't.
I don't think it
necessarily always happensor happens to the extent that it's needed.
And the other thing is that
even when English is your first language
and you are supporting or
and you are going to the health serviceor social care service,
and you have particular care needsor emerging care needs,
(17:26):
the system is again, so under resourced
now that the likelihood isyou'll only get your needs met
if you have a relative shoutingabout your needs
and articulating your needs,forget the language, you need that.
So in a way on top of that,then it need be used.
(17:46):
Even if you can manage the interpreterand the translation
issues,you still need that relative there.
So that's a really, difficult thing.
I mean, advocacydefinitely is critical, isn't it?
In in accessing quality care.
That's very clear to me from my graphic
(18:06):
research in the sector, advocacy matters.
And if you've got the additional barrierof language, it's an additional burden.
And there's some really troublingresearch, isn't there?
Especially from the US, about everydayforms
of racism, creating barrierswhere, you know, they actually advise
black people to take a white personwith them to the hospital.
(18:30):
You know, you're actually going
to be considered more seriouslyand listened to more seriously.
If you just have a white person with you.
I mean, this is clearly visible
in their, research.
And I think we have shades of thatin both our countries as well.
And, and the cost that that's,
(18:51):
that's another barrierthat's hard to quantifies.
And it, it's those everydayexperiences of marginalisation
which impact our wellbeingand our health and hard to pinpoint.
And the other reasonthat people access services later
in, in poorer states of health,which is related to language,
(19:13):
is that they're not in their languagesand they're not appropriate
to their cultural expectationsand understandings of care.
So we don't have services that meettheir needs easily.
You're describing a situationin perpetual crisis.
I've heard people talk about it of,you know, everyone experiencing,
(19:37):
and requiring, advocacyto get any sort of care.
So, yeah, we're talking about compounding,aren't we?
Barriers.
After, what,
over a decade of of economic austerityand funding cuts, severe
funding cuts to local serviceswhere social care
(19:59):
is, is, is resourced,
where in a profound state of crisis,
as you were talking there,I was thinking about
what I think my second point was,which was that,
the needs of people who don't haveEnglish is the first language
on, related language,but relates to more complex
(20:20):
things than just language, so particularcare arrangements and things.
And you describe that as cultural needs.
I, I always have, as we talked at,kind of be in my bonnet
about what we mean by culture and,and perhaps we can think about this
a little bit morebecause we have different acronyms
to refer to different groups, in Australia and in the UK.
(20:43):
And I think in Australia,you use this acronym called Kaldi,
which is cultural and.
Culturally and linguistically diverse.
So we do we could talk about called groups
and in the UK but had been.
Yeah, in the UK there's
there's a host of as if inadequatedescriptors or acronyms,
(21:06):
but I suppose the most common onethat people might have heard is the,
which gets shortens to Bame,which throws up a whole other
set of issues, but which stands for blackand minority ethnic communities.
And I mean, we could tella whole other podcast
talking about the issues with that,but I guess straight off you can say that
(21:29):
that kind of collapses togethera whole set of needs and,
trying to bring it back to language,for example.
I mean, we're talking about anyonewho is being me
is probably kindof a majority in the world.
And so how do you how do youhow do you encapsulate the needs,
(21:50):
let alone the language and the usesof, people, those people, these people,
because that includes me, in that one acronym.
But on top of that,when you're navigating the system,
there are so many other social hierarchiesas well.
If you can talk in the right,if you can talk the language,
if you can navigate to social careor health care language.
(22:12):
But on top of that,if you can talk a certain
kind of language, and this is where I sayclass issues come into it, if you
if you can talk with a certainkind of authority, if you can,
you know,if if you're from a certain backgrounds
and people will take you moreseriously and.
Age is another dimension, all of these
are, intersecting that may very rose.
(22:35):
But to.
So I guess I was just thinking neitherof those acronyms encapsulate though.
Yeah.
I wondered what that's you know,what the benefits are of cold.
And if you are having that therein the first place.
And and maybeif there are other particular pitfalls.
Look, I think that'sa really interesting question.
Why do we have these categoriesand other useful
(22:58):
and and so that sort of leads me backto one of the first points
I made at the start actually, wasthat language is a interesting lens on
understanding the migration process,the settlement process
and and more contemporary
kind of conceptions of transnationalsocial fields and transnational ties.
