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Chu N, Pho J, Dark L, Tan A, Alford S, Tang CY, Ellison C, Lim D. A scoping review into the service needs of people from culturally and linguistically diverse backgrounds living with disability to engage in meaningful occupations. Aust Occup Ther J 2024; 71:408-422. [PMID: 38359914 DOI: 10.1111/1440-1630.12938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Although there is a large proportion of people from culturally and linguistically diverse backgrounds within Australia, their rate of access to disability services is disproportionately low. This review aims to understand the service needs of people from culturally and linguistically diverse backgrounds with disability to facilitate engagement in meaningful occupations. METHODS Arksey and O'Malley's scoping review framework was employed. Ten databases were searched for Australian studies. A deductive content analysis framework was applied in the synthesis. RESULTS Fourteen papers were included. Themes that emerged include language and cultural needs and considerations, which highlights the need for information sharing to take account of intergenerational, intercultural and sociolinguistic differences. It also identified the need for improved training and skills of existing interpreters. Culturally competent and responsive services was another theme identified, which emphasised the need to enhance the workforces' understanding of cultural practices. There is also a strong call for a more culturally diverse workforce to reduce the use of some interpreters and to build a more culturally competent workforce. The last theme was responsive service delivery, which requires the governance to support the development of a nurturing trusting therapeutic relationship. CONCLUSIONS Service providers should be trained on the inequities and intersectionality of this population. Further research is required to explore current disability policy in Australia with an intersectionality lens to ensure recommendations can be made to address barriers and ensure this population receives services in a manner that enhances their ability to engage in occupations meaningfully.
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Affiliation(s)
- Natalie Chu
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Jacqueline Pho
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Leigha Dark
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Aidan Tan
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Clarice Y Tang
- College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Caroline Ellison
- Justice and Society, University of South Australia, Magill, South Australia, Australia
| | - David Lim
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney, Sydney, New South Wales, Australia
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Ali Y, Caballero GE, Shatnawi E, Dadich A, Steiner‐Lim GZ, Alliance CBD, DiGiacomo M, Karamacoska D. Assessing the impact of an online dementia awareness initiative co-created with and for English, Arabic and Vietnamese speaking communities: A case study. Health Expect 2024; 27:e14026. [PMID: 38618991 PMCID: PMC11017301 DOI: 10.1111/hex.14026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/11/2024] [Accepted: 03/12/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Awareness and understanding of dementia remain limited in ethnically diverse populations in multicultural societies due to culturally inappropriate and inaccessible information. OBJECTIVE To establish the impact, helpers and hinderers of an online multilingual dementia awareness initiative co-created with and for English, Arabic and Vietnamese speaking people. DESIGN A case study using mixed methods to assess the impact and implementation of an information session on dementia knowledge. SETTING AND PARTICIPANTS The study was conducted with English, Arabic and Vietnamese speaking individuals in Canterbury-Bankstown, Australia. INTERVENTION STUDIED A dementia alliance co-created an online multilingual dementia information session, which was delivered synchronously in English, Arabic and Vietnamese by trained facilitators. MAIN OUTCOME MEASURES In-session group discussions, quizzes and a postsession survey assessed the impact on dementia knowledge. A postimplementation focus group explored the factors that helped and hindered the initiative. RESULTS The online dementia information session successfully supported participants understanding of dementia causes, impacts and care strategies. The initiative was hindered by competing priorities and limited accessibility to target audiences, while it was helped by the support of an established organisation and feedback mechanisms. DISCUSSION Ongoing dementia education and awareness-raising campaigns that are culturally sensitive are needed in communities to promote dementia literacy and help-seeking. CONCLUSIONS An online multilingual dementia information session can be an effective way to improve dementia literacy and advocate for change in multicultural communities. PATIENT OR PUBLIC CONTRIBUTION English, Arabic and Vietnamese speaking members of the Canterbury Bankstown Dementia Alliance participated in the co-creation and evaluation of this initiative.
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Affiliation(s)
- Yousra Ali
- School of PsychologyWestern Sydney UniversityPenrithAustralia
| | | | - Eman Shatnawi
- NICM Health Research InstituteWestern Sydney UniversityPenrithAustralia
| | - Ann Dadich
- Translational Health Research Institute (THRI)Western Sydney UniversityPenrithAustralia
- School of BusinessWestern Sydney UniversityPenrithAustralia
| | - Genevieve Z. Steiner‐Lim
- NICM Health Research InstituteWestern Sydney UniversityPenrithAustralia
- Translational Health Research Institute (THRI)Western Sydney UniversityPenrithAustralia
| | | | - Michelle DiGiacomo
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of HealthUniversity of Technology SydneyBroadwayAustralia
| | - Diana Karamacoska
- NICM Health Research InstituteWestern Sydney UniversityPenrithAustralia
- Translational Health Research Institute (THRI)Western Sydney UniversityPenrithAustralia
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Fry JM, Antoniades J, Temple JB, Osborne RH, Cheng C, Hwang K, Brijnath B. Health literacy and older adults: Findings from a national population-based survey. Health Promot J Austr 2024; 35:487-503. [PMID: 37452578 DOI: 10.1002/hpja.779] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 05/01/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023] Open
Abstract
ISSUE ADDRESSED With an ageing population and growing complexity and fragmentation of health care systems, health literacy is increasingly important in managing health. This study investigated health literacy strengths and challenges reported by older Australians (people aged 65 or over) and identified how socio-demographic and health factors related to their health literacy profiles. METHODS The sample comprised 1578 individuals responding to the Australian Government's 2018 Health Literacy Survey, conducted between January and August. Regression modelling was used to estimate the association between each of nine domains of the Health Literacy Questionnaire (HLQ) and individual socio-demographic and health characteristics. The model allowed for correlation between HLQ scores that was linked to unobserved characteristics of individuals. RESULTS Across the health literacy domains, few individuals received mean scores in the lowest score range. Key individual characteristics associated with higher health literacy were increasing age, English proficiency, higher education levels, better self-assessed health and having certain chronic conditions (cancer, hypertension and arthritis). CONCLUSIONS Our findings suggest that, among those aged 65 or over, being older or living with chronic illnesses were associated with greater confidence in engaging with providers, accessing information and navigating health services compared to individuals aged 65-69 and those older individuals without chronic illness. Lower health literacy was associated with psychological distress and low English proficiency. SO WHAT?: Interventions to improve individual health literacy and organisation health literacy responsiveness to minimise complexity of the Australian health system are required. This may enhance uptake and use of health information and services for the underserviced members of the community.
