Journal of Ethnic and Migration Studies

ISSN: 1369-183X (Print) 1469-9451 (Online) Journal homepage: https://www.tandfonline.com/loi/cjms20

The need for a ‘migration turn’ in aged care policy:

a comparative study of Australian and German
migration policies and their impact on migrant
aged care

R. Brandhorst, L. Baldassar & R. Wilding

To cite this article: R. Brandhorst, L. Baldassar & R. Wilding (2019): The need for a ‘migration
turn’ in aged care policy: a comparative study of Australian and German migration policies and their
impact on migrant aged care, Journal of Ethnic and Migration Studies

To link to this article: https://doi.org/10.1080/1369183X.2019.1629893

Published online: 21 Jun 2019.

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JOURNAL OF ETHNIC AND MIGRATION STUDIES
https://doi.org/10.1080/1369183X.2019.1629893

The need for a ‘migration turn’ in aged care policy: a

comparative study of Australian and German migration
policies and their impact on migrant aged care
R. Brandhorsta, L. Baldassara and R. Wildingb
a
Discipline Group of Anthropology and Sociology, University of Western Australia, Perth, Australia;
b
Department of Social Inquiry, La Trobe University, Melbourne, Australia

ABSTRACT ARTICLE HISTORY

Despite their sociodemographic importance, investigations of the Received 24 September 2018
intersections of ageing and migration remain infrequent. We Accepted 4 June 2019
address this gap by analysing the policy approach to migrant
KEYWORDS
aged care in two countries: Australia and Germany. Our Migration policy; aged care
comparative analysis highlights how national histories of policy; transnational ageing;
migration and associated welfare regimes have given rise to German integration policies;
different approaches to meeting the needs of older migrants. Australian multiculturalism;
Germany has a prevalence of mainstream aged care services, transnational social policies
which do not sufficiently address the needs of an increasingly
culturally diverse older population. In this respect, Australian
multicultural policy, supporting ethnic organisations as aged care
providers, facilitating ethno-specific and multicultural services,
offers an instructive model. Nevertheless, Australia’s strict parent
migration regulations reflect an assumption that older migrants
are an economic burden. Neither country provides an innovative
transnational social policy. We argue for a ‘migration turn’ in aged
care policies to address three critical needs: (1) to increase
awareness of the growing proportion of older migrants in
countries of immigration; (2) to ensure that policy frameworks
better acknowledge and meet the needs of a diverse ageing
population; and (3) to highlight the need for political recognition
of the role of transnational informal care networks and bi-lateral
and transnational policies to support them.

1. Introduction
Ageing and migration are two important sociodemographic trends and challenges currently
facing policymakers in the Global North (King et al. 2017, 194). Yet, investigations of their
intersections remain infrequent, with limited analysis of how mobility and migration have
affected the experience of ageing (but see Brandhorst 2017; Ciobanu, Fokkema, and Nedelcu
2017; Näre, Walsh, and Baldassar 2017; Wilding and Baldassar 2018). Many older migrants
maintain ties with friends and kin in their countries of origin and lead transnational lives
that are impacted by migration policy. Simultaneously, they have to cope with the aged
care system in their country of settlement, which may be different from their homeland
and may not reflect their expectations of ageing and wellbeing.

CONTACT R. Brandhorst rosa-maria.brandhorst@uwa.edu.au

© 2019 Informa UK Limited, trading as Taylor & Francis Group
2 R. BRANDHORST ET AL.

This paper focuses on how migration and aged care policies address (or fail to address)
the needs of ageing migrants and proposes the need for a ‘migration turn’ in aged care
policy. It suggests that researchers, policymakers and service providers concerned with
ageing should pay closer attention to the impact of migration experiences on the lives
and support networks of older people. Our notion of a ‘migration turn’ is aligned with
both the ‘mobilities turn’ (e.g. Cresswell 2006; Sheller and Urry 2006; Urry 2007) and
the ‘transnationalism paradigm’ (e.g. Glick Schiller, Basch, and Blanc-Szanton 1992;
Faist 2010), which encourage analysis to move beyond ‘sedentary’, ‘territorial’ and national
concepts of society to consider the flows of people, information and other resources that
produce transnational social spaces and networks (Pries 2000). Family care, aged care and
social support, according to this lens, do not necessarily take place only within geographi-
cally proximate sites or nation-states, but across them. In this way, the notion of a
‘migration turn’ in aged care policy builds on the ‘mobilities and transnational migration
turn’ by acknowledging the impact of current mobility of older people and their transna-
tional support networks as well as the importance of networks of care and support that
circulate across distance and national borders. However, in addition, a ‘migration turn’
is intended to address a significant gap in aged care concepts and policies by highlighting
the particular intersections of migration and aged care, including the ongoing impact of
past migration and of long-term migrant settlement by drawing attention to the
growing proportions of older migrants who are ageing in host societies to ensure that
ageing policy frameworks better acknowledge and meet the needs of an increasingly
diverse ageing population.
Transnational ageing and transnational care have been largely neglected in social ger-
ontology and social work, with few exceptions (e.g. Torres 2015; Horn and Schweppe
2016; Ciobanu and Hunter 2017; Ciobanu, Fokkema, and Nedelcu 2017). This correlates
with the focus of social work, nursing, and gerontology on the organisation of aged care
within the national context of the welfare state (Baldassar 2007; Homfeldt, Schröer, and
Schweppe 2008), which fails to capture older migrants’ realities and needs. For
example, the current global policy emphasis on ‘ageing in place’ implicitly assumes that
an older person remains embedded in a stable, longstanding community that is geographi-
cally proximate, thus failing to acknowledge the role of migration in transforming experi-
ences of place and associated experiences of community, family and home (Wilding and
Baldassar 2018). Instead, we argue for a transnational migration lens in studies of ageing,
care and ageing in place, challenging the dominant assumption of older people as seden-
tarist and not mobile (Ciobanu and Hunter 2017).
A ‘migration turn’ in aged care policies is necessary for three key reasons. First, to
increase awareness of the growing proportion of older migrants in countries of immigra-
tion. Second, to ensure that ageing policy frameworks better acknowledge and meet the
needs of an increasingly diverse ageing population by providing culturally and linguisti-
cally appropriate aged care. Third, to raise awareness, including political recognition of
new forms of ageing in place that acknowledge and support the role of transnational net-
works of care (Baldassar et al. 2017), including the important role of distant carers who
organise care for their parents across distance. Aged care policies have to acknowledge
that migrants can experience a ‘simultaneous embeddedness’ in both the home and
host societies through continuing family, social, political and economic ties (Glick Schiller,
Basch, and Blanc-Szanton 1992). Furthermore, they need to consider older migrants’
 JOURNAL OF ETHNIC AND MIGRATION STUDIES 3