(23:19):
And, and that's where this language,
it needs to be contextuallyin, in Australian, migration history.
So if I can give a little potted historyand see what, see if that helps.
In general you could divide Australianmigration history.
And it has been by many commentatorsinto a number of broad periods.
(23:40):
And for simplicity,I'll just talk about some main ones.
The first one is usually calledassimilationist
or assimilation ism,and that was from 1900 to about the 1950s.
So this is the period of the formationof the Australian nation state.
1901 was the Federationof Australian States.
(24:00):
We had landmark policies
like the Immigration Restriction Act,
which is colloquially knownas the White Australia Policy.
And this was,you know, a period in Australian history
which is extremely formative
and the impacts of which are stillbeing felt today, where the charter group
or the group againstwhich all others were defined
(24:22):
was the the British Protestantcolonialists.
And interestingly,
the Irish Catholicsjoined that group eventually
in that period, through their advocacy
and work in the Australian Labour Partyand the private school system.
That's a historywe could, I'll just break it out.
(24:44):
But we talk about the charter groupin the assimilationist
period as being Anglo Celtic,
from whichall other identities are defined, in
particular indigenous and ethnic groups,because we had two people,
what was considered a terra nullius,an, people land.
(25:05):
And that was only
debunked, you
know, really quite recentlywith native title,
indigenous people didn't get citizenshipup until the late 60s,
and the Immigration Restriction Actwas not disbanded until the early 70s.
So this is a significant history.
And in that period,we were peopling Australia
(25:27):
with a very carefully designedimmigration policy, which we continue
to have very carefully designed policiesthat work because we are an island nation.
So you can determine who gets inand who doesn't.
Anyway,let me get back to assimilation ism.
This period.
If we look at language and,social policy,
(25:47):
it was about becoming Australian,a straight line thesis that,
you know, we wanted people to come,but they had to become Australian.
And what Australian was,nobody really defined.
But it was this Anglo Celtic centreand it was English speaking
and so all policy was gearedto assimilation ism.
And my grandmother, who arrived before
(26:10):
the war, remembers this as everyoneneeding to become a new Australian,
and you were admonished publicly
if you were heardspeaking your first language.
It was not,thought to be a positive thing
to maintain the languagesfrom the sending areas.
It was consideredto, limit the capacity of someone
(26:34):
to integrate and settleand to become a new Australian.
And it was considered to not help them,learn English.
Now that all fell apart
in the 50s, 60s and 70s.
And, sociolinguisticswas particularly useful in
helping us understandthat if you support L1 learning,
(26:56):
that is your first language,you will have better outcomes in L2,
which is your second language,your new language in the host country.
So that revolutionised our thinking.
Unfortunately, that message isstill not out there in some areas,
and I know even in EuropeI lived in Italy.
So three years, about a decade ago,and they were still talking
(27:17):
about how L1 impacts negatively on L2,which is actually wrongheaded.
It's wrong thinking.
But in the UK, if you didn't speak Englishas a first language
at home, you were assumedwhen you started school to be backwards.
And so in a similar kind of practiceprevailed where you would have, you know,
(27:39):
parents desperate for their childrento not be seems to be backwards.
And actually,I was just thinking a little bit earlier,
you you referred to,
host country in sending country.
And we don't use those terms in the UK.
And I think it relates to the languageand, and the assumptions from that
(28:00):
simulations, period.And I wondered if you could just explain.
Well, I
talk about sending areasinstead of home country
to avoid some of the essential izingthat can happen.
This is methodological nationalism, right?
This is Werner's critique ofof talking about peoples
as national groups, because we knowthey're very heterogeneous.
(28:23):
So language mattersalso in the way we conceptualise, write
and think about things.
And that's another layerthat we need to be really mindful of.
Yeah.
But during the assimilationist period,it was very much a straight line thesis.
And home countrieswere thought to be homogenous cultures,
and the host country was thought to be aand a homogenous culture that you could
(28:45):
assimilate into.
And so we were cold
calling new arrivals new Australians.
That's,it's it's emblematic in the language.
The language really is a windowon the social policy of the time.
And the conceptualisation
and migration itself was conceptualisedas a, as a process
where you left your homeland
(29:07):
and you, you know, you forgot it.
And you then settled in the new country.
And we had a migration of settlementpolicy for most people, not all.
And that was reflectedalso in our social policy.