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Affiliation(s)
- Jane M Fry
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jo Antoniades
- National Ageing Research Institute (NARI), Melbourne, Victoria, Australia
| | - Jeromey B Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Richard H Osborne
- Centre of Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Christina Cheng
- Centre of Global Health and Equity, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Kerry Hwang
- National Ageing Research Institute (NARI), Melbourne, Victoria, Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Melbourne, Victoria, Australia
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Gaviola MA, Omura M, Inder KJ, Johnson A. Caring for people with dementia from culturally and linguistically diverse backgrounds in nursing homes: A scoping review. Int J Nurs Stud 2024; 151:104674. [PMID: 38215689 DOI: 10.1016/j.ijnurstu.2023.104674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/05/2023] [Accepted: 12/09/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND With continued increase in global migration, older people population in most countries is culturally diverse. Despite lesser preference for nursing home placement, people with dementia from culturally diverse backgrounds with higher needs and acuity do access nursing homes, however, little is known about care provision. OBJECTIVE The aims of this review were to map and synthesise available literature on care provision amongst people with dementia from culturally and linguistically diverse backgrounds in nursing homes and identify literature gaps that could inform future research. DESIGN A scoping review was conducted guided by the six-step scoping review methodology of Levac and colleagues. METHODS A literature search was conducted from August to September 2022 and updated in June 2023 using six databases: Medline, CINAHL, Embase, Cochrane Library, PsycINFO, and Scopus. Screening of articles, data extraction, and quality appraisal was performed independently by two authors. Articles included were primary empirical studies that explored care provision to people with dementia from culturally and linguistically diverse backgrounds living in nursing homes. Critical appraisal was conducted using the Joanna Briggs Institute Critical Appraisal Tool. Data were analysed using thematic analysis. Results were presented in a table and narrative format. RESULTS Of the 1149 articles identified, 25 were included. A majority of the articles were qualitative (n = 17) and conducted in Western countries such as those in Europe (n = 11), as well as Australia (n = 5) and the United States (n = 4). Data analysis led to the development of three themes: (1) maintaining a sense of home; (2) fostering communication and interaction; (3) barriers and facilitators to providing care. Most articles did not specify the model underpinning the approaches to care provision. CONCLUSIONS Care provision for people with dementia from culturally and linguistically diverse backgrounds living in nursing homes entails an environment which enables them to live up to the standards of what "home" means to them, communicate their needs, and engage in meaningful interactions. Predominant barriers to care provision relate to language and the facility's resources and capacity to deliver culture-specific care. Methodological quality of the studies that explored care provision for people with dementia from culturally and linguistically diverse backgrounds in the nursing home context is mostly limited. To strengthen the evidence base, there is a need for more rigorous research that informs care provision approaches and development of an inclusive model of culturally appropriate care to people with dementia from culturally diverse backgrounds in the nursing home context. TWEETABLE ABSTRACT A scoping review synthesised evidence on care provision amongst people with dementia from CALD backgrounds in nursing homes.
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Affiliation(s)
- Minah Amor Gaviola
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
| | - Mieko Omura
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
| | - Kerry Jill Inder
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
| | - Amanda Johnson
- School of Nursing and Midwifery, The University of Newcastle, NSW, Australia.
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5
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Chejor P, Cain P, Laging B, Porock D. Dementia care for people from culturally and linguistically diverse backgrounds: Qualitative secondary analysis of the Aged Care Australian Royal Commission data. Australas J Ageing 2023; 42:751-761. [PMID: 37792441 DOI: 10.1111/ajag.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Understanding the concerns and experiences of people living with dementia from culturally and linguistically diverse backgrounds is critical to ensure culturally appropriate care is delivered. This study aimed to describe the current experiences and concerns of older people from culturally and linguistically diverse backgrounds using the publicly available evidence from the Australian Royal Commission into Aged Care Quality and Safety. METHODS This was a qualitative secondary analysis of the Australian Royal Commission into Aged Care Quality and Safety data to explore new and nuanced insights about care for culturally and linguistically diverse people living with dementia. Using the keywords to search the data corpus, we extracted a topic-specific data set focused on dementia care and cultural diversity. Thematic analysis was used to identify and describe the present practices and challenges. RESULTS Our findings showed that the need for cultural connection for older people from culturally and linguistically diverse backgrounds increases as dementia progresses. Access to culture-specific food and music facilitated connection with their culture of origin. Many older people from culturally and linguistically diverse backgrounds with dementia reverted to their language of origin; however, the inability to communicate due to a lack of language support impacted their health and well-being, and care provision. CONCLUSIONS Further work is needed to provide the necessary cultural experiences and language support to ensure comfort and equity in the provision of dementia care for Australians from migrant backgrounds.
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Affiliation(s)
- Pelden Chejor
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Patricia Cain
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
| | - Bridget Laging
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Davina Porock
- Centre for Research in Aged Care, School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia
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Xiao L, Gordon S, Ahmad M. Experiences of family caregivers of people with dementia from a Muslim migrant background in high-income countries: a systematic review and meta-synthesis. Aging Ment Health 2023; 27:2319-2328. [PMID: 37300492 DOI: 10.1080/13607863.2023.2222078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 03/08/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The cultural and religious beliefs and values of family caregivers of people with dementia have a profound impact on the use of dementia care services in high-income countries. Yet, little is known about how caregivers of people with dementia from a Muslim migrant background in high-income countries perceive their caregiving journey. AIM To synthesise findings from rigorous qualitative studies on the experiences of family caregivers of people with dementia from a Muslim migrant background in high-income countries. METHODS Meta-ethnography of qualitative studies was applied to address the aim. Five databases including MEDLINE, CINHAL, PsycINFO, Web of Science and Scopus were searched. Inclusion criteria were qualitative or mixed study design studies on family caregivers of people with dementia from a Muslim migrant background in a home care setting in high-income countries. Studies were excluded if they used a quantitative research design, were not written in English and were not original studies. FINDINGS In total 17 articles met the inclusion criteria and were included in the study. Meta-synthesis of the data revealed three themes from the life course intersectionality perspective: caregiving as both positive and negative experiences; factors affecting caregivers' experiences; and coping strategies used by caregivers. CONCLUSION Caregivers of people with dementia from a Muslim migrant background living in high-income countries have both positive and negative caregiving experiences. However, dementia care services were not tailored to address their care needs and expectations arising from their religious and cultural beliefs.
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Affiliation(s)
- Lily Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sue Gordon
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Mahjabeen Ahmad
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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Shatnawi E, Steiner-Lim GZ, Karamacoska D. Cultural inclusivity and diversity in dementia friendly communities: An integrative review. DEMENTIA 2023; 22:2024-2046. [PMID: 37871120 PMCID: PMC10644696 DOI: 10.1177/14713012231206292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help seeking behaviours. Dementia friendly communities have been shown to reduce stigma, and the gap in health and social outcomes for people impacted by dementia. Despite the large presence of established dementia friendly communities, their functioning in multicultural communities remains underexplored. The aim of this review was to identify the barriers and facilitators of cultural inclusivity to inform the development of a multicultural dementia friendly community. We systematically searched for academic and grey literature regarding existing and prospective age or dementia-friendly communities that engaged with culturally and linguistically diverse communities. Using the matrix method, data on the barriers and facilitators to engagement were extracted. Papers were analysed for common themes and findings were integrated in a narrative format. A total of 3,164 papers were identified, 11 of which met inclusion criteria. There were 6 dementia friendly communities in North America, 3 in Europe, 1 in Australia and 1 in Asia. Analyses revealed that barriers to cultural inclusivity were centered around the accessibility of services, sociocultural factors, and the environment, including issues such as low awareness of dementia and stigma, language barriers, isolation, and the inaccessibility of transport and buildings. Leveraging existing cultural leaders and social structures to target culturally and linguistically diverse populations and develop tailored dementia friendly initiatives were key facilitators. To foster cultural inclusivity in dementia friendly communities, a culturally specific lens that addresses these barriers and utilises facilitators must be applied from the design stage through to implementation and evaluation.
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Affiliation(s)
- Eman Shatnawi
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Genevieve Z Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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Allam I, Gresham M, Phillipson L, Brodaty H, Low LF. Beliefs around help-Seeking and Support for Dementia in the Australian Arabic Speaking Community. DEMENTIA 2023:14713012231166170. [PMID: 36990452 DOI: 10.1177/14713012231166170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND The number of people with dementia in multicultural Australia is rapidly increasing. Despite its culturally diverse population, there is limited research about how people from ethnic minority groups understand and approach help-seeking and support for dementia. The aim of this study is to understand the perceptions of dementia symptoms, help-seeking and support in the Australian Arabic-speaking community. METHODS This study used a cross-sectional qualitative research design. Individual, semi-structured interviews using projective stimulus techniques were used. Participants were three Arabic-speaking people aged over 70 who were experiencing cognitive changes or dementia symptoms, six carers, and five health or social care practitioners experienced in working with Arab-Australians. Phone or video chat interviews were conducted in either Arabic or English. Interviews were audiotaped, translated when needed, transcribed verbatim and inductive thematic analysis was undertaken. FINDINGS Seven themes were identified. Participants described dementia as relating to symptoms of confusion and memory loss. Carers and older people believe that when older people are experiencing these cognitive symptoms, they must be cared for primarily by ensuring their happiness and comfort. Barriers to help-seeking and support included a lack of help-seeking due to cultural norms of family orientated care, families are unsure of where to seek help and fear of community judgement. Two ways to facilitate help-seeking and support were to build trust through culturally appropriate support and to educate the community. CONCLUSION Family, trust and community were identified as central pillars of the Australian-Arabic-speaking community. There is a need to increase dementia literacy in this community particularly around help-seeking and decreasing stigma. Education should be promoted by trusted community members and religious leaders. As the first point of professional contact, general practitioners need to be upskilled to support Arabic-speaking Australians around dementia.