physical, virtual, communicative or imaginative mobility and ties to the country of origin
(Urry 2007; Ciobanu and Hunter 2017). Decades of intense global population migration
now require governments to acknowledge and adapt to the transnational lives of their
migrant citizens and residents, which have been produced and shaped by national
migration policy histories. We argue that the care of older people now requires transna-
tional policy frameworks, such as transnational social welfare and aged care agreements,
portability of pension benefits when moving at a later age, as well as bilateral and multi-
lateral health insurance agreements.
Our discussion is based on a comparative analysis of the migration and aged care pol-
icies of two very different nations: Australia and Germany. We draw on an extensive lit-
erature review, including an analysis of German and Australian migration and aged care
government policy documents, press reports, as well as ethnographic fieldwork conducted
in aged care organisations in Australia.
Australia and Germany both have rapidly ageing populations. In Germany, 21.2% of
the population is aged 65+; this figure is expected to increase to 27% by 2060 (German
Federal Office of Statistics 2018). In Australia, 16% of the population is aged over 65.
In both countries, the fastest growing group comprises people aged 85+ (ABS 2017a;
German Federal Office of Statistics 2018), which means that both nations are anticipating
increased demand for aged care services. In addition, the numbers of ageing migrants are
increasing rapidly in both countries. In Germany, 23.6% of the population is either born
abroad or has parents born abroad (German Federal Office of Statistics 2017). In Australia
in 2016, 25% of the population was born overseas (ABS 2017b) and had a median age 10
years higher (44) than the Australian-born population (34), accounting for 37% of people
aged 65+. In Germany, the proportion of migrants aged 65+ is lower (9.4% of the migrants
and 23.7% of the non-migrants are 65+) (German Office for Migration and Refugees
2012), but expected to increase. The 5.9 million guest worker migrants who arrived in
the 1950s and 1960s are now beyond retirement age, as are the 4.2 million migrants of
German descent from the successor states of the former Soviet Union who settled in
Germany from 1990 to 2000.
The intersecting demographic trends of ageing and migration mean that both nations
are facing the important issue of dealing with cultural diversity of ageing populations.
Despite similar experiences of population ageing and immigration, there is a considerable
difference in service delivery and policies relating to the care of older migrants in German
and Australian aged care systems. We argue that these different approaches originate in
different migration policies, different histories of integration and multiculturalism, and,
to a lesser degree, in different welfare, long-term care (LTC) and aged care systems.
We begin by outlining the relevant Australian migration policy history, Australian mul-
ticultural policies, the institutional structure for ethnic groups in Australia and their
impact on the aged care of older migrants, before turning to an analysis of German
migration policy history, guest worker and integration policies. We then develop a com-
parative analysis of how Australia and Germany currently cater for their older migrant
populations and compare the development of aged care policies and organisations specifi-
cally tailored for migrants in both countries. Importantly, we also reflect on how they have
emerged out of and are responsive to diverging migration policy histories. We conclude by
providing recommendations for a ‘migration turn’ in aged care concepts and policies for
countries of immigration.
4 R. BRANDHORST ET AL.