So migration policy, social policy,language policy, all of these aligned,
and they were revised in the 50s, 60s
(29:27):
and 70s with a more integrationist stance,which was beginning to recognise
that, no, people don't magically forgettheir homeland cultures
and they don't forget their language.
And these are really central.
And if you support them, you have,you know, healthier people.
And sociolinguisticswas really central to that work.
(29:48):
So we started to build
the building blockswe needed for the very progressive
policies of multiculturalism,which came in the 1970s.
And I look back at those timesas really the heyday that the
they were my formative years.
I went to university in those years,and really it was very progressive.
(30:09):
We were even talkingabout structural forms of pluralism,
where we would deliver servicesin language for different groups.
We had language schools, we had schools,for different communities.
We had health servicesfor different communities
geared in language and attentive
(30:30):
to all of the intersectionsthat make up cultural ways of being.
And did it by then, didthat, did that period recognise
and accept that
Australia hadn't been a terror nucleus?
That and so werethose where those services
(30:50):
being designed to also supportthe people whose land had been
stolen occupied.
That's a really good question.
It's very interestingto look at the policy
and even research.
There have been very two distinct,distinct, separate silos of work,
(31:11):
one on Indigenous Australian historiesand one on white settler histories.
And the white settlerhistories is the migration stream,
which is the one I've been in,and the indigenous is a separate stream.
More recently they've been coming togetherand people have been asking questions,
about their intersectionsbecause, you know, migrants
(31:34):
and indigenouspeople are also, mixed families as well.
And mixed histories and,and points of intersection
in those histories,especially in regional Australia.
But for good policy reasons, actually,
they were kept separate because there werethey did have a different set of needs.
And this brings us to the pointabout called,
(31:55):
you know,this is a debate, an ongoing debate.
On the one hand,we it's useful to have a name
to talk about diversity,like cultural linguistic diversity,
because this is basedon the fundamental philosophy
which informs multiculturalism,which is to treat people equally.
We need to be awareand recognise their differences.
(32:19):
Whereas if we have the counterpointphilosophy,
which is to treat people equitably,we have to treat them all the same.
We're missing those differences.
The other side of that argument is thatit's inherently othering, racialised.
Another thing. Yeah.
So where and interestingly,cultural and linguistic
diversity in the Australian contextand the policy context doesn't
(32:43):
refer to English speakers,it just refers to non-English speakers.
And an earlier acronym was NSL, NASB,if I remember
correctly, non-English speaking languagebackground or something like that.
Then we moved to called
and you could do an analysisof the acronyms, and it would be a window
(33:04):
onto this shiftingunderstanding of culture and language,
different understanding aboutwhat's involved in the settlement process
and different understandingsabout migration.
But what multiculturalism
allowed us to consider
was multiple identities, intersections.
This these were the building blocksfor trans nationalism that came later,
(33:25):
which was to say, well, actually,and that became more visible with,
social uses of new technologies andthe revolution in poly media environments.
We can now talk about transnationalsocial fields when we talk about families
existing across distance, in ways
that really confound and critiquethe straight line thesis that you leave
(33:47):
your homeland and you don't,you know, you forget about it
and you settle in a new countrywith transnational frames of reference.
We talk about people inhabitingboth places simultaneously.
And that also seems to accountmuch better for
the fact that now there are, latergenerations of people
who are still connected to wherever it wasthat their parents and grandparents,
(34:11):
travel
from and also
connects to here, but in different waysfrom how you might be connected,
if you don't have that journey,that history of migration
and your family background.
And that is somethingI'm really interesting interested
in, actually, iswe still have research silos
about service delivery, which is reallya settlement focus and fraying.
(34:33):
And then transnational issues.
Yeah, be goodto bring them a bit together.
And and for understandable reasonsthey've been a bit siloed.
But now's the timeI think to to start talking
about service deliverythat embraces a transnational frame
because they have been quite separatein our even in our research.
So I tend to be a transnational familiesresearch scholar now,
(34:56):
but I did start out my careeras a more service provision person.
And I think language and these issues
help us again, are a window onto this.
Unfortunately, with 911
and the financial crisis and you know,
(35:17):
those things, if we remember back,
we had in Australia a very pointed
dismantling of multicultural,certainly structural
pluralism in service provisionand whether in fact it was more costly.
I don't know,we've ever done the homework on that.
(35:37):
I don't think it wasbecause it had better outcomes.