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Affiliation(s)
- Issra Allam
- 522555The University of Sydney Faculty of Medicine and Health, Sydney, NSW, AU
| | - Meredith Gresham
- Centre for Healthy Brain Ageing, 98994University of New South Wales Faculty of Medicine, Sydney, NSW, AU
| | - Lyn Phillipson
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, AU
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales Faculty of Medicine, Sydney, NSW, AU
| | - Lee-Fay Low
- The University of Sydney Faculty of Medicine and Health, Sydney, NSW, AU
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Knipping D, Garnett A, Jiang BB. Access and Use of Services by Caregivers of Older Adults: A Scoping Review of Cultural and Linguistic Diversity. J Appl Gerontol 2023. [PMID: 36866817 DOI: 10.1177/07334648231158490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Westernized countries are home to an increasingly culturally and linguistically diverse (CLD) older adult population. Informal caregivers of CLD older adults face unique challenges accessing and using home- and community-based services (HCBS). This scoping review sought to identify facilitators and barriers to access and use of HCBS for informal caregivers of CLD older adults. Arksey and O'Malley's framework guided a systematic search of five electronic databases. The search strategy retrieved 5979 unique articles. Forty-two studies met the inclusion criteria and informed this review. Facilitators and barriers were identified at three stages of using services: knowledge, access, and use of services. Findings concerning access to HCBS were subdivided into willingness and ability to access HCBS. Results emphasize the need for changes in healthcare systems, organizations, and providers to provide culturally appropriate care and improve the accessibility and acceptability of HCBS for informal caregivers of CLD older adults.
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Affiliation(s)
| | - Anna Garnett
- Nursing, 6221University of Western Ontario, London, ON, Canada
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Ketchum FB, Monsees J, Kim AJ, Schmachtenberg T, Kind A, Shah M, Hoffmann W, Thyrian JR, Gilmore-Bykovskyi A. Pathways of care: a qualitative study of barriers and facilitators to engaging dementia care among underserved and minority populations in the US and Germany. Aging Ment Health 2023; 27:389-398. [PMID: 35138213 PMCID: PMC9360197 DOI: 10.1080/13607863.2022.2033695] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/17/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To identify barriers and facilitators to the use of formal dementia services among underserved and minority groups (UMG) in the United States and Germany. METHOD Semi-structured qualitative interviews with caregivers (N = 18) of persons with dementia in the United States and Germany. Data were analyzed using thematic analysis. RESULTS Caregivers described their experiences in three stages of seeking, initiating, and utilizing care, and different factors served to hinder or enable the use of care services in each stage. The most important factors included limited knowledge about dementia, challenges interacting with healthcare systems, and how closely formal services met the expectations and needs of caregivers, particularly with regard to accommodating cultural or ethnic/racial identity. Caregivers preferred interacting with service care providers who shared a similar identity to receive information or services. CONCLUSION Barriers and facilitators to using dementia care services vary by stage of engaging services and may be shared across different healthcare contexts. Targeting specific barriers and strengthening facilitators could help reduce disparities in dementia care among UMG.
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Affiliation(s)
- Fred B Ketchum
- Department of Neurology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jessica Monsees
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Alice J Kim
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Tim Schmachtenberg
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
| | - Amy Kind
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
- Center for Health Disparities Research, University of Wisconsin, Madison, Wisconsin, USA
| | - Manish Shah
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Andrea Gilmore-Bykovskyi
- Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
- Center for Health Disparities Research, University of Wisconsin, Madison, Wisconsin, USA
- Madison School of Nursing, University of Wisconsin, Madison, Wisconsin, USA
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11
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Gilbert AS, Antoniades J, Croy S, Thodis A, Adams J, Goeman D, Browning C, Kent M, Ellis K, Brijnath B. The experience of structural burden for culturally and linguistically diverse family carers of people living with dementia in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4492-e4503. [PMID: 35599431 PMCID: PMC10083988 DOI: 10.1111/hsc.13853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 03/27/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of 'structural burden' to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi-structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo-centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno-specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer-directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno-specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible.
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Affiliation(s)
- Andrew Simon Gilbert
- National Ageing Research InstituteParkvilleVictoriaAustralia
- La Trobe UniversityBundooraVictoriaAustralia
| | - Josefine Antoniades
- National Ageing Research InstituteParkvilleVictoriaAustralia
- Curtin UniversityBentleyWestern AustraliaAustralia
| | - Samantha Croy
- National Ageing Research InstituteParkvilleVictoriaAustralia
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Antonia Thodis
- National Ageing Research InstituteParkvilleVictoriaAustralia
- Swinburne University of TechnologyHawthornVictoriaAustralia
| | - Jon Adams
- University of Technology SydneyUltimoNew South WalesAustralia
| | - Dianne Goeman
- University of NewcastleCallaghanNew South WalesAustralia
- Monash UniversityClaytonVictoriaAustralia
| | - Colette Browning
- Federation UniversityMount HelenVictoriaAustralia
- Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Mike Kent
- Curtin UniversityBentleyWestern AustraliaAustralia
| | - Katie Ellis
- Curtin UniversityBentleyWestern AustraliaAustralia
| | - Bianca Brijnath
- National Ageing Research InstituteParkvilleVictoriaAustralia
- University of Western AustraliaCrawleyWestern AustraliaAustralia
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12
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Temple J, Wilson T, Brijnath B, Radford K, LoGiudice D, Utomo A, Anstey KJ. The role of demographic change in explaining the growth of Australia's older migrant population living with dementia, 2016-2051. Aust N Z J Public Health 2022; 46:661-667. [PMID: 36047851 DOI: 10.1111/1753-6405.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine the demographic drivers contributing to the future growth in the population of older migrants in Australia living with dementia. METHODS Using birthplace-specific cohort-component projection models, we projected the number of older migrants living with dementia. ABS data on births, deaths, migration and birthplace were used, alongside Australian Institute of Health and Welfare (AIHW) estimates of dementia prevalence with birthplace dementia weights calculated from administrative data. RESULTS The number of older migrants living with dementia is projected to increase from about 134,423 in 2016 to 378,724 by 2051. Increases in populations with dementia varied considerably, from a slight decrease for those born in Southern & Eastern Europe to over 600% increases amongst the South-East Asia, Southern & Central Asia, and Sub-Saharan Africa-born populations. CONCLUSIONS Cohort flow is the primary driver increasing the number of older migrants living with dementia. This growth is largely inevitable because the cohorts are already living in Australia as part of the migrant population, but currently at ages below 60 years. IMPLICATIONS FOR PUBLIC HEALTH High relative growth and shifting birthplace composition in the number of migrants living with dementia poses implications for culturally appropriate care, health care access and workforce needs to support migrant families, carers and their communities.