2. Australian multicultural policies and their role in Australia’s nation-

building
Australia is a comparatively young settler society of only 50 years of citizenship and just
over 100 years of nationhood, shaped by the forced displacement of the indigenous popu-
lation and a long-standing and carefully controlled immigration programme that began
with colonisation. One of the first pieces of legislation passed by the newly federated Aus-
tralian states was the Commonwealth Immigration Act 1901. Colloquially known as the
White Australia Policy, it served to restrict entry to white European migrants only. Not
officially disbanded until the early 1970s, its impact is enduring (Tavan 2005). The
other pillar of Australian immigration policy was a century-long focus on settlement
migration, with ‘preferred settlers’ expected to assimilate into the dominant Anglo-
Celtic Australian way of life (Jupp 2007). Reference to ‘race’ or nationality as criteria
for entry was deleted from the Migration Act of 1958 and Australia embarked on an ener-
getic immigration programme as part of the post-war campaign to ‘populate or perish’.
Southern European immigration predominated in the 1950s and 60s, followed by arrivals
from Asia in the 1970s when the points system was introduced to determine entry based
on skills rather than ‘race’ (Jupp 2007).
Until recently, Australian migration policy was steadfastly aimed at family settlement,
supported by family reunion (Baldassar 2017) and assimilation (Castles and Miller 2009).
The ethnic diversification resulting from immigration and increasing indigenous protests
contributed to debates about British hegemonic culture and prompted new policy models
beyond assimilation (Moran 2017, 26). By the 1970s, Australia, along with Canada,
became one of the frontrunners of official multiculturalism, incorporating it into the
nation-building project (Stratton and Ang 1994). While multiculturalism remains strongly
entrenched in contemporary Australian popular, public and political life, its application in
policy has been increasingly contested since the late 1990s.
Australia’s construction as a diverse multicultural nation has a dynamic history. While
it was the Whitlam Labour administration (1972–1975) that arguably introduced the
rhetoric of multiculturalism, multicultural policies were launched by the Frazer adminis-
tration (1975–1983), which established the Department of Immigration and Ethnic Affairs
as well as an Ethnic Affairs Unit in the Department of the Prime Minister. During this
time, the Ethnic Affairs Council’s 1977 landmark ‘Australia as a Multicultural Society’
Green Paper proposed an Australian model of multiculturalism, emphasising that what
‘Australia should be working towards is (…) not a melting pot, but a voluntary bond of
dissimilar people sharing a common political and institutional structure’ (Moran 2017,
38). Its aims were greater government recognition of different ethnic identities and an
especially important role for ethnic community organisations. The result, as Moran
(2017, 43) argues, was that:
Ethnic groups could legitimately operate alongside other kinds of groups in society like trade
unions, employers, the established churches and the Australian Medical Association, with
their spokespersons seeking the ear of government, and contributing to community
debate: ‘Multiculturalism means ethnic communities getting “into the act”’. (Australian
Ethnic Affairs Council 1977, p.14, italics in original)

Ethno-cultural groups like migrant organisations were encouraged to institutionalise

themselves and were eligible for government subsidies. In 1979 the Federation of Ethnic
 JOURNAL OF ETHNIC AND MIGRATION STUDIES 5

Communities’ Councils of Australia was established as the national representative of

ethnic groups with direct access to government. Supported by federal and regional govern-
ment funding, these migrant organisations became institutionalised, gained considerable
influence and diversified their spectrum of services from primarily cultural affairs to social
services, including youth and aged care.
This institutionalisation and political recognition of the growing number of ethnic com-
munities, in combination with the Australian privatisation of social services since the 1980s
promoted the creation of non-profit and private organisations in the education-, social- and
aged care sectors, providing the ideal climate for the engagement of migrant organisations in
social welfare. As a result, migrant organisations have become influential stakeholders across
all areas of migrants’ lives. Some serve as cultural and integration brokers, others as labour
unions, student associations, or as a meeting point for the community.
Importantly, migrant organisations were not seen as segregation movements that
inhibit migrants from integrating, but as an important part of the Australian multicultural
endeavour. Diversity was conceptualised as central to national identity, which legitimised
and supported the articulation of cultural diversity through migrant organisations. Fur-
thermore, migrants were seen as potential customers in an Australian/Anglo-Saxon
liberal welfare regime, characterised by the predominance of the private welfare market,
private insurance, customer choice, minimising de-commodification effects and the
influence of the state (Esping-Andersen 1990, 111, 117). In the 1980s, the Australian
welfare state experienced a further privatisation of social services, which began under
the Labour government and increased in the Howard administration. It focused on the
divestment of public enterprises and on the outsourcing of social services to private sta-
keholders (Aulich and O’Flynn 2007, 157). The Australian system promoted private
health and aged care insurance and private LTC providers, creating a plethora of diver-
sified aged care organisations, including migrant aged care organisations catering to the
older members of their communities.
Several phases of multicultural policy and service delivery have been identified, ranging
from ethno-specific care models to ‘mainstreaming’, which is the idea that all services
should provide culturally and linguistically appropriate care to all customers. The 1970s
and 1980s phases of multiculturalism were characterised by the development of pluralist
multicultural services and the creation of ethno-specific health and aged care programmes,
employing bi-cultural health and aged care workers as cultural brokers (Kelaher and Man-
derson 2000, 6). The category ‘Non-English-Speaking Background’ (NESB), later changed
to ‘Culturally and Linguistically Diverse’ (CALD), was developed to highlight the particu-
lar cultural and linguistic needs and barriers of migrants in an English-speaking context.
During the Hawke (1983–1991) administration, the Ethnic Affairs Taskforce of the Aus-
tralian Council on Population and Ethnic Affairs published, ‘Multiculturalism for All Aus-
tralians: Our Developing Nationhood’ (1982). In contrast to European approaches,
multiculturalism in Australia was described as pertaining to all Australians, not just
migrants, including the indigenous population (Joppke and Morowska 2003, 12).
In 1996, under the Howard administration, the less cost intensive ‘mainstreaming’ of
multicultural health and aged care services was developed with the aim that all services
would provide culturally appropriate care and cater to the needs of people with
different ethnicities (Kelaher and Manderson 2000, 4, 6). The trend towards mainstream-
ing was also a response to critics of multiculturalism, most strongly represented by a
6 R. BRANDHORST ET AL.