If you think about prevention
and how we're living longerand in poorer states of health,
but that work wasn't donewhen we moved to post multiculturalism,
sometimes called mainstreaming,where the thesis is that all our services
deal with the diversity of our population,but in reality
(35:59):
it becomes a form of mainstream,which is monocultural.
And I wonder if that's actuallyalso what's happening in the UK
in these sort of post-racialBritain contexts.
I wonder where all that work
from the Birmingham school in,
you know, there ain't node
black in the Union Jack,which was very informative for Australia
(36:21):
and the development of cultural studiesand identity, identifying identity
politics in a where's that all gone toin this moment
when we look at service deliveryand diversity, as you say, you know,
people have said to me
here, there's so many issuesthat it just gets lower down the list.
But reallyI think it's integral, isn't it?
(36:44):
And it seems very peculiarto even entertain
the thought that we're post-racialin the UK.
When you think about all the kindof ongoing political issues
that have come up and, and the activismin the resistance against the racism
that that has been kind of uncoveredin our institutions and is ongoing.
At the same time, it's not a centralisingisn't it, because we're saying we are
(37:07):
we are diverse, we are super diverse,we are multicultural,
and we deal with it in our primaryservices, in our, you know, one service.
So that tensionreally needs some unpacking doesn't it?
And it's thatbut it's back to that philosophical point.
Do we do we need to recognise difference
in order to deliver equitableservices or not?
And how do we unpack that?
(37:29):
And bringing that to the questionof service delivery and service
provision in care?
We had in the centre for care a seminar
by one of our, one of the professorsworking with the Catherine Needham
and Patrick Hall, who presentedon their book Social Care in the UK
(37:49):
for Nations Between Two Paradigms,published by Bristol University Press.
And those two paradigms,
I think, which I was not at the seminar,but yeah, it.
Was a really great seminar.
I was so pleased to be there.
It really gave me a understanding of
UK history.
And, you know, it's interesting.
(38:10):
The title says Four Nations,
but those four nations arethe four nations of the United Kingdom.
And within that it sort of implicitlyshows heterogeneity, right?
Doesn't it?
And there's language issuesin those four nations with Welsh and,
Gaelic and so on.
But the other diversitiesof the migrant histories,
(38:32):
just seem to disappear a bit.
And we talked about that
at the end of the seminar,and I think people are really interested.
And because I have comewith an Australian frame,
where we've had a Royal commission into aged care quality, health and standards.
And even in that, I have to say,
(38:52):
diversity issues were not key, but,you know, they were mentioned using
the nomenclature of called and indigenousculture and linguistic diversity.
And there were mentions of it.
And we havehad as a result, recommendations
about how to provideethno specific services.
(39:14):
And this brings me to, the seminar
and, and this work. So
should we support ethno specific services,
which are a form of structural pluralism,where we're using service
delivery and languageand recognising cultural needs.
(39:35):
And I suppose if we map that onto the two,
the tensions between the two paradigms in,
Catherine Needham and PatrickHall's work,
they called the two paradigms,I think, differentiated and standardised.
So the standardised is that approach
which is regulated, consistent,
(39:58):
you know, considers safety issues,institutionalised,
centralised, triesto treat everyone equally.
So this is standardised care.
On the one hand, the one paradigm.
And those are the kind of, the benefitsor advantages of standardising that care.
So you have a certain levelof at security,
(40:20):
of knowing that you, you have the rightto get access to all of that.
Schenker. Exactly, exactly.
Whereas the other paradigm was,I think they called it differentiated,
which was personcentred, micro commissioned, asset based,
more flexible,responsive to individual needs.
(40:41):
And this could be more likewhere you would find ethno specific.
But what happens thereis that with all that
flexibility, are we,
sort of sacrificing consistency.
And are wethen challenging safety and standards and,
(41:01):
and so the royal Commission in Australiakind of said looked at ethno specific,
which is from that differentiated,paradigm and said, well,
yes, it is the best care for
to deal with cultural differencesand language differences,
but we need to standardise itso that we meet certain standards.
And so now you need to employat least this many language speakers,
(41:26):
and you need to do this, this and this,which is good at one level.
But what it's resulted inis a lot of ethno specific providers
have said we just can't meet that.
So we've sort of sacrificedthe really good programs
that I could see were continuing thatreally did try and manage those things.
And where you sort of see it, and my workis mainly qualitative and micro.
(41:49):
Okay.