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Affiliation(s)
- Jeromey Temple
- Melbourne School of Population and Global Health, University of Melbourne, Victoria
| | - Tom Wilson
- Melbourne School of Population and Global Health, University of Melbourne, Victoria
| | | | - Kylie Radford
- Neuroscience Research Australia, University of New South Wales
| | - Dina LoGiudice
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria
| | - Ariane Utomo
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Victoria
| | - Kaarin J Anstey
- Neuroscience Research Australia, University of New South Wales
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Stenberg J, Hjelm K. Migrant informal caregiver perceptions and experiences of caring for a family member with dementia: A systematic review and thematic synthesis. J Clin Nurs 2022; 32:2178-2192. [PMID: 35655377 DOI: 10.1111/jocn.16390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/11/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To describe migrant family caregivers' experiences and perceptions of caring for a family member with dementia. BACKGROUND There are demographic trends of aging populations and increased migration between countries. Age-associated diseases, such as dementia, are expected to increase, with migrants being at significantly increased risk. Knowledge of how dementia care is provided within migrant families is scarce. DESIGN Systematic review and thematic synthesis of qualitative research were performed to inform the development of interventions that can acknowledge and respond to the needs, concerns and preferences of migrant family caregivers. METHODS Searches were performed in PubMed, PsycINFO and CINAHL and reference lists in published articles were reviewed for the period 2000-October 2020. The CASP checklist for qualitative research was used to assess evidence quality, and the ENTREQ framework was used as a guide for study reporting. RESULTS Twenty-six articles from 10 Western countries, including 360 informal migrant caregivers from more than 30 countries of origin, were eligible. Within four areas of construct-perceptions of dementia and initial help-seeking; barriers to accessing and using formal dementia care; caregiver burden and coping and resilience-12 descriptive themes were identified. Several concepts cut across the themes, such as language difficulties; the role of the family in relation to care and support; cultural perceptions of dementia and care; stigma, pride and shame; the importance of religion and the importance of trust. CONCLUSIONS The review revealed commonalities among migrant family caregivers that resulted in reduced understanding of dementia and the importance of diagnosis and treatment. RELEVANCE TO CLINICAL PRACTICE To prevent a negative trajectory in caregiving, with perceived demands causing high levels of stress and strain, several barriers to migrants accessing and using formal care need to be assessed and addressed.
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Affiliation(s)
- Jenny Stenberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Katarina Hjelm
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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14
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Dementia care-sharing and migration: An intersectional exploration of family carers' experiences. J Aging Stud 2022; 60:100996. [DOI: 10.1016/j.jaging.2021.100996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/20/2022]
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15
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Nguyen TA, Tran K, Esterman A, Brijnath B, Xiao LD, Schofield P, Bhar S, Wickramasinghe N, Sinclair R, Dang TH, Cullum S, Turana Y, Hinton L, Seeher K, Andrade AQ, Crotty M, Kurrle S, Freel S, Pham T, Nguyen TB, Brodaty H. Empowering Dementia Carers With an iSupport Virtual Assistant (e-DiVA) in Asia-Pacific Regional Countries: Protocol for a Pilot Multisite Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e33572. [PMID: 34783660 PMCID: PMC8663455 DOI: 10.2196/33572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 12/04/2022] Open
Abstract
Background Dementia is a global public health priority with an estimated prevalence of 150 million by 2050, nearly two-thirds of whom will live in the Asia-Pacific region. Dementia creates significant care needs for people with the disease, their families, and carers. iSupport is a self-help platform developed by the World Health Organization (WHO) to provide education, skills training, and support to dementia carers. It has been adapted in some contexts (Australia, India, the Netherlands, and Portugal). Carers using the existing adapted versions have identified the need to have a more user-friendly version that enables them to identify solutions for immediate problems quickly in real time. The iSupport virtual assistant (iSupport VA) is being developed to address this gap and will be evaluated in a randomized controlled trial (RCT). Objective This paper reports the protocol of a pilot RCT evaluating the iSupport VA. Methods Seven versions of iSupport VA will be evaluated in Australia, Indonesia, New Zealand, and Vietnam in a pilot RCT. Feasibility, acceptability, intention to use, and preliminary impact on carer-perceived stress of the iSupport VA intervention will be assessed. Results This study was funded by the e-ASIA Joint Research Program in November 2020. From January to July 2023, we will enroll 140 dementia carers (20 carers per iSupport VA version) for the pilot RCT. The study has been approved by the Human Research Committee, University of South Australia, Australia (203455). Conclusions This protocol outlines how a technologically enhanced version of the WHO iSupport program—the iSupport VA—will be evaluated. The findings from this intervention study will provide evidence on the feasibility and acceptability of the iSupport VA intervention, which will be the basis for conducting a full RCT to assess the effectiveness of the iSupport VA. The study will be an important reference for countries planning to adapt and enhance the WHO iSupport program using digital health solutions. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621001452886; https://tinyurl.com/afum5tjz International Registered Report Identifier (IRRID) PRR1-10.2196/33572
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Affiliation(s)
- Tuan Anh Nguyen
- Social Gerontology Division, National Ageing Research Institute, Melbourne, Australia.,UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia.,Health Strategy and Policy Institute, Ministry of Health, Hanoi, Vietnam
| | - Kham Tran
- Social Gerontology Division, National Ageing Research Institute, Melbourne, Australia.,UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Adrian Esterman
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Bianca Brijnath
- Social Gerontology Division, National Ageing Research Institute, Melbourne, Australia
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Penelope Schofield
- Department of Psychology, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Sunil Bhar
- Department of Psychology, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Nilmini Wickramasinghe
- Department of Psychology, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Ronald Sinclair
- Faculty of Sciences, University of Adelaide, Adelaide, Australia
| | - Thu Ha Dang
- Department of Psychology, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Sarah Cullum
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Yuda Turana
- School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Ladson Hinton
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Katrin Seeher
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Andre Q Andrade
- Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, Australia
| | - Maria Crotty
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Susan Kurrle
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Stefanie Freel
- Department of Germanic Languages and Literature, University of Toronto, Toronto, ON, Canada
| | - Thang Pham
- Department of Neurology and Alzheimer Disease, Vietnam National Geriatric Hospital, Hanoi, Vietnam
| | - Thanh Binh Nguyen
- Department of Neurology and Alzheimer Disease, Vietnam National Geriatric Hospital, Hanoi, Vietnam
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
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16
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Harper AE, Terhorst L, Moscirella M, Turner RL, Piersol CV, Leland NE. The experiences, priorities, and perceptions of informal caregivers of people with dementia in nursing homes: A scoping review. DEMENTIA 2021; 20:2746-2765. [PMID: 33899537 DOI: 10.1177/14713012211012606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers' dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual's care. However, little is known of the informal caregivers' perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. METHODS In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com, CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. RESULTS We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. CONCLUSION Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers' perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers' satisfaction with nursing home care for residents with dementia.
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Affiliation(s)
- Alexandra E Harper
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Marybeth Moscirella
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Rose L Turner
- Health Sciences Library System, 499478University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine V Piersol
- Department of Occupational Therapy, Jefferson College of Rehabilitation Sciences, 6559Thomas Jefferson University, Philadelphia, PA, USA
| | - Natalie E Leland
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, 6614University of Pittsburgh, Pittsburgh, PA, USA
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Dementia knowledge and associated factors among older Chinese adults: a cross-national comparison between Melbourne and Beijing. Int Psychogeriatr 2021; 33:1057-1067. [PMID: 33757605 DOI: 10.1017/s1041610221000053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This study compared dementia knowledge between older Chinese adults in Melbourne, Australia, and Beijing, China, and explored factors associated with dementia knowledge between these two groups. Ultimately, this study aimed to inform the development of tailored dementia education programs for older Chinese adults. DESIGN A cross-sectional design was employed in this study. SETTING Participants were recruited from 5 Chinese community senior groups in Melbourne and 10 community health centers in Beijing from March to May 2019. PARTICIPANTS A total of 379 older Chinese adults aged 50 and over completed the questionnaire, including 153 from Melbourne and 226 from Beijing. MEASUREMENTS Dementia knowledge was assessed using the Alzheimer's Disease Knowledge Scale (ADKS). Demographic characteristics, dementia-related experience, and the mental health status of participants were collected. Stepwise linear regression was used to analyze the factors associated with dementia knowledge. RESULTS In general, older Chinese adults in Melbourne and Beijing reported similar levels of dementia knowledge for both the overall ADKS scale (mean ± SD: 17.2 ± 2.9 in Melbourne vs. 17.5 ± 2.9 in Beijing, p > 0.05) and the seven subdomains. Of the subdomains, the highest correct response rates were observed in the life impact of the dementia subdomain, and the lowest rates were observed in the caregiving subdomain. Stepwise linear regression analysis revealed that younger age and self-reported dementia worry were significantly associated with higher levels of dementia knowledge in the Melbourne group, whereas a positive family history of dementia was significantly associated with higher levels of dementia knowledge in the Beijing group. CONCLUSIONS Older Chinese adults living in Melbourne and Beijing share similar levels of dementia knowledge, but factors associated with their knowledge are different. These findings will inform the development of culturally and socially appropriate dementia education programs for older Chinese populations in different countries.
