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Research
Migration and Asian communities; understanding migrant Sikh carers caring for an older person with dementia in Wolverhampton

Introduction
Recent research (Jutlla and Moreland 2007) has highlighted the difficulties that Asian carers have in accessing services when caring for a family member with dementia. Whilst the evidence of barriers in service provision for Asian carers is relatively well rehearsed, there is an ongoing need for further research as to how and why these barriers are experienced by Asian carers. Taking a biographical approach to fieldwork, this doctoral study highlights the importance of migration experiences and personal histories of carers, and the extent to which those experiences influence the perceptions and experiences of formal and informal care services amongst Sikh carers in Wolverhampton caring for an older person with dementia. Whilst the white native communities have a tendency to stereotype Asian families, despite the realities (Ulric 1998), this research confirms the Sikh community and carers to be more diverse than is normally assumed. Whilst there are a great number of interesting perspectives arising from the research, this paper concentrates upon one aspect arising from the diversity of migration route. To illustrate this, this paper provides example data from case studies after a brief explanation of the research methodology and key concepts employed in the study.

Background and rationale for research (including methodology)
A number of major studies (e.g. Ballard and Ballard 1979; Bhachu 1985; Gardner 2002) have been conducted that provide some insights into migration and its subsequent experiences for minority ethnic migrants, including research not specifically focused upon Sikhs. Additionally, there have been a number of studies that have researched caring for a person with dementia in South Asian communities. These studies (e.g. Seabrook and Milne 2004; Jutlla and Moreland 2007) have reported similar findings to each other such as the lack of awareness and understanding of dementia in such communities, as well as the additional language, cultural and access and entitlement barriers South Asian carers' experience as service users.

When considering experiences of caring for a person with dementia, none of the studies:

  • Deal with a migrant Sikh community per se;
  • Focus on Wolverhampton as a geographical location;
  • Focus on Sikh carer experiences of caring for a person with dementia; and
  • Apply a narrative analytical methodology in the analysis of data.

Conducting a qualitative study of Sikh carers' experiences of caring for a person with dementia in Wolverhampton consequently not only makes this study unique, but also adds a UK based community dimension to the general understandings of South Asian communities and issues of caring for a person with dementia. The aim of this doctoral study therefore was to understand how migration experiences and personal histories influence experiences of caring for a person with dementia for Sikh carers in Wolverhampton. Taking a biographical approach to research, the study used 2-3 narrative interviews per participant, the outcomes of which were analysed using constructivist grounded theory (Charmaz 2006). Due to practical difficulties associated with gaining access to suitable carer participants, the research finished with twelve Sikh carer participants in the study.

The data analysis was conducted within a realist framework (Danermark et al 2002). Briefly, a realist framework distinguishes between:

  • The real: underlying social structures such as social classes (Wright 2009) and social processes such as cultural activities and routines, now often termed habitus (Bourdieu 1986);
  • The actual: the world as experienced by the carer-participants themselves; and
  • The empirical: the factually related interpretive schema and repertoires employed by the carers to describe, analyse and reflect upon their experiences as Sikhs, carers and migrants.

As there was a life history approach taken across the 2-3 interviews with each participant, subsequent analysis found that their responses were couched in terms of narratives – recurring themes that allowed the participant to make sense of their life experiences, and provide a temporal ordering of those experiences in order for evaluative and reflective insights to arise and be articulated within the interviews (De Fina 2009).  

Example Findings
A key central feature that helps to account for the Sikh migrant carer experience was found to be that of (re)positioning, an understanding that has been derived from the work of Harre et al (Harre et al 2009; Harre and Van Langenhove 1999; Sabat et al 1999). The use of parentheses around the ‘re’ of repositioning is deliberate, for the experience of being defined as a carer (for instance) was, for Sikh females, often a element of caring that was added to existing, already positioned, carer roles, obligations and identities.  Whilst one might argue sociologically that these additional duties is an example of repositioning, the participants themselves did not conceive of it as such, instead seeing such developments as an extension of pre-existing roles and identities already inhabited. For Sikh men, the caring role was more often perceived of as an actual repositioning – a movement of experiences and perceptions at the levels of personal and interpersonal identity as well as the levels of responsibilities and duties (Raeff 2010).