So I'm going to go to some of my moremicro studies is in is in dementia care.
You know, you've got
someone who's lived in Australiafor 50 years.
They're now in their 80s.
They've got progressive cognitive decline.
It days Apache.
They're reverting to their first language,
(42:09):
which is something that happenswith cognitive decline.
Maybe no one in their familyspeaks that language fluently
because it's really their first language,like a dialect from their home country.
People might still, in their familyhave standardised forms of the language
but not know that dialect.
So they become increasinglysocially isolated.
Their personhood is at risk because
(42:32):
it's difficult to co narrate their life.
And I think narrative methodologiesare really helpful to understand dementia
because you find in couples, for example,
that the spouse without dementiawill co narrate the person's life
and ability to participateand in social engagements
(42:53):
by kind of filling in the gapsin their attempts to speak.
It's a beautiful kind of theoryand method.
And what happens in care settings,institutional care settings in particular,
if there's no one that has that languageor even those cultural understandings
about touch and, what the care ways,
(43:13):
that person can becomevery shut down and isolated.
And I've seen it,I've seen the person very withdrawn.
And then it's very difficult to interprettheir care needs.
And, and there's, you know,increasing use of chemical restraint
because of problematic behaviours.
And sometimes what's the root ofthis is communication issues sometimes.
(43:37):
And I'm not an expert on dementia, but
I had seen these things unfold.
And I think we need more researchand we need to look at this.
And I think language matters here.
So I think the Royal Commissionis right to say language is a key here.
And let's let's have some standards aroundcare delivery and language in language.
(43:57):
But then I think if we make the
the standards too high to
achieve,we're also undermining what's possible.
And maybe we need to think more creativelyabout how to deliver those needs.
As I said at an earlier pointin our conversation, the migrant care
workers have different languagebackgrounds to the older population.
(44:20):
At some point,these are going to line up better,
and so I'm hopeful about,
the future as well.
But at the moment,that's an area that needs more research.
It's really useful to hearsome of the complexities that came out
in, in the researchthat you were describing, with people
(44:40):
with dementia as well,because I was thinking then
that's an added layer of complexity,where because of the condition of dementia
and the progressive natureof dementia, communication is so, so key.
And then when then you also need to takeinto account people's language needs.
When English or the dominant languageof wherever they are,
(45:01):
is not the first language.
In addition and I thinkwhen when we outside of this podcast
talked about this,I was quite fixated on the fact that,
anyway, there are lots of issueswith meeting people's communication
needs and dementia and lots of,there's lots of pre judgements or,
(45:21):
inaccurate judgements and understandingsabout dementia that we need much more.
We need to become much better at in, in
service delivery and just in meetingthe care needs of people with dementia.
However, I then went and looked back at,at a WhatsApp conversation
that I'd had with the family memberabout supporting a family member who,
(45:41):
had dementiaand had gone back to their first language.
And I realised that the the exchangethat I'd had with this family member
was about respite care for this person.
And, and I had put in that, I'm so relieved that there's someone there
that is going to be speakingthat that first language.
So it's, itit is a really significant thing.
(46:03):
And you're absolutely right.
It's it's about being ableto hear the language,
understanding how you might communicatein, in, in whatever that language is,
regardless of whether there's
a perfect understanding of dementiaby the person that is providing that care.
So and it's it's even more subtle,I think, in those really,
(46:26):
intimate momentsin, in, in, in meaningful
living in, in institutional settingswhere,
you know, I've seen this many timeswhere the person living with
dementia is finding it difficultto communicate in any language, really.
But the if their carer has familiarity
(46:48):
with the cultural waysand ways of being and
and they can often more easilypredict or interpret
what language that is offeredor is available.
And oftenthis is around simple things like food.
Food is so powerful.
I mean, really?
And why?
I mean, the Royal Commission in Australiauncovered just some desperately
(47:09):
inadequate situationswhere, you know, for,
too little was being spent on food,and food was being used as medicine,
where everybody was just given laxativesbecause they weren't moving enough.
So we'll just start giving them anyway.
And, you know, people becoming incontinentafter a respite period
(47:31):
because they're not gettingthe mobility they need and they're getting
laxatives in their food.
I mean, all this stuffis critically important,
and I can't even remember where I beganbecause I've got a funny side track now.
That I was, I was absorbed in your very,
rich and disturbingbut very important description about it.