growing extreme right populist party, who viewed it as promoting migrant welfare at the
expense of ‘ordinary Australians’. This anti-multiculturalism sentiment was further
strengthened with the advent of the terrorist attacks on the 11th September, 2001; her-
alded as a turning point in Australian government support for multiculturalism and a
global retreat from multiculturalism (Joppke 2004; Vertovec and Wessendorf 2010).
The conservative Howard government (1996–2007) abolished the Office for Multicultural
Affairs in 2002 and reintroduced the citizenship test. This reflected a weakening commit-
ment to multiculturalism in formal policy and a reemphasis on ‘core’ Australian culture
based on British origins (Joppke and Morowska 2003).
Meanwhile, critiques of Australian multiculturalism from the political left have long
argued that multiculturalism primarily features on the political rhetorical surface (Jupp
2007; Fozdar and Low 2015). For example, Hage (1998) argues that the Australian
brand of multiculturalism has always maintained an identity that foregrounds white Euro-
pean culture and accommodates diversity only insofar as it is acceptable to the main-
stream. Furthermore, commentators from both sides of politics express the view that by
providing different services for different groups, multiculturalism risks separatism and cul-
tural segregation, and the stress on pluralism ignores the ‘socioeconomic rift opening up
between immigrants and the domestic population’ (Joppke and Morowska 2003, 14).
Despite recent developments, the Australian case describes a downscaling rather than a
full retreat from multiculturalism as found in other countries in Europe (Joppke 2004).
Multiculturalism remains deeply rooted in Australian society and its institutions
(Moran 2017), evident in the numerous powerful migrant organisations, including
ethno-specific aged care services. However, the trend towards mainstreaming continues
and is evident in the 2017 National Aged Care Cultural Diversity Framework. While
the Framework supports ethno-specific services, it emphasises that: ‘ … all elements of
the aged care system and all aged care service providers should be able to meet consumers’
diverse characteristics and life experiences’ (Aged Care Diversity Framework 2017, 2),
requiring all services to reduce barriers for clients from different ethnic and social back-
grounds and sexual orientations.
The retreat from multiculturalism also coincided with a revision of the Australian
migration programme in the late 1990s, including the excision of the Australian border
zone, restrictive offshore asylum seeker policies as well as a shift in focus from family
reunion schemes to a rising number of skilled and Temporary Working Visas (Castles,
Vasta, and Ozkul 2014). This includes stricter parent migration regulations and controls
for older people who wish to visit family in Australia. The Parent Visa is linked to high
application costs (up to AUS $ 50,000) and processing times of up to 30 years (Department
of Home Affairs 2018a, 2018b). These are practical impediments to the immigration of
elderly parents, who are often an important source of informal care to their migrant
children.
Like the former German guest worker programmes, the Temporary Working Visas
expect migrants to return to their countries of origin after their work contracts are com-
pleted, increasing the migrant workers’ insecurity and precarity. Furthermore, the inter-
twinement of the right of immigration, residence and citizenship with demands of the
labour market and economic criteria, exemplifies the utilitarian perspective of Australian
immigration policies. The migrant intake depends on the demands of the labour market
with ‘Skilled Entrants’, determined by a points system, being the largest category
 JOURNAL OF ETHNIC AND MIGRATION STUDIES 7

(Department of Home Affairs 2018b). The points system includes an assessment of age
that penalises those applying for work visas who are over the age of 30 and often restricts
visas to people who are under the age of 45. Wealth is one of the few means of avoiding
these constraints, with visas such as the Subclass 188 Significant Investor stream enabling
applicants to enter Australia by making an investment of at least AUS $5 Million (Depart-
ment of Home Affairs 2018c). These visa conditions reflect an assumption that older
migrants are perceived as an economic burden, overlooking the contributions by older
people both to the workforce and to their families and communities. Temporary migration
schemes represent a radical departure from family reunion and settlement, ‘bringing new
challenges for transnational families as well as a critical need for innovative transnational
social policy to address them’ (Baldassar 2017, 165).
A ‘migration turn’ in Australian aged care would help to safeguard the important gains
that have been made to migrant aged care through previous multicultural policy. Further-
more, a ‘migration turn’ in Australian aged care would encourage re-evaluation of the
family reunion and parent visa restrictions to highlight the hidden costs of Temporary
Migration schemes, and the critical need for innovative transnational social policy.

3. German Gastarbeiter and ‘integration’ policies and the move towards a

society of immigration
In contrast to Australia, Germany only relatively recently began to consider itself a country
of immigration. In this section, the German temporary work and integration policies,
which have until recently discouraged the creation of migrant organisations, are discussed.
In addition, the German welfare state’s focus on public welfare, selected non-state chari-
table organisations and family responsibility is outlined.
In Germany, the political management of migration began in the 1950s and 1960s with
the so-called Gastarbeiteranwerbung, the guest worker treaties introduced following the
Second World War in response to workforce shortage and economic growth. Until
1973 only seasonal and temporary sojourners on work contracts were expected to enter
the country (Sökefeld 2007). In East and West Germany, the guest workers’ resident
permits were linked to their temporary work contracts. Migrants were expected to leave
the country after their contract expired and retire in their country of origin. The guest
worker programme was intended to support productive work located in Germany while
ignoring the reproductive tasks of migrants, such as child, family and aged care. It was
assumed that these tasks would be performed by families who remained in the country
of origin, where migrants were expected to return. Thus, no infrastructure for migrant
families or aged care was created. However, when the recruitment of labour migrants
was ended in 1973 due to economic recession, and in spite of the FGR offering
financial incentives for migrants to return to their country of origin, many migrant
workers decided to stay. Moreover, they brought their relatives over and later received
German citizenship. Hence, Germany was pressured to reconceptualise its stance
towards migration and migrant settlement.
In its first response to the unexpected outcome of the guest worker policies, the FRG for-
mulated ‘integration policies’. The term ‘integration’ was favoured over ‘assimilation’, which
was ‘contaminated’ by its association with national-socialist thinking (Brubaker 2003, 41).
While the first integration policies might appear limited in the sense that they did not
8 R. BRANDHORST ET AL.