Data analysis suggested that migration experiences and personal ontological histories of those migration experiences did have an impact on experiences of caring when a family member develops dementia. (Re)positioning thus occurs across a number of interrelated areas of existence.  These areas of existence include the level of identity, the level of family and Sikh community functioning, and at the level of the quest for assistance and support of health and social services (financial as well as practical assistance) for both the person with dementia and the participants themselves as carers.

Migration itself, by definition, involves a repositioning of place. As a result of both migration and marriage, the participants experience a repositioning within families as well as the local ethnic community with their formal and informal support systems. When a family member develops dementia, the participants were repositioned from their substantive existing relational role (e.g. husband or wife) to that of the caring role.  The caring role may be taken on by default (e.g. an extension of existing positions previously defined as part of being married or being sons and daughters or daughters-in-law) or be arranged in concert with significant others, such as health professionals, applying the label of primary care-giver. Not surprisingly, such repositioning has knock-on effects, including ones associated with personal identity and acceptance and acknowledgement (or not) in the different contexts the carers operate in, such as Sikh temples and other community buildings and activities. 

Discussion: Transnationalism and Identities
Transnational migrants, because of their links to their original countries as well as their newly settled countries, have what have been called ‘multi-stranded social relations’ (Phillipson and Ahmed 2006: 158). These multi-stranded social relations often give rise to transnational migrants having ‘an almost palpable sense of conflicting desires’ arising from membership of different communities (Gardner 2002:209). The ‘constant re-evaluation of one’s past, present and future locations’are the hallmarks of the transnational experience whereby the participants juxtaposed the advantages against the disadvantages of living in the UK (Gardner 2002:209). Such ambivalence may be the result of ‘idealised expectations of life in Britain’ when compared to reality (Blakemore and Boneham 1994: 92). Shifting images and relationships to an individual’s country of origin too become idealised, both as a result of comparison, but also because of memory loss or reconfiguration (Randall 2010).

As a result of such sociological (external) as well as psychological (internal) (re)positioning processes, the participants in this study too developed, to varying degrees, idealised narratives of situations and circumstances pre and post-migration.  The demanding nature of caring for a person with dementia caused the participants to idealise their societies of origin, including the types of support available to them in that society. For those direct migrants from working class backgrounds in rural Punjab, this idealisation involved the articulation of rosy images of involved and extensive informal family and community support. The participants from more affluent middle class backgrounds (such as forced Sikh migrants from East Africa) suggested strongly that their support ‘back home’ was provided formally from servants in the home. Amar Kaur (pseudonym), aged 77 years, migrated from a middle class background in East Africa to Wolverhampton, and was insistent that,

‘In Africa I had servants...they would do the work, you just relaxed and did nothing. The children were raised so nicely in Africa because, when you've got a small child, it's really hard when you're on your own...you have to do everything...Over there, it's not difficult to raise a child.. If you want to do a bit of work yourself, then you just said to the servant... ‘pick him up’...he will pick him up, feed him whatever... It's really hard for a person to do everything on their own…It is so difficult, you have to do everything for yourself here’ (Amar Kaur).

Amar was thus coping – and hence repositioning herself – by defining her family circumstances and self as being in reduced circumstances, and thus not being able to have a lifestyle involving servants that she had previously enjoyed. 

Other participants made similar comments about the disjunctions they experienced between the country of origin and country of settlement. Simarjeet Kaur (pseudonym), a daughter-in-law who too migrated to Wolverhampton from a middle class background in rural Punjab, has subsequently redefined her existence and identity from 'daughter-in-law' to that of 'daughter-in-law as servant'.  Simarjeet, in an interview, said that,

‘For me I went from a rich place, to a poor place... that's how it felt... it was like I came here and became a servant ... Making chapattis all day long… like we had servants there, they did our work but...my dad would say that they are human beings too... He would never make them eat separately from us or eat anything different to us...some people did that, they would give all the bad things to the servants... But my dad would say they are like our children... you treat the servants the same...they kept them like children... And I used to think... 'I'm their daughter-in-law, and they're keeping me like a servant' (Simarjeet Kaur).

