Introduction
The challenges faced by aging migrants in accessing equitable healthcare solutions have become a focal point of international research and policy discussions. With unique barriers—cultural dissonance, linguistic obstacles, systemic inequities—these populations often struggle to secure the support they deserve. Home healthcare serves as a cornerstone for dignity and independence among aging migrants, enabling them to age in familiar environments while addressing their critical health needs. Organizations like Care24, which provides 24-hour home healthcare services tailored to individual needs, exemplify efforts to bridge these gaps. Leveraging insights from the Joanna Briggs Institute’s evidence-based scoping review framework, this blog explores the pathways toward equitable home healthcare delivery tailored to aging migrants.
Understanding Evidence-Based Practice and Joanna Briggs Framework
The Foundation of Evidence-Based Practice (EBP)
Evidence-Based Practice (EBP) remains essential in shaping healthcare systems that are responsive and inclusive. By combining clinical expertise, patient values, and the best available evidence, EBP fosters effective decision-making. Joanna Briggs Institute (JBI) takes this further, offering globally recognized methodologies that focus on the nuanced needs of diverse populations, including aging migrants.
JBI’s Impact
The Joanna Briggs Institute’s frameworks, including its scoping review methodology, enable healthcare professionals to synthesize research and implement practical interventions effectively. This blog emphasizes the importance of JBI’s resources in understanding and addressing healthcare inequities faced by aging migrants.
Joanna Briggs Methodology: Home Healthcare for Aging Migrants
The scoping review was conducted using the Joanna Briggs Institute (JBI) framework, a robust and systematic approach designed to map the breadth and depth of research on a specific topic. This methodology is particularly effective for exploring complex healthcare challenges, such as those faced by aging migrants in home healthcare settings. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, ensuring transparency and rigor throughout the process.
Joanna Briggs Inclusion and Exclusion Criteria
The JBI PCC (Population, Concept, Context) framework was employed to establish clear inclusion and exclusion criteria:
- Population: Aging migrants aged 65 and older, including refugees, asylum seekers, and displaced persons.
- Concept: Home healthcare services, focusing on accessibility, utilization, outcomes, and barriers.
- Context: Studies conducted in community-based care, home nursing, and remote health management settings.
Studies not meeting these criteria, such as those focusing on non-migrant populations or unrelated healthcare services, were excluded. This structured approach ensured the review remained focused and relevant.
Joanna Briggs Search Strategy
Researchers collaborated with a librarian to create a comprehensive search strategy, ensuring the inclusion of all relevant studies. They utilized databases such as CINAHL, Medline, Scopus, and Web of Science, applying tailored keywords and Boolean operators. To capture diverse perspectives, the team also reviewed reference lists from selected articles and included gray literature, such as conference proceedings and reports.
Joanna Briggs: Study Selection and Screening
The selection process unfolded in multiple stages:
- Initial Screening: Researchers reviewed titles and abstracts to assess their relevance to the inclusion criteria.
- Full-Text Review: They conducted a detailed examination of selected studies to confirm eligibility.
- Data Extraction: Using the JBI SUMARI tool, the team extracted key data points, such as participant demographics, healthcare barriers, and outcomes.
The researchers resolved disagreements through discussion or by consulting a third reviewer. To maintain transparency, they documented the entire process with a PRISMA flow diagram..
Data Analysis
An inductive content analysis approach was employed to identify key themes and trends. Data were coded and grouped into thematic categories, such as cultural and linguistic accessibility, informal caregiving, structural challenges, and health outcomes. This iterative process allowed for continuous refinement and ensured the findings were comprehensive and meaningful.
Results
The scoping review included 35 studies conducted across various geographical regions, including the Netherlands, the United States, Sweden, Denmark, and Canada. These studies provided valuable insights into the experiences of aging migrants and their interactions with home healthcare services.
Key Findings
- Cultural and Linguistic Accessibility: Language barriers and cultural misalignment were identified as significant obstacles. Many older migrants reverted to their native language, complicating communication with healthcare providers. Limited health literacy further exacerbated these challenges, making it difficult for migrants to navigate healthcare systems and access services.
- The Role of Informal Caregiving: Family members often served as primary caregivers, bridging gaps in formal healthcare. However, this reliance placed substantial emotional and financial strain on caregivers, highlighting the need for formal support systems.
- Structural and Systemic Challenges: Affordability, limited awareness of services, and systemic biases in needs assessments were major barriers. Policies prioritizing cost efficiency over cultural appropriateness further widened disparities.
- Health Outcomes and Identity Preservation: Culturally tailored care models improved health outcomes and fostered a sense of belonging among aging migrants. These models emphasized cultural familiarity, such as traditional meals and religious practices, enhancing emotional well-being.
Table: Criteria for Inclusion and Exclusion in Research
| Criteria | Included | Excluded |
|---|---|---|
| Population | Aging migrants aged 65+, including refugees | Non-migrant older adults and younger populations |
| Concept | Home healthcare services and their accessibility | Studies focused on unrelated healthcare topics |
| Context | Community-based, home nursing, and remote health care | Studies outside of home healthcare settings |
Table: Geographical Distribution of Studies
| Geographical Location | Number of Studies |
|---|---|
| Netherlands | 10 |
| United States | 8 |
| Sweden | 6 |
| Denmark | 4 |
| Canada | 3 |
Discussion
The findings of this scoping review underscore the critical role of home healthcare in addressing the complex needs of aging migrants. Despite its potential to improve health outcomes and foster independence, significant barriers persist, including linguistic challenges, cultural misalignment, and systemic inequities.
Cultural and Linguistic Barriers
Language attrition among aging migrants complicates communication with healthcare providers, leading to misunderstandings and reduced trust. Healthcare systems often fail to provide culturally and linguistically tailored information, leaving migrants unaware of available services.
Informal Caregiving Networks
Family caregivers play a vital role in bridging gaps in care, but their reliance on informal networks places substantial emotional and financial strain on caregivers. Integrating informal caregiving into formal healthcare systems through targeted support and training programs can alleviate caregiver burden and improve outcomes.
Systemic Challenges
Healthcare policies often overlook the specific needs of aging migrants, limiting their ability to access appropriate services. Expanding public awareness campaigns, providing multilingual resources, and investing in culturally tailored programs are essential to reducing disparities.
Future Directions
Innovative care models, such as telehealth platforms with multilingual capabilities, can improve accessibility for aging migrants. Longitudinal studies evaluating the impact of culturally tailored interventions can inform policy and practice improvements.
Conclusion
Equitable home healthcare for aging migrants requires systemic changes rooted in cultural competence and inclusivity. By leveraging the Joanna Briggs Institute’s methodologies and fostering collaboration among healthcare stakeholders, we can build a future where every aging migrant receives the care they deserve. Let’s bridge gaps and create lasting change.
References
Al-Hamad, A., Yasin, Y.M., Yasin, L., & Jung, G. (2025). Home Healthcare Among Aging Migrants: A Joanna Briggs Institute Scoping Review. Healthcare, 13(863). https://doi.org/10.3390/healthcare13080863. The article is available under the Creative Commons Attribution (CC BY 4.0) license. You can access the original publication here.