provide a comprehensive legalisation for migration, were based on jus sanguinis, and
focussed on assimilation, they were a first step in accepting that the labour migrants were
not temporary but had become part of German society. The ‘integration’ discourse can
thus be interpreted as the foundation for recognising Germany as a country of immigration.
In contrast to the notion of multiculturalism, the concept of ‘“integrating” immigrants (…)
rests on the premise of an already integrated, bounded society, which faces the risk of dis-
integration and unbinding due to immigration’ (Joppke and Morowska 2003, 3).
This perspective is especially clear in the former particularly restrictive ethnic or
descent-based German citizenship law (Brubaker 2003, 46). Until 2000, the German
nation was defined on the basis of j. sanguinis, as a descent community, where nationality
and national belonging were based on blood ties and inheritance, not birthplace. While
long-settled non-citizens such as immigrants with residency status had similar rights to
German citizens, they lacked political rights. This became especially critical for the chil-
dren of migrants born in Germany. The new citizenship law launched in 2000 introduced
jus soli citizenship for the second generation (if their parents had a legal residence permit
for a minimum of 8 years) (Oswald 2007, 186). However, dual citizenship for non-EU
nationals is still only granted in exceptional cases (Oswald 2007, 182).
Sökefeld (2007, 47) argues that German concepts of nation and culture remain
influenced by notions of descent and ethnicity. Culture is perceived as primordial and
inherited. As immigrants are ‘the cultural other’ and culture is unchangeable, immigrants
by definition cannot integrate. This is especially clear in the German term Migrationshin-
tergrund (migration background). According to this notion, even people born in Germany
to migrant parents will remain ‘people with a migration background’. Whereas public and
political discourses expect immigrants to integrate into German society, the primordial
notion of culture and ethnicity legitimates their exclusion (Sökefeld 2004, 2007). The
expectation to ‘integrate’ into German society assumes that becoming German implies
giving up one’s own cultural, religious and political ties to the country of origin. As inte-
gration in this context is not seen as a mutual task of society, but an expectation placed on
migrants, the notion of integration is intransitive and has assimilationist overtones.
In contrast to settler societies like Australia, Germany did not conceptualise itself as a
country of immigration until the 1990s. The continued ambivalence towards immigration
is reflected in the fact that Germany still does not have a Minister of Migration and the
Federal Office for Migration and Refugees is located under the Minister of the Interior.
Because migration is conceptualised as a one-way process of settlement, transnational
ties undermine integration. In the context of the expectation of migrants’ assimilation
and the quest for migrants’ loyalty, migrant organisations are not encouraged but
rather seen as a threat, associated with segregation inhibiting integration. Migrants are
instead encouraged to integrate into German organisations and speak German. This has
led to a less prominent role of migrant organisations in Germany than in Australia.
Another factor contributing to the relative weakness of migrant organisations in
Germany is the corporatist-statist legacy of the German welfare regime. In Esping-Ander-
sen’s welfare regime typology (1990), the German welfare regime belongs to the Continen-
tal European Conservative-Corporatist model. It is characterised by the dominance of the
state as a primary provider of welfare, with subsidiarity and family responsibility as impor-
tant principles. The German aged care model is based on compulsory Long-Term-Care
Insurance (LTCI) (Theobald, Hampel, and Mansfeld 2011; Peng and Yeandle 2017, 30).
 JOURNAL OF ETHNIC AND MIGRATION STUDIES 9

People needing care can access a cash allowance to provide family or informal care at
home, home care with a professional care worker or residential aged care. The system
of social service provision based on the subsidiarity principle has long been dominated
by public and not-for-profit service providers. The state delegates social welfare and
aged care services to public service providers, primarily six major non-state charitable
organisations: Caritas and Arbeitersameriterbund of the Catholic Church, the Diako-
nische Werk e.V. of the Evangelical Church, the Jüdische Wohlfahrtsverband of the
Jewish community, and the Arbeiterwohlfahrt, the social service organisation originally
founded by the Social Democratic Party. Social services for migrants are expected to be
provided by these organisations (Puskeppeleit and Thränhardt 1990).
Following the Second World War, there was a strong push to create a public sphere
separated from market forces (Hockerts 2012, 70f.). Despite the opening of the social
service sector to private stakeholders in 1994 under the conservative and liberal govern-
ment of Chancellor Kohl, and the increase of private aged care facilities (European
Union 2014), welfare and social services remain closely linked to the state and recognised
charity organisations. With aged care and social work still focussed on organisations and
services within the national welfare state, there is insufficient recognition of the support
networks of people with close ties outside of Germany (Homfeldt, Schröer, and Schweppe
2008, 19). This dominance of the national welfare state and its assimilationist ‘integration’
policies has not encouraged the creation of migrant social welfare organisations.
Despite reluctance to recognise itself as a country of immigration, Germany now has a
highly diverse population, and since 1999 there have been moves towards acknowledging a
more pluralist society. The 2000 Report on the Situation of Foreigners in Germany, issued
by the Federal Commissioner of Foreign Affairs (2000, 228 in Joppke and Morowska 2003,
5), makes no mention of a German homogenous ‘core’ culture that immigrants could
share. Instead, Germany is defined as a heterogeneous society with a ‘multiplicity of coex-
isting life styles’ (Joppke and Morowska 2003). This ‘rules out the possibility that “inte-
gration” could mean “assimilation”’ (Joppke and Morowska 2003). The only integration
criteria, according to the report, are the ‘Acceptance of the values of the Constitution
(Grundgesetz) and knowledge of the German language’ (Joppke and Morowska 2003,
5). According to these developments, Joppke and Morowska (2003) argue that
Germany practices ‘de facto multiculturalism’. In a liberal context based on principles
of non-discrimination, ‘integration cannot be intransitive’ (as a one-sided imposition of
cultural norms), instead it is seen as a mutual task (Joppke and Morowska 2003, 6):
De facto multiculturalism has become a pervasive reality in liberal, immigrant receiving
states. It has many facets, from the principled protection of rights to pragmatic concessions
in the interest of public health or security. The individual rights and liberties protected by the
constitutions of liberal states have allowed immigrants qua individuals to find recognition
and protection for their distinct cultural practices. (Joppke and Morowska 2003, 9)

Since 2000, German immigration and integration policies have decisively changed, begin-
ning with the reform of citizenship law, followed by reforms of migration law in 2005
(Zuwanderungsgesetz) and of residence law (Aufenthaltsgesetz) in 2007 (Schulte 2011,
39), adopting reforms regarding residency, reducing the barriers to citizenship, expanding
the right of asylum, creating regulations for skilled migration, and introducing federally
funded integration and language courses.
10 R. BRANDHORST ET AL.

