Living in the Margins: The ICE (Intersectional-Intergenerational Cultural and Ecological) theory of EM of Pakistanis living in the UK.

Elder mistreatment (hereafter EM) is a complex, diverse and universal health and social problem (Burnes et al., 2015b) which has hitherto been predominately researched in the indigenous (white) populations of western countries. As a result, the predominant explanations are considered to be universal, potentially masking important cultural and ethnic differences. There is, however, a growing body of literature suggesting that variations exist in the perception, understanding and reporting of EM among different ethnicities of majority populations in western countries. The United Kingdom (UK), like other ethnically diverse western countries, has a heterogeneous population which includes sizeable numbers of Pakistani older people. At present, however, no comprehensive theoretical framework exists which explains the diverse and multi-etiological nature of EM among Pakistani communities; this thesis addresses this knowledge gap. A qualitative approach was used for this study underpinned by the philosophical basis of constructivist grounded theory (CGT) to explore the understanding of EM among Pakistanis living in Sheffield, UK. Two focus groups (male = 1; female = 1) and 22 in-depth individual interviews were conducted with a diverse range of participants: older people, young family members and community stakeholders. The data were analysed using the CGT principles of analytic coding, memo writing, constant comparison, theoretical sampling and theoretical saturation. The findings suggest that if EM among Pakistanis is to be better understood, then consideration has to be given to older peoples’ lifetime migratory advantages and disadvantages, their current social, economic and health status, and the existing and past relationships and interactions with their family members and with the wider society. Based on the results, a cultural and ecological theory of EM was constructed. This theory argues that intersectional and intergenerational (hereafter IG) factors help to explain who is at risk of EM in four different ecological systems: the individual, relational or family, the community and wider society. The power and privileges and consequently the marginalization of others are central arguments of the theory. It was also found that Pakistanis follow a complex but prescriptive process in addressing the issues around EM in the community. Finally, the thesis concludes with the implications and recommendations for practice, future research and policies. Widening IG relationships, changing caregiving trends and the mistreatment of older people in the target society are three examples of these implications.