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18
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Byles J, Cavenagh D, Bryant J, Mazza D, Browning C, O'Loughlin S, Sanson-Fisher R. Use of medical services by older Australian women with dementia: a longitudinal cohort study. Aust N Z J Public Health 2021; 45:497-503. [PMID: 34309976 DOI: 10.1111/1753-6405.13146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/01/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the use of Medicare-subsidised health services by women with and without dementia. METHODS Data from women of the 1921-26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. RESULTS A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non-emergency GP attendances (short [<30 minutes] IRR=1.11 [1.07, 1.13]; long [>30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. CONCLUSIONS The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs).
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Affiliation(s)
- Julie Byles
- Centre for Women's Health Research, The University of Newcastle, New South Wales
| | - Dominic Cavenagh
- Centre for Women's Health Research, The University of Newcastle, New South Wales
| | - Jamie Bryant
- Health Behaviour Research Group, The University of Newcastle, New South Wales
| | - Danielle Mazza
- Department of General Practice, Monash University, Victoria
| | | | | | - Rob Sanson-Fisher
- Health Behaviour Research Group, The University of Newcastle, New South Wales
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Wilson T, Temple J, Brijnath B, Utomo A, McDonald P. The ageing of Asian migrant populations in Australia: projections and implications for aged care services. ASIAN POPULATION STUDIES 2021. [DOI: 10.1080/17441730.2021.1953689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tom Wilson
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Jeromey Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | | | - Ariane Utomo
- School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Australia
| | - Peter McDonald
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
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Temple J, Wilson T, Brijnath B, Utomo A, McDonald P. English Language Proficiency Among Older Migrants in Australia, 2016-2046. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2021; 23:403-429. [PMID: 34131412 PMCID: PMC8193169 DOI: 10.1007/s12134-021-00836-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 01/10/2023]
Abstract
Australia’s population is growing, ageing and exhibiting increasing heterogeneity with respect to birthplace and ethnic composition. Yet, little is understood about the levels of English language proficiency among the next generation of older migrants in Australia. Utilising a modified cohort-component model incorporating detailed language proficiency transition probabilities, we project birthplace populations by levels of English language proficiency to mid-century. Our results show that although Asian-born migrants tend to have lower levels of English proficiency, the majority of older migrants with poor proficiency are currently from a predominantly European background. In the future, we project a strong shift in the population of poor English speakers toward an Asian-born dominance as some European-born migrant groups dwindle in size and cohort flow increases population growth among older Asian migrants. Specifically, most of the population growth among older migrants with poor English proficiency occurs among Chinese and Mainland Southeast Asian migrants. However, we demonstrate that population growth among the total migrant population with poor proficiency is considerably lower than populations with good proficiency or from English-speaking households. Over the projection horizon, the total older migrant population with poor English proficiency increases by under 80,000 compared with an increase of 726,000 with good levels of proficiency and 518,000 in English-speaking households. However, we caution against conflating improved English language proficiency with a policy shift away from ethno-specific aged care services as culture, which is more than language, strongly influences perceptions of quality of aged care.
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Affiliation(s)
- Jeromey Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Tom Wilson
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Melbourne, Australia
| | - Ariane Utomo
- School of Geography, Faculty of Science, University of Melbourne, Melbourne, Australia
| | - Peter McDonald
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
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21
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Wilson T, Temple J, Brijnath B, McDonald P, Utomo A. Projections of Older European Migrant Populations in Australia, 2016-56. JOURNAL OF POPULATION AGEING 2021; 16:1-25. [PMID: 33488841 PMCID: PMC7814173 DOI: 10.1007/s12062-020-09319-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022]
Abstract
Many of the European migrant populations which settled in Australia in the three decades after World War Two are now much older, and their aged care and health care needs are changing. While there is a considerable literature on individual aspects of ageing in many migrant groups (particularly as it pertains to culturally appropriate aged care), little research attention has been given to population aspects of ageing and its implications. The aim of this paper is to address this lacuna by presenting projections of Australia's Europe-born older migrant population from 2016 to 2056. The population projections were created by a cohort-component model modified to accommodate multiple birthplace populations. Findings show the older Europe-born population is projected to experience a slight increase over the next few years, reach a peak of just under one million in the early 2030s, and then undergo a gradual decline thereafter. The Europe-born share of Australia's 65+ population will fall, from 25.5% in 2016 to 10% by 2056. Populations born in Western and Southern Europe are likely to decline throughout the projection horizon while, the Northern Europe-born and Ireland-born older populations are projected to grow continually. The populations born in the UK and South Eastern Europe initially grow before decline sets in. To a large extent the future population size of these older migrant groups will be the result of cohort flow. We discuss the implications of the coming demographic changes for government policy and culturally appropriate service provision.
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Affiliation(s)
- Tom Wilson
- Demography and Ageing Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Melbourne, VIC 3010 Australia
| | - Jeromey Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Melbourne, VIC 3010 Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Melbourne, Australia
| | - Peter McDonald
- Demography and Ageing Unit, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Melbourne, VIC 3010 Australia
| | - Ariane Utomo
- School of Geography, Faculty of Science, University of Melbourne, Melbourne, Australia
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22
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Berdai Chaouni S, Claeys A, van den Broeke J, De Donder L. Doing research on the intersection of ethnicity and old age: Key insights from decolonial frameworks. J Aging Stud 2020; 56:100909. [PMID: 33712097 DOI: 10.1016/j.jaging.2020.100909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 11/27/2022]
Abstract
Population aging and international migration are two of the most critical social trends shaping the world today. As a result, scholars across the globe have begun to investigate how to better incorporate ethnicity into gerontological research. The integration of insights from life-course theory, post-colonial, and feminist theories have resulted in valuable attempts to tackle issues related to ethnicity and old age. Inspired by these bodies of research, this paper explores how decolonial perspectives can strengthen social gerontological research at the intersection of ethnicity and old age. This theoretical paper advances four key insights drawn from decolonial perspectives that expose some current blind spots in gerontological research at the intersection of aging and ethnicity. Through a process of awareness and resistance decolonial perspectives reveal that: 1) colonial thinking is deeply embedded in research; 2) critical reflection about who is considered the "knower" in research is warranted; 3) alternative ways to generate, analyze, and publish knowledge exist; and 4) the places and systems of knowledge production are not neutral. To address these issues empirically, decolonial frameworks call us to actions that include decolonizing the conceptual underpinnings of the research enterprise, scholars themselves, research-in-action (through "epistemic disobedience"), and current knowledge systems and structures that reflect and reinforce colonialism. Potential applications of these insights are explored, but acknowledged as an essential first step on a nascent path. This paper concludes by arguing that decolonial perspectives offer a more genuine gaze by demanding nuanced reflections of contemporary realities aging persons embodying the intersection of aging and ethnicity, like racialized older migrants and ethnic minorities, while simultaneously revealing how historically-rooted power hierarchies that are often invisible constrain their aging experiences.
