16 December 2015

Cultural diversity challenging in dementia care say Nurses on NurChat

Dementia is arguably the biggest health challenge of our time affecting over 850,000 people in the UK and growing. As a culturally diverse popluation, the number of people with dementia from minority ethnic backgrounds in the UK could rise by almost 7 times to 170,000 by 2051 according to the Alzheimer’s Society.

The nature of cultural diversity including different languages, ideas, customs and health practices is likely to present local and national challenges in achieving personalised dementia care. Resources will become stretched even further if the cost of dementia care trebles to over £50 billion as expected by the Department of Health.

The focus on living well with dementia relies on a personalised approach that meets the needs of the individual and protects their dignity. In a recent #NurChat twitter chat, registered nurses and healthcare practitioners, including those who specialise in dementia, joined together to discuss the challenges faced when providing culturally-appropriate dementia care.

Effective communication, not only for a person with dementia but also their family and carers was highlighted as a crucial element of successful person-centred approach. Some people with dementia may revert to their native language if English is not their first language, which can make understanding their wishes difficult in the absence of additional support. Even then, issues of confidentiality can occur if a third party is required to translate.

A postcode lottery of dementia services has been widely reported, with the prescription of anti-dementia drugs varying greatly between areas of affluence and poorer postcodes. The bias of the healthcare system towards English speakers can also make it extremely difficult for those without English as a first language to access the treatment and services available to them.

Cultural barriers presented by the person and their family may also make achieving a diagnosis and accessing treatment difficult. In some cultures, there is no equivalent word for dementia, leading to labels of ‘mad’ and ‘crazy’ by family and community members. Cognitive decline is accepted as a natural part of ageing, which can also create a barrier to diagnosis and support. Leading dementia researcher and author Dr Shibley commented in the #NurChat,

A major factor in care in dementia across cultures is the acceptance of the diagnosis and the support by friends and family… In some cultures, there's a phenomenon called 'family scaffolding' where the family 'protects' the person with dementia from dx (diagnosis)”.

You can read the full transcript of the NurChat discussion on the challenges of personalised dementia care across cultures here.