The Sikh migrants in this research, like similar transnational migrants (e.g. Bhattacharyya and Shibusawa 2008), thus have a tendency to idealise their previous lives in their country of origin, though many of the participants were clear that they intended to stay in the UK for the better health and social services provided here compared to their country of origin.  This response suggests that migrant communities are not unaffected by trends and developments in the country of settlement.  One such development is the perceived move towards nuclear family living as families become more geographically dispersed, and hence more ‘privatised’ and isolated in their living circumstances.  Community proximity in the old country often meant that ‘one person’s pain... was everybody’s pain’ (Boota Singh). Despite the perceived increase in isolation as a result of a shift towards nuclear families of Sikh families in Wolverhampton, many of the families still have localised extended family settlement patterns.  Nonetheless, such evolutionary changes have resulted in an increase by the participants talking about the fragmentation of families and support mechanisms, in their view partly offset by more developed health and social services in the UK. Similarly, in this sample, retirement to their countries of origin was not seen as an option due to the advantages of treatment available in the UK for both carers and the cared-for.

Conclusion 
It has not been possible in this article to do more than scratch the surface of the many interesting perspectives and issues that have arisen in this research.  Due to that, the article has focused upon some examples of migrant perspectives and comparisons between country of origin and country of settlement.  Key social processes, such as those of (re)positioning, narrative creation and idealisations, have been presented and briefly explained by examples of narrative quotes from participants.  Future articles and conference presentations will deal with the rich findings of the research.

References 
Ballard, R. & Ballard, C. (1979). The Sikhs: The Development of South Asian Settlements in Britain. In Watson, J. L. Between Two Cultures: Migrants and Minorities in Britain. Basil Blackwell: Oxford. pp. 21-56.

Bhachu, P. (1985). Twice Migrants: East African Settlers in Britain. Tavistock: London.

Bhattacharyya, G. & Shibusawa, T. (2008). Experiences of Aging Among Immigrants from India to the United States: Social Work Practice in a Global Context.Journal of Gerontological Social Work. Vol. 52, No. 5, pp. 445-462.

Blakemore, K. & Boneham, M. (1994). Age, Race and Ethnicity: a comparative approach. Open University Press: Buckingham.

Bourdieu, P. (1986). The Biographical Illusion. In Gay, P. Evans, J. & Redman, P. (eds). Identity: A Reader. Sage: London.

Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Sage: London.

Danermark, B. Ekstorm, M. Liselotte, J. & Karlsson, J. (2002). Explaining Society. Critical Realism in Social Sciences. Routledge: London.

De Fina, A. (2009). Narratives in interview – The case of accounts. Narrative Inquiry. Vol. 19, No. 2, pp. 233-258.

Gardner, K. (2002). Age, Narrative and Migration. Berg: Oxford.

Harre, R. & Van Langenhove, L. (1999). Positioning Theory. Blackwell: Oxford.

Harre, R. Moghaddam, T. P. Cairnie, D. Rothbart, D. & Sabat, R. (2009). Recent Advances in Positioning Theory. Theory and Psychology. Vol. 19, No. 5, pp. 5-31.

Jutlla, K. & Moreland, N. (March 2007). Twice a Child III: The Experiences of Asian Carers of Older People with Dementia in Wolverhampton. Dementia UK: West Midlands.

Phillipson, C. & Ahmed, N. (2006). Transnational communities, migration and changing identities in later life: a new research agenda. In Daatland, S. O. & Biggs, S.Ageing and Diversity. Multiple pathways and cultural migrations. Policy Press: Bristol. pp. 157-174.

Raeff, C. (2010). Self Constructing Activities. Theory and Psychology. Vol, 20, No. 1, pp. 28-51.

Randall, W. L. (2010). The Narrative Complexity of Our Past: In Praise of Memory’s Sins. Theory and Psychology. Vol. 20, No. 2, pp. 5-31.

Sabat, S.R. Fath, H. Moghaddam, M. &Harre, R. (1999). The Maintenance of Self-Esteem: Lessons from the Culture of Alzheimer’s Sufferers. Culture and Psychology.Vol. 5, No. 1, pp. 5-31.

Seabrooke, V. & Milne, A. (Jan 2004). Culture and Care in Dementia: A Study of the Asian Community in Northwest Kent. The Mental Health Foundation: UK.

Ulric, M. (1998). They look after their own, don’t they? Inspection of community care services for black and ethnic minority older people. Department of Health: London.

Wright, E. O. (2009). Class Patternings. New Left Review. Vol. 60, pp. 101-118.

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