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Affiliation(s)
- Saloua Berdai Chaouni
- Vrije Universiteit Brussel, Department of Adult Educational Sciences, Pleinlaan 5, 1090 Brussels, Belgium; Erasmus University of Applied Sciences Brussels, Department of Media, Management and Society, Zespenningenstraat 70, 1000 Brussels, Belgium.
| | - Ann Claeys
- Vrije Universiteit Brussel, Department of Adult Educational Sciences, Pleinlaan 5, 1090 Brussels, Belgium; Erasmus University of Applied Sciences Brussels, Department of Health Care and Landscape Architecture, Laarbeeklaan 121, 1090 Brussels, Belgium.
| | | | - Liesbeth De Donder
- Vrije Universiteit Brussel, Department of Adult Educational Sciences, Pleinlaan 5, 1090 Brussels, Belgium.
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Brijnath B, Gilbert AS, Kent M, Ellis K, Browning C, Goeman D, Adams J, Antoniades J. Beyond crisis: Enacted sense-making among ethnic minority carers of people with dementia in Australia. DEMENTIA 2020; 20:1910-1924. [DOI: 10.1177/1471301220975641] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The ‘family crisis’ narrative is frequently used in dementia studies to explain ethnic minority families’ pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers’ agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families’ pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the ‘family crisis’ narrative as it illuminates the agency of carers’ in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy campaigns as well as initiatives that address structural inequities.
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Affiliation(s)
- Bianca Brijnath
- National Ageing Research Institute, Australia; School of Occupational Therapy and Social Work, Curtin University, Australia; Department of General Practice, Monash University, Australia
| | - Andrew Simon Gilbert
- National Ageing Research Institute, Australia; Department of Social Inquiry, La Trobe University, Australia
| | - Mike Kent
- Centre for Culture and Technology, Curtin University, Australia
| | - Katie Ellis
- Centre for Culture and Technology, Curtin University, Australia
| | - Colette Browning
- School of Nursing and Healthcare Professions, Federation University, Australia; Centre for Research on Ageing, Health and Wellbeing, Australian National University, Australia
| | - Dianne Goeman
- School of Medicine and Public Health, University of Newcastle, Australia; Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
| | - Jon Adams
- Discipline of Public Health, Faculty of Health, University of Technology Sydney, Australia
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Wilson T, McDonald P, Temple J, Brijnath B, Utomo A. Past and projected growth of Australia's older migrant populations. GENUS 2020; 76:20. [PMID: 32834077 PMCID: PMC7403568 DOI: 10.1186/s41118-020-00091-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/20/2020] [Indexed: 01/05/2023] Open
Abstract
In recent years, Australia’s older population (aged 65 and over) has been growing rapidly, accompanied by a shift in its country of birth composition. Although a great deal of research has been undertaken on past and current aspects of Australia’s migrant groups, little attention has been paid to future demographic trends in older populations. The aim of this paper is to examine recent and possible future demographic trends of Australia’s migrant populations at the older ages. We present population estimates by country and broad global region of birth from 1996 to 2016, and then new birthplace-specific population projections for the 2016 to 2056 period. Our findings show that substantial growth of the 65+ population will occur in the coming decades, and that the overseas-born will shift from a Europe-born dominance to an Asia-born dominance. Cohort flow (the effect of varying sizes of cohorts moving into the 65+ age group over time) will be the main driver of growth for most older birthplace populations. The shifting demography of Australia’s older population signals many policy, planning, service delivery and funding challenges for government and private sector providers. We discuss those related to aged care, health care, language services, the aged care workforce, regulatory frameworks and future research needs in demography and gerontology.
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Affiliation(s)
- Tom Wilson
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Peter McDonald
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Jeromey Temple
- Demography and Ageing Unit, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Melbourne, Victoria 3010 Australia
| | - Bianca Brijnath
- National Ageing Research Institute (NARI), Parkville, Australia
| | - Ariane Utomo
- School of Geography, University of Melbourne, Melbourne, Australia
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Ahmad M, van den Broeke J, Saharso S, Tonkens E. Persons With a Migration Background Caring for a Family Member With Dementia: Challenges to Shared Care. THE GERONTOLOGIST 2020; 60:340-349. [PMID: 31786594 PMCID: PMC7039377 DOI: 10.1093/geront/gnz161] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives By shedding light on the reasons why persons with a migration background (PwM) may take up the role of family caregiver of a person with dementia, and how this relates to gender norms, we aim to elucidate cultural and social dynamics that impede care sharing. Research Design and Methods A qualitative study of 12 PwM who provide care, or have recently provided care, for a family member with dementia was conducted through semi-structured interviews. Identified themes and patterns were analyzed with the help of Hochschild’s interpretive framework of framing and feeling rules. Findings Our findings illuminate how motivations to provide care are framed through two moral framing rules, reciprocal love and filial responsibility, and how these framing rules are accompanied by the feeling rule of moral superiority over non-caregiving family members. We show how shared dementia care is impeded though these moral framing and feeling rules, and how gender norms impact on an unequal distribution of care-tasks. Implications Healthcare practitioners should identify the moral dialectics of caregiving. This means that, on the one hand, they should be aware that moral framing rules may pressure women into exclusive caregiving, and that this can lead to health problems in the long term. On the other, healthcare practitioners should recognize that providing care can create a deep sense of pride and moral superiority. Therefore, showing acknowledgement of the caregiver contribution is a crucial step in creating trust between the caregiver and healthcare practitioner. Furthermore, asking for support should be normalized. Governmental advertisements on care–support can achieve this.
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Affiliation(s)
- Menal Ahmad
- Department of Citizenship and Humanization of the Public Sector, University of Humanistic Studies, Utrecht, The Netherlands
| | | | - Sawitri Saharso
- Department of Citizenship and Humanization of the Public Sector, University of Humanistic Studies, Utrecht, The Netherlands.,Department of Sociology, VU Amsterdam, The Netherlands
| | - Evelien Tonkens
- Department of Citizenship and Humanization of the Public Sector, University of Humanistic Studies, Utrecht, The Netherlands
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Owokuhaisa J, Rukundo GZ, Wakida E, Obua C, Buss SS. Community perceptions about dementia in southwestern Uganda. BMC Geriatr 2020; 20:135. [PMID: 32293301 PMCID: PMC7158106 DOI: 10.1186/s12877-020-01543-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 03/31/2020] [Indexed: 11/24/2022] Open
Abstract
Background With the increasing number of people surviving into older age in Africa, dementia is becoming a public health concern. Understanding the social dynamics of dementia in resource-limited settings is critical for developing effective interventions. We explored community perceptions about people with dementia in southwestern Uganda. Methods Fifty-nine individuals (aged 19–85 years, 56% female) participated in seven focus group discussions. In addition, 22 individual in-depth interviews were conducted among individuals (aged 22–84 years, 36% female). Both interviews and focus group discussions were audio recorded, transcribed verbatim, and evaluated using a quantitative content analysis approach. Results Five themes were generated during content analysis: i) Labeling of the illness, ii) Presentation of the person with dementia, iii) Causation, iv) Impact of the disease on people with dementia and their caregivers and v) Views on how to address unmet needs in dementia care. Dementia was commonly referred to as “okuhuga”or “okwebwayebwa” (also, oruhuzyo/ empugye / akahuriko) which translates as “mental disorientation”. The participants reported that most people with dementia presented with forgetfulness, defecating and urinating on themselves, wandering away from home, going out naked, and picking up garbage. Some participants perceived memory problems as a normal part of the aging process, while others attributed the cause of dementia to syphilis, cancer, allergy, old age, satanic powers, witchcraft, poor nutrition, or life stress. Participants reported multiple sources of stress for caregivers of people with dementia, including financial, social, and emotional burdens. Finally, participants suggested that community and governmental organizations should be involved in meeting the needs of people with dementia and their caregivers. Conclusions Community members in southwestern Uganda largely identified dementia as a problem that comes with older age, and can identify key features of dementia presentation. Participants identified significant stressors affecting people with dementia and their caregivers, and reported that families and caregivers would benefit from education on the management of symptoms of dementia, and assistance in overcoming associated financial, social, and emotional burdens related to caretaking.