(47:53):
Food.
So, you know, I've had,
Italian residents in aged carejust say we don't really want much.
We just want fresh ingredients andingredients that we recognise as our food.
You know, could we have some pastaand some good parmesan cheese
(48:14):
and some fresh tomatoes and basil?
It's not hard and it's not expensive.
And, and the other thing they say iscould we prepare it?
But, you know, it's this whole dignity
of risk issue about standards and safety.
(48:34):
And this is all about cultureand language as well.
And when we get down to the nitty gritty
in those
micro ethnographic encountersthat I do my research
on, it is about what mattersand what's meaningful.
And this is often around food, language
(48:55):
and ways of being touch these kinds of,
aspects of communication more broadly.
Is, is about meeting people's
just human social happiness, you know,
and I guess thinking back to thinking backto Catherine and Patrick's book
(49:16):
and those the tensionsbetween that standardised care and their
differentiated care, which I think is
also called person centred care.
I can absolutely see the
and potentially the importanceof being able to meet,
(49:38):
you know, diverse needs,lots of different needs and to also,
well, send to the personand send to the person's
the person, family or community and say,you know what it is that you need.
And it might be something like food,it might be particular communication
and in particular languages,I guess I also in the UK
at least worry that the risk is
(50:00):
that then takes the kind of onus off
the state and local authoritiesto to even think about those things
and just say, okay, the family knows best,the hassle knows best
or that person knows best,and then it kind of becomes cost cutting,
or corner cutting exercisewhere costs can be saved.
(50:21):
And, and that's not a bad thing,
but the actual costs are still thereand they just fall much more heavily
on unpaid carers and on on householdswho are already so under resourced.
It is it's, it's it's fraught isn't it.
And, and I did like the conclusionactually which was we made something
like clumsy and good enough solutionsthat promote learning and feedback.
(50:45):
And I think,I think that's a really positive note to,
to mention,which was the conclusion of their work.
And I think it is about that.
It's about now moving forward andand naming
the tensions between those paradigmsand working through them.
And I think part ofthe answer is messy ness
(51:06):
and what you're describing thereabout the inherent risks
of the person centred,which I would call, relation centred.
I think that's a better wordbecause you immediately added community.
And I think the person centredmodel is quite medicalized
and looks at the possessed personas the disease.
Whereas I think if we talk aboutrelationship centred, we have a broader
(51:28):
perspective that social relational,which is what is essentially
the best definition of care,I think, and personhood.
And if we think about those risks,
we're also sort of tendingto see what happens in Australia.
Is the migrant communityas a deficit model.
(51:49):
But actually there's enormous resourcesthere as well.
If we can facilitate them and support themand not take advantage of them.
So I think there'ssomething about an answer there as well.
How can we facilitate community
as resource rich models without
further burdening
(52:10):
the care burden dimensionwhich you've raised?
I think there is some answers therethat we need to work out,
and I think that'swhere my research is heading.
And, I think this book kind of pointsto that direction as well.
It sounds like they're saying that we needto be having these conversations,
which is the starting point,which is absolutely true.
(52:35):
And I'd also like the next chapter
of the book to bring diversity inand to do a bit of what
we've been doing today in our podcast,which is what is the history of language
policy and migrationand settlement policy in service delivery,
and where have we got to and
(52:55):
why has this point of diversityseemingly disappeared a bit?
And how do we bring it back?
And and how does that history map on tothe care needs
and the care experiences of peoplewho have lived that history and are here?
And, and, and where does that take us interms of policy?
Where does that take us in termsof what we need.
(53:16):
For this policy?
Addressing the challengethat the book ends with, you know,
clumsy and good enough solutionsthat promote learning and feedback.
You know, I think I think there'ssomething in that direction.
Yeah, we've ended up doingquite a good mini review of the book.
And I think, I think your languagematters.
(53:37):
Podcasts really does matter.
And part of it is trying to work outwhat the questions are actually.
But I think you're on tosomething really important.
Yeah.
Because as you were saying earlieron there social level,
there's the level that we've talkedabout language and care needs of people
who, who, who we're thinking aboutwithin the centre for care.
And then there's alwayshow also how we talk about masses
(54:01):
and care and issues of care.
And that also matters.
So I think as hopefully as we go throughthe podcast
series will untangle, untangle,some of that matters.
A bit moreand I wish you well, more power to you.
Thank you very much.
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