An important related development was the creation of the German Islam Summit
(Deutsche Islam Konferenz) in 2006, ensuring the political participation and represen-
tation of Muslim associations, and of the German Integration Summit (Deutscher Integra-
tionsgipfel) in 2006, involving stakeholders from policy, media, migrant- and labour
organisations. The recent coalition’s agreement of conservatives and the Social Democrats
in 2018 on a new ‘Immigration Law’ (Fachkräfteeinwanderungsgesetz) marks a final move
to recognition as a country of immigration (Deutscher Bundestag 2018). The law aims at
recruiting skilled labour and reducing the barriers for qualified workers to migrate to
Germany. In contrast to Australia, after obtaining a skilled migration or working visa,
the migrant can directly apply for permanent residence and citizenship. Furthermore,
the political rhetoric of the major parties now argues that integration is a mutual task
of both immigrants and German society. However, this two-way process of integration
remains highly controversial, as a growing far right, evident across Europe, continues to
articulate the assimilation approach, aligned to ethno-nationalism and Christian ‘core’
culture.
Despite these migration and integration policy reforms, there is still a considerable
difference in policy and practice between de facto multiculturalism, unofficially practiced
in heterogeneous liberal societies, and official multiculturalism, practiced for instance in
Australia or Canada, in which states have officially recognised immigrants as distinct
ethnic groups, and provide institutional support for them (Joppke and Morowska 2003,
8). This difference is particularly clear in the status, institutionalisation and political rec-
ognition of migrant organisations as political actors and non-profit organisations. Thus,
until recently, Germany has tolerated cultural difference in the private sphere and in com-
munity-level associations, but in contrast to Australia, has hesitated to give cultural differ-
ence or ethnic representatives a public status. This longstanding lack of public status of
ethnic migrant organisations has resulted in a scarcity of social and aged care services tai-
lored for migrant groups.
With Chancellor Merkel’s political move to open the borders for refugees stranded at
the Hungarian border, and the resultant immigration of one million refugees in 2015, the
topic of immigration became the focus of political debate and triggered a polarised discus-
sion about integration. Despite its reluctance, Germany continues to be a country of immi-
gration. According to the census of the German Federal Office of Statistics, 2 million
people migrated to Germany and 860 000 left Germany in 2015. This results in a net immi-
gration of 1.14 million in 2015 (German Federal Office of Statistics 2015). With increasing
immigration, Germany needs to adapt to its new culturally and linguistically diverse popu-
lation, and ensure possibilities of participation and political representation not just in the
labour market, but also in reproductive spheres. First steps have been made regarding the
education system, by establishing Islam lessons in schools and Islam teacher training at
universities. However, especially in the area of aged care, a growing need to cater for Ger-
many’s cultural diversity and the culturally and linguistic needs of migrants remains.

4. Migration and aged care

There is a considerable difference in service delivery and policy relating to care of older
migrants in the German and Australian aged care systems. In this section, we argue
 JOURNAL OF ETHNIC AND MIGRATION STUDIES 11

that these differences originate in different migration policies (integration vs. multicultur-
alism) and to a lesser degree in different welfare and LTC-systems.
Australia’s relatively long history of multicultural policies and their strong link to Aus-
tralian nation-building have created conditions in which migrant organisations could
flourish. These migrant organisations were not seen as suspicious segregation movements
that impede migrants from integration, but as part of the Australian national multicultur-
alist agenda. With the ageing of migrant communities, migrant organisations have devel-
oped appropriate aged care services. In Perth, Western Australia, for example, six migrant
organisations founded the Board and Management of the Stirling Ethnic Aged Homes
Association in 1994, now called MYVISTA (2018), a non-profit home and residential
aged care organisation. Care staff includes Southern Europeans who speak Italian, Mace-
donian, and Croatian. Another example is UMBRELLA Multicultural Community
Care (2018) created by the Western Australian Association of Polish Women, originally
directed at home care services for older Polish migrants, but later extended to other
migrant groups. Multicultural or pluralistic services cater to people of different ethnicities
and deal specifically with intercultural issues. Also, mainstream services are obliged to
reduce barriers for migrants and provide cross-cultural training to workers. This is impor-
tant as increasing numbers of aged care workers are from migrant backgrounds them-
selves, particularly Asian and African, and have different languages to the majority of
their clients, who are mainly European background. Furthermore, almost all services
have access to interpreters through the government’s Telephone and Interpreter Service
(see Kelaher and Manderson 2000, 7).
It must also be noted that, despite its strong multicultural service delivery history, in
their recent review of Australian Research on Older People from Culturally and Linguis-
tically Diverse Backgrounds, the Federation of Community Councils in Australia found
that older people from migrant backgrounds in Australia, ‘have higher levels of disadvan-
tage and other risk factors than older Anglo-Australians’ (FECCA 2015, 4), including lack
of appropriate services. Lower income, limited English language ability, limited under-
standing of available services, different understanding of illness (in particular mental
health and dementia), cultural stigma and institutional discrimination in the welfare
sector constitute barriers to the access of health- and aged care services. All these
factors can lead to delayed diagnosis, which results in older migrants having higher
rates of poor health. In addition, there is a lack of appropriate treatment and service
options, particularly for emerging communities, and people living in rural or remote
areas. These risk factors are further compounded by a set of major reforms in the aged
care sector currently underway, which is being reoriented from a regulated grants based
approach to a consumer-directed care model (COTA 2015). This raises particular chal-
lenges for older migrants, due to language barriers. The Council on The Ageing identified
a lack of appropriate consultation as a key barrier to the engagement of older migrants
with the aged care system (COTA 2013).
Furthermore, the increasingly restrictive migration policies (see Section 2), specifically
for older migrants and for migrants at risk of overstaying, impede the transnational care
practices of older migrants. Short-term visa restrictions prevent migrants from importing
care across distance by calling on a relative from their country of origin. The restrictions
on leaving and staying out of Australian that apply to some visa category holders make it
difficult to organise transnational care or visit family members abroad. In addition, the
12 R. BRANDHORST ET AL.