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Affiliation(s)
- Judith Owokuhaisa
- Department of Internal Medicine, Faculty of Medicine, Mbarara University of Science and Technology, P. O. Box 1410, Mbarara, Uganda.
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edith Wakida
- Office of Research Administration, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- Department of Pharmacology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Stephanie S Buss
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Nielsen TR, Waldemar G, Nielsen DS. Rotational care practices in minority ethnic families managing dementia: A qualitative study. DEMENTIA 2020; 20:884-898. [PMID: 32208745 PMCID: PMC8044611 DOI: 10.1177/1471301220914751] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although minority ethnic families have a lower uptake of dementia care services, little research has explored how minority ethnic carers cope with and manage dementia care in their everyday lives. The aim of this study was to investigate organization of family dementia care in Turkish, Pakistani, and Arabic speaking minority ethnic families from the perspective of family carers, primary care dementia coordinators, and multicultural link workers in Denmark. METHODS Semi-structured qualitative individual and group interviews with minority ethnic family carers, primary care dementia coordinators, and multicultural link workers. Hermeneutic phenomenology was used as theoretical framework and results were analyzed using thematic analysis. RESULTS A total of 21 individual and four group interviews were conducted, including a total of 30 participants. A key finding was that the care responsibility was usually shared between several family members, who took turns to provide 24-hour care for the person with dementia. Rotational 24-hour care, either by having the person with dementia live with different family members or by having different family members take turns to move in with the person with dementia, emerged as a common alternative to formal care. Another important finding was that despite decreasing the burden of care of individual family carers, rotational care could be confusing and stressful to the person with dementia and could have a negative impact on the quality of life of all involved. CONCLUSION The way minority ethnic families organize dementia care have implications for understanding and communicating about support needs. Higher reliance on shared family care should not be taken to indicate that minority ethnic communities are not in need of support from formal services.
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Affiliation(s)
| | - Gunhild Waldemar
- Danish Dementia Research Centre, University of Copenhagen, Denmark
| | - Dorthe S Nielsen
- Migrant Health Clinic, Odense University Hospital, Denmark; Centre for Global Health, University of Southern Denmark, Denmark; Health Sciences Research Center, University College Lillebælt, Denmark
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Tang CY, Turczyniak M, Sayner A, Haines K, Butzkueven S, O'Connell HE. Adopting a collaborative approach in developing a prehabilitation program for patients with prostate cancer utilising experience-based co-design methodology. Support Care Cancer 2020; 28:5195-5202. [PMID: 32072326 DOI: 10.1007/s00520-020-05341-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 02/02/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Engaging patients in a prehabilitation program prior to commencement of cancer treatment is a known challenge. Utilising experience-based co-design (EBCD) methodology, this study aimed to explore the prostate cancer treatment journey from the perspectives of the patient and health professionals and collaboratively develop a prehabilitation program for patients with prostate cancer. METHODS EBCD was utilised for this study. Patients, support persons and health professionals were selectively identified and recruited from two metropolitan health services in Melbourne. Selection criteria included (i) recent clinical/patient experience with prostate cancer treatment and (ii) willingness to share positive experiences and challenges in two 2-hour face-to-face workshops. Findings from these workshops were thematically analysed to identify key themes addressing aims of the study. RESULTS Twenty participants including eight patients, one support person and 11 health professionals were recruited. Four key touchpoints were identified. All participants acknowledged positive interactions between patients and health professionals. Patients often described the journey as lonely, stressful and frustrating especially prior to commencement of treatment. A lack of a consistent approach in identifying and preparing patients with prostate cancer for treatment was identified. A structured prehabilitation program was proposed as a solution. Practical ideas to be implemented including timing of commencement, educational content and strategies to boost engagement were formulated. CONCLUSIONS The findings from the study provided practical guidance for future clinicians when implementing a prehabilitation program. Future study is required to evaluate the effectiveness of such a prehabilitation program in improving patient engagement and preparedness for prostate cancer treatment.
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Affiliation(s)
- Clarice Y Tang
- Department of Physiotherapy, Western Health, Gordon Street, Footscray, VIC, 3011, Australia.
- Department of Physiotherapy, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- School of Allied Health, La Trobe University, Melbourne, VIC, 3086, Australia.
| | - Monica Turczyniak
- Department of Physiotherapy, Western Health, Gordon Street, Footscray, VIC, 3011, Australia
| | - Alesha Sayner
- Department of Physiotherapy, Western Health, Gordon Street, Footscray, VIC, 3011, Australia
| | - Kimberley Haines
- Department of Physiotherapy, Western Health, Gordon Street, Footscray, VIC, 3011, Australia
| | - Sally Butzkueven
- Department of Cancer Services, Western Health, Furlong Road, St Albans, VIC, 3011, Australia
| | - Helen E O'Connell
- Department of Surgery, University of Melbourne, Melbourne, Australia
- Department of Urology, Western Health, St Albans, Australia
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Berdai Chaouni S, Smetcoren AS, De Donder L. Caring for migrant older Moroccans with dementia in Belgium as a complex and dynamic transnational network of informal and professional care: A qualitative study. Int J Nurs Stud 2020; 101:103413. [PMID: 31678839 DOI: 10.1016/j.ijnurstu.2019.103413] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Due to its labour migration history, Belgium is confronted with an increasingly older population of people of Moroccan background who have been diagnosed with dementia. These migrants came to the country during the labour migration wave of the nineteen-sixties and seventies to work in mines and other industries and they are now ageing. Yet little is known about how dementia care is provided to this older population. OBJECTIVES This study explores how dementia care is provided to these Moroccan older people with dementia, and what challenges do caregivers face in providing care. METHODS A qualitative study including 31 informal caregivers of older Moroccan migrants with dementia and professional caregivers in the field of dementia care in several Belgian cities was conducted. After an initial focus group including 6 informal and professional caregivers, individual in-depth interviews were held with 12 informal caregivers of Moroccan decent and 13 professional caregivers. In order to be included in the study, informal caregivers had to have a recent experience in caring for an older family member with dementia. The professional caregivers had to be active in the field of dementia care (General Practitioners, nurses, psychologists,…) and have experience with older migrants with dementia. RESULTS Analyses of the collected data reveal that current dementia care is a challenging, complex and dynamic search process. This process is shaped by (1) multiple factors reflecting the changing care needs of the care recipient during the course of the dementia, (2) the individual (transnational) recourses of the informal caregivers and the (3) current (lack of) accessibility of professional dementia care (driven by the absence of an accessible migration-, culture- and religion-sensitive professional care). The limited professional service-use is predominantly compensated through the search for transnational external helpers. The limited migration, cultural and religious sensitivity of current dementia care is often overlooked by professional caregivers. CONCLUSION The study provides a better understanding of the complex reality of dementia care for older migrants in which these different aspects intersect. This understanding enable health professionals and policy makers to develop a better suited care for older migrants with dementia.
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Affiliation(s)
- Saloua Berdai Chaouni
- Department of Educational Sciences, Vrije Universiteit Brussels, Pleinlaan 2, 1050 Brussels, Belgium.
| | - An-Sofie Smetcoren
- Department of Educational Sciences, Vrije Universiteit Brussels, Pleinlaan 2, 1050 Brussels, Belgium.
| | - Liesbeth De Donder
- Department of Educational Sciences, Vrije Universiteit Brussels, Pleinlaan 2, 1050 Brussels, Belgium.
