Duty of care and care practice in Flanders: Differences according to origin

In non-Western cultures, the solidarity within the family, especially the duty of care of children towards their parents and grandparents – also called filial obligation – is strongly emphasized. This observation is often ascribed to the difference between cultures: are either collectivist or individualistic values accentuated? (Triandis & Suh, 2002). Research in the Netherlands shows that there are also differences within the group of migrants. Immigrants from Moroccan or Turkish origin show a higher score on the familial responsibility index than people with an immigration background from former Dutch colonies such as Suriname or the Dutch Antilles. For the latter, there is much more interaction with Dutch culture than for people from Turkey or Morocco (Merz et. al., 2009). Research in Belgium has also shown that filial obligation among migrants is felt strongly and more consciously than among the native population (Lodewijckx & Pelfrene, 2012). More so than the group with an exclusively Belgian origin, the group with migrants from countries such as Turkey, Morocco, Algeria or Tunisia put family first when it comes to receiving care or financial support.

In our 2011 research, every respondent living in Flanders was asked whether he/she was of Belgian origin. Due to research procedures, the origin was determined by means of the nationality of the father and mother at birth, respectively (for more information: Vanderleyden & Moons, 2013). The countries of origin were grouped together which resulted in a variable consisting of three categories:

The answers to most questions about filial obligation point out that the majority of respondents – more or less – endorse the idea of duty of care. More than half of the respondents disagree with the statement that it is not the task of the children to care for their parents; half of the respondents do not agree with the supposition that you cannot take care of your parents when you have small children. Almost half of the respondents agree that older people only belong in a residential or nursing home when no one of the family is able to care for them. Four out of ten respondents disagree with the statement that it is better for older people to live in a residential or nursing home than to be dependent on the care of their children. The table shows that there are remarkable differences according to origin.

People from Eastern Europe/outside Europe agree more often than Belgians with the statements – except for one - that support traditional family solidarity. People from Western Europe conform to the Belgians. For example: Two out of three persons from Eastern Europe/outside Europe disagree with the statement that it is better for older people to live in a nursing home than to be dependent on their children. Among the Belgians, 40% does not/does not at all agree with this statement; for people in Western Europe this percentage is 35%.

Differences according to origin are confirmed via the synthesis index which was calculated on the basis of 5 items (0 = lowest score for duty of care; 5 = highest score). Multivariate analysis shows that a more traditional view on family solidarity is indeed influenced by origin. The people who originate from Eastern Europe/outside Europe show a significantly higher score on the scale of filial obligation and those who originate from Western Europe do not differ from the Belgians, which also becomes clear from the response to the individual statements. Other personal characteristics also have an impact on the adherence to traditional values with respect to familial solidarity, especially age, religion and having children or not. People who call themselves religious have a more traditional view of familial solidarity, and compared to aged people, youngsters are more traditional in their attitude. Contrary to expectations, people with children seem to be less attached to family solidarity.

We formulated the following question: Do care practices differ according to the origin of the people involved? Or: Do people from foreign origin, and especially those who come from Eastern Europe/outside Europe - in accordance with their traditional views on family solidarity - care more often for family members who are ill, impaired or old than, for instance, Belgians?

Within the group of caregivers, we selected only those persons that provide care for parents/in-laws (this comprises 43% of the cases in which care is provided). By means of a multivariate analysis, we looked at predicting factors for informal care by children with regard to their parents/in-laws in comparison with the group that does not provide any care at all.

In an initial model we only added origin as an independent variable. Do persons from Western Europe, Eastern Europe or outside Europe provide more care? The answer is clear: care practice is not influenced by origin. The variable does not provide an explanation and is totally insignificant. In a second model we added different background characteristics such as gender, age, marital status, education and employment. It is remarkable that gender is not significant when controlling for the other variables, whereas some studies point out that it is (still) primarily women who provide care (see, among others, Hoefman, 2009). Does the identity of the care recipient have anything to do with this? When it comes to a parent or in-law, care is provided and apparently sons figure in this as much as daughters. As for age, it is the age group of 45-64 that mainly provides care, but in comparison to the oldest age group of over 65s, the younger age category provides care more often. The marital status also shows significant differences. Compared to those who are married, the chance that unmarried people provide care is less probable. People who are widowed or divorced do not significant differ from those who are married. Education is not significant when controlling for the other variables, but employment is. In comparison with people who work full time, those who are retired or work part time appear more often as informal caregivers. Adding a network variable, namely whether someone functions as a volunteer or not, does add an extra explanation of the model. Finally, we wanted to know whether filial obligation, the way in which people think about the traditional family solidarity, influences care practices. This variable shows a significant effect under the control of all other variables. Taken together, personal characteristics, the network and the set of values with regard to filial obligation explain 18% of the total variance, which is, in itself, not so much. All in all, this indicates that there are other important factors that determine whether informal care for a parent/inlaw is provided. Sadiraj et. al (2009) state that in fact there is only one reason why informal care is provided, namely that someone in the social network needs this care.

Overall, we can conclude that family solidarity is a broad concept with various dimensions, such as duty of care and care practice, that have to be looked at separately. Because people feel that they have a responsibility, this does not necessarily mean that they will put it into practice.