restrictions on family reunion and Parent Visa migration make it difficult for migrant chil-
dren to care for their parents.
In Germany, despite rising immigration and the increasing percentage of older people
born abroad, aged care policies and the aged care sector have scarcely adapted to the
growing older migrant groups (Lampert et al. 2005). In their study of older Turkish
migrants, Okken, Spallek, and Razum (2008) identify a lack of language services, ethno-
specific and multicultural services in German home and residential aged care organis-
ations. This scarcity of aged care services for migrants is linked to the weaker position
of migrant organisations and Germany’s migration history. Firstly, under the German
temporary guest worker policies, migration was considered temporary and linked to
labour contracts and the productive sphere, with family and the reproductive sphere
ignored and expected to occur in migrant countries of origin. This resulted in a neglect
of aged care services for migrants. Secondly, the scarcity of aged care services targeted
at migrants and the late development of migrant aged care concepts in Germany can be
explained by the early ‘integration’ policies. In contrast to Australian multicultural pol-
icies, German early intransitive integration/or assimilation policies and discourses until
the 1990s assumed migrants would assimilate into German organisations, speak
German and cut cultural ties with their country of origin. A maintenance of cultural, reli-
gious, political or social ties with the country of origin was perceived as a threat that
undermined ‘integration’. This has resulted in a relatively weak level of institutionalisation
and a limited political representation and participation of migrant organisations in
Germany.
Another, though less significant, factor explaining the relative weakness of migrant
welfare organisations in Germany is the system of social service provisions based on a sub-
sidiarity principle, dominated by public sector and non-profit service providers. Although
Germany provided space for immigrant religions like Islam, or the Russian Orthodox
Church (Bauböck 1999), the major social welfare and LTC service providers today are
public or Christian church-based organisations, which hold 55% of care facilities (Hock-
erts 2012, 76f.). According to a study by Halm and Sauer (2015), mosque-based organis-
ations are engaged in social welfare and aged care, however, they are not equally eligible for
government funding, as they are not fully recognised as a charity welfare provider. A rep-
resentation at the national level as in Australian multicultural policies would be a solution.
The creation of an Islamic non-profit welfare organisation with institutional support (Isla-
mischen Wohlfahrtsverband) would be an interesting approach.
Lewicki (2017) argues that Christian welfare organisations have not sufficiently adapted
to the diversity of German society. The Evangelical Diakonisches Werk and the Catholic
Caritas signed a ‘Memorandum to provide culturally specific aged care’ (Memorandum für
kulturspezifische Altenhilfe) in 2001 (Forum für eine kultursensible Altenhilfe 2017). Both
are members of the Forum for Culturally-Sensitive Aged Care (Forum für eine kultursen-
sible Altenhilfe), initiated in 2006 – a national coalition of organisations aiming to develop
‘intercultural awareness’ and make aged care accessible for older migrants. This constitutes
a first step towards more adequately catering to the needs of older migrants. However,
migrant organisations, e.g. mosque-based organisations, are not sufficiently included in
the decision-making and non-Christians are seldom involved at the leadership level of
these Christian charity organisations (Khan-Zvornicanin 2016). Furthermore, mainstream
aged care services that have not attempted to address cultural barriers to the access of aged
 JOURNAL OF ETHNIC AND MIGRATION STUDIES 13

care services are still prevalent. Few of these members are interested in informing older
migrants about their services by employing bi-cultural health or aged care workers.
Insufficient knowledge about mandatory aged care insurance, LTC provisions and ser-
vices that migrants are eligible for, a limited knowledge of the German language, the
experience of (institutional) discrimination in the German welfare sector and in LTCI
assessments, the focus on the family and distrust in public institutions constitute signifi-
cant barriers to the access of aged care services. According to a survey of the Medical
Service of the Health Care Insurance Westfahlen Lippe, only 2% of older Turkish migrants
used residential aged care facilities (Okken, Spallek, and Razum 2008, 418), while 91% pre-
ferred being cared for at home by family members and receive the aged care cash-allow-
ance. Okken, Spallek and Razum (2008) identify language and cultural issues as the key
barriers that prevent older Turkish migrants accessing different aged care services (Zeman
2005). Traditional home and residential aged care facilities do not cater for the linguistic
and cultural needs of different migrant groups and mainly focus on clients of the majority
culture (Okken, Spallek, and Razum 2008; Brzoska and Razum 2009; Brandhorst 2016).
Despite the lack of formal policy directed at migrant aged care needs, some migrant
groups have successfully developed culturally-specific aged care services. For example,
due to the significant numbers of ageing Turkish migrants in Germany (350,000 are 65
+), the Turkish community in Berlin founded the first private residential aged care organ-
isation for Turkish migrants in 2006, the Internationale Pflegehaus Kreuzberg (n.d.).
While initially directed to the Turkish migrant population, it recently opened to other
migrants and adopted a more multicultural pluralistic approach. The care staff speaks
Turkish, Arabic and Russian. Furthermore, the Turkish community in Berlin founded
the home care service ‘Türk Huzur Evi’ that focuses on cultural needs and care for
Turkey-born elderly. The care staff is either bilingual or completed a Turkish language
course. Recently, more private aged care organisations directed to migrant clients were
founded in cities with a high migrant population. There is an increasing need for culturally
sensitive care organisations, due to the ageing of the first generation of Turkey-born guest
workers: 2.8 million migrants are Turkey-born, 350,000 are over 65 (German Federal
Office of Statistics 2015).
Aged care organisations specifically directed to older migrants mark a decisive change
in the German aged care system and its mainstream majority culture approach towards
adapting to the cultural diversity of German society. However, in contrast to other aged
care and welfare systems, such as Australia, and in the face of the increasing German
migrant population in recent years, this pluralistic approach is relatively late. This reluc-
tance can be explained by the history of German migration policies conceptualising
migrants as temporary guests, delegating the responsibility of care to migrants’ countries
of origin, suspecting that migrant organisations would thwart integration, and the lack of
political recognition of migrant organisations as non-profit social service organisations.

5. Conclusion
The demographic challenges regarding population ageing and increasing immigration in
both Australia and Germany are indicative of the projected changes in focus needed in
aged care service delivery and policy in the coming years. Aged care and migration policies
as well as aged care providers have to adapt to increasing numbers of older migrants, who
14 R. BRANDHORST ET AL.

need equal access to appropriate LTC-services. As a result, we argue that there is a need for
a ‘migration turn’ in aged care policies to ensure that ageing policy frameworks better meet
the needs of an increasingly diverse ageing population, to raise political recognition of the
role of transnational informal care, and to develop innovative transnational social policies.
Germany needs to find ways to provide culturally and linguistically appropriate aged
care. In this respect, the Australian multicultural migration policy, recognising and subsi-
dising ethnic organisations as aged care service providers, and focussing on ethno-specific
and multicultural aged care, as well as on bi-cultural and multicultural trained aged care
workers can provide interesting examples for a ‘migration turn’ in the German aged care
system. Despite the criticism of Australian multiculturalism becoming increasingly mono-
cultural in its mainstreaming approaches and implicitly promoting the segregation of
different cultural groups, the multiculturalist policy in the 1970s and 1980s and its
effort to provide aged care services that accommodate the needs of a culturally and linguis-
tically diverse population serve as a compelling approach for aged care policies directed to
the increasing diversity of ageing populations. The model of ethno-specific care that
employs bi-cultural health- and aged care workers is instructive.
Notwithstanding this, there is also a need for a ‘migration turn’ in Australia, where an
emphasis on cost-reducing mainstreaming service approaches risks undermining the
delivery of ethno-specific care, and the move to consumer-directed care raises particular
challenges for meeting the needs of older migrants. In addition, the introduction of stricter
parent migration and family reunion schemes make transnational care increasingly
difficult. Reflecting global trends, Australia’s stricter parent migration regulations and con-
trols for older people who wish to visit family in Australia reflect an implicit assumption of
older migrants as an economic burden, without taking adequate account of the contri-
butions they make, particularly in the form of unpaid child care.
In both Australia and Germany, transnational and distant family care and support net-
works of older migrants remain insufficiently recognised in migration, welfare and aged
care policies (Brandhorst 2016; Baldassar 2017). Distant support networks are usually
not considered in most LTC, health and aged care related policies, which tend to focus
on national support structures. Transnational ageing and care thus implies challenges
to ‘nationally bounded welfare states, which historically have tended to be organised
according to a logic of solidarity among nationals and permanent residents of a given
state territory’ (Böcker and Hunter 2017, 353).
German and Australian policies have to acknowledge that migrants can experience a
‘simultaneous embeddedness’ in both the home and host societies through continuing
family, social, political and economic ties (Glick Schiller, Basch, and Blanc-Szanton
1992). Baldassar (2017), Brandhorst (2019) and Wilding and Baldassar (2018) identify sig-
nificant barriers to people providing transnational aged care. Lack of bilateral healthcare
agreements and care leave provisions, for instance, are obstacles for providing transna-
tional care to relatives far away or across borders. Furthermore, the migrants’ entitlement
to LTC and social welfare depends on their citizenship, residency status, labour market
and insurance payments record (e.g. mandatory LTC-insurance) (Ackers and Dwyer
2002). Consequently, the different types and needs of older migrants and the transnatio-
nalisation of ageing and care call for the need of a global migration governance and for
transnational social policy (Faist 2009; Chambon, Schröer, and Schweppe 2013; Baldassar
2007, 2017). Aged care organisations need to cater for new forms of ageing in place that
 JOURNAL OF ETHNIC AND MIGRATION STUDIES 15

acknowledge the role of transnational care, where the social networks of older migrants are
not confined to the local neighbourhood but are linked to other places as well. Further-
more, there is a need for recognition of distant carers, who might organise the care for
their parents across national borders, in aged care organisations.

Disclosure statement
No potential conflict of interest was reported by the authors.

Funding
This research was jointly supported by the German Research Foundation Grant BR 5645/1-1
(awarded to R. Brandhorst) and the Australian Research Council Discovery Project
DP160102552, 2016–2018 (L. Baldassar and R. Wilding).

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