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Kataoka-Yahiro MR, Davis J, Ka’opua LS, Sy A. Sociodemographic Characteristics and Preferences for Family (Informal) and Formal Caregiver Help With ADLs. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2019. [DOI: 10.1177/1084822318801811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this article was to compare sociodemographic characteristics and various care preferences for family and formal caregivers help with activities of daily living (ADLs). The sample was 56,337 noninstutionalized U.S. civilian adults, 40 to 65 years of age. This is a cross-sectional study using secondary data from the National Health Interview Survey (NHIS)—2011 to 2014. Respondents’ sociodemographic characteristics and various care preferences for caregiver help with ADLs were analyzed. Subsequent analysis examined associations using adjusted multivariable logistic regression models. Preference for family caregivers help with ADLs was independently and significantly associated with race/ethnicity, age, gender, education, acculturation, and income. Future studies need to examine sociodemographic characteristics and caregiver preferences to tailor health care services for aging adults in the United States.
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Affiliation(s)
| | - James Davis
- University of Hawaii at Manoa, Honolulu, HI, USA
- John A. Burns School of Medicine, Honolulu, HI, USA
| | - Lana Sue Ka’opua
- University of Hawaii at Manoa, Honolulu, HI, USA
- Ha Kupuna National Resource Center for Native Hawaiian Elders, Honolulu, HI, USA
| | - Angela Sy
- University of Hawaii at Manoa, Honolulu, HI, USA
- John A. Burns School of Medicine, Honolulu, HI, USA
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Tillmann J, Just J, Schnakenberg R, Weckbecker K, Weltermann B, Münster E. Challenges in diagnosing dementia in patients with a migrant background - a cross-sectional study among German general practitioners. BMC FAMILY PRACTICE 2019; 20:34. [PMID: 30803438 PMCID: PMC6388491 DOI: 10.1186/s12875-019-0920-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 02/14/2019] [Indexed: 11/10/2022]
Abstract
Background Diagnosing dementia, a syndrome affecting 35.6 million people worldwide, can be challenging, especially in patients with a migrant background. Language barriers and language-based diagnostic tools, cultural differences in the perception of the syndrome as well as restricted access to healthcare can influence medical care. For the first time in Germany, this study investigates whether German general practitioners (GPs) feel prepared to meet the diagnostic needs of these patient groups and whether there are challenges and support needs. Methods A cross-sectional study among a random sample of 982 general practitioners in Germany was conducted from October 2017 to January 2018 (response rate: 34.5%). A self-developed, written, standardised questionnaire was used. Descriptive statistics as well as multiple logistic regression analyses were performed using data of 326 GPs. Results Ninety-six percent of GPs reported having experienced barriers at least once. Uncertainties in diagnosing dementia in patients with a migrant background were indicated by 70.9%. There was no significant association between uncertainties in diagnosing dementia and GPs’ sociodemographic characteristics. The most frequently reported barriers were language barriers that affected or prevented diagnostics (89.3%) and information deficits in patients with a migrant background (59.2%). Shameful interaction or lack of acceptance of the syndrome was also common (55.5%). A demand for more information about the topic was expressed by 70.6% of GPs. Conclusions Public health measures supporting GPs in their interaction with patients with a migrant background as well as information and services for dementia patients are needed. Efforts to facilitate access to interpreting services and to focus on people with a migrant background in healthcare are necessary. Trial registration German Clinical Trials Register: DRKS00012503, date of registration: 05/09/2017 (German Institute of Medical Documentation and Information. German Clinical Trials Register (DRKS) 2017). Clinical register of the study coordination office of the University hospital of Bonn: ID530, date of registration: 05/09/2017 (Universitätsklinikum Bonn. Studienzentrum. UKB-Studienregister 2017).
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Affiliation(s)
- Judith Tillmann
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Bonn, Germany.
| | - Johannes Just
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Bonn, Germany
| | - Rieke Schnakenberg
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Bonn, Germany.,Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Klaus Weckbecker
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Bonn, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Bonn, Germany
| | - Eva Münster
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Bonn, Germany
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Schaffler JL, Tremblay S, Laizner AM, Lambert S. Developing education materials for caregivers of culturally and linguistically diverse patients: Insights from a qualitative analysis of caregivers' needs, access and understanding of information. Health Expect 2019; 22:444-456. [PMID: 30767349 PMCID: PMC6543161 DOI: 10.1111/hex.12867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 11/28/2018] [Accepted: 12/13/2018] [Indexed: 12/05/2022] Open
Abstract
Objectives To explore the information needs of caregivers of culturally and linguistically diverse (CALD) patients, and how they access and understand health information related to the management of their care person's chronic illness(es). Background Caregivers of CALD patients experience greater unmet needs compared to the general caregiver population. They experience many challenges in identifying resources and accessing formal supports to aid in self‐management behaviours. Methods Eleven caregivers were recruited from outpatient clinics in Québec, Canada. Consenting caregivers participated in one face‐to‐face or phone interview. A qualitative descriptive design and inductive content analysis were used to identify themes. Results Caregivers described a “village” approach to caregiving in which more than one individual was involved in patient care. The specific roles ascribed to caregivers defined their information needs. Caregivers described two categories of information needs: perceived and unperceived. Perceived information needs were explicit, and centred on the medical management of illnesses. Unperceived needs were unrecognized knowledge gaps that emerged during interviews and focused on self‐care. Conclusion Although caregivers' perceived needs are often met, their unperceived needs remain unmet. Health‐care providers should perform need assessments to identify caregivers' unperceived needs, with the aims of providing culturally competent care and ongoing support.
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Affiliation(s)
- Jamie L Schaffler
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Sarah Tremblay
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Andréa M Laizner
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada.,McGill University Health Centre, Montréal, Québec, Canada.,Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Sylvie Lambert
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada.,St. Mary's Research Centre, Montréal, Québec, Canada
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Abstract
The importance of better care integration is emphasized in many national dementia plans. The inherent complexity of organizing care for people with dementia provides both the justification for improving care integration and the challenges to achieving it. The prevention, detection, and early diagnosis of cognitive disorders mainly resides in primary care, but how this is best integrated within the range of disorders that primary care clinicians are expected to screen is unclear. Models of integrated community dementia assessment and management have varying degrees of involvement of primary and specialist care, but share an emphasis on improving care coordination, interdisciplinary teamwork, and personalized care. Integrated care strategies in acute care are still in early development, but have been a focus of investigation in the past decade. Integrated care outreach strategies to reduce transfers from long-term residential care to acute care have been consistently effective. Integrated long-term residential care includes considerations of end-of-life care. Future directions should include strategies for training and education, early detection in anticipation of disease modifying treatments, integration of technological developments into dementia care, integration of dementia care into general health and social care, and the encouragement of a dementia-friendly society.
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Affiliation(s)
- Brian Draper
- a School of Psychiatry , University of NSW , Sydney , NSW , Australia
| | - Lee-Fay Low
- b Faculty of Health Sciences , University of Sydney , Sydney , NSW , Australia
| | - Henry Brodaty
- c Centre for Healthy Brain Ageing , University of NSW Sydney , Sydney , NSW , Australia
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Language and Culture in the Caregiving of People with Dementia in Care Homes - What Are the Implications for Well-Being? A Scoping Review with a Welsh Perspective. J Cross Cult Gerontol 2018; 34:67-114. [DOI: 10.1007/s10823-018-9361-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Barriers in providing primary care for immigrant patients with dementia: GPs' perspectives. BJGP Open 2018; 2:bjgpopen18X101610. [PMID: 30723796 PMCID: PMC6348325 DOI: 10.3399/bjgpopen18x101610] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/04/2018] [Indexed: 12/02/2022] Open
Abstract
Background Dementia rates are growing rapidly in all regions of the world. In the Netherlands, the incidence of dementia among older immigrants will increase twice as fast compared with the native older population. It, therefore, needs special attention. Aim To describe the barriers for providing primary care to immigrant patients (Turkish, Moroccan and Surinamese) with dementia from the perspectives of GPs. Design & setting A mixed-method study, consisting of an online survey and focus groups. Method An online survey was performed among 76 GPs working in the four biggest cities of the Netherlands. The barriers to providing primary care for immigrants with dementia were identified. Subsequently, three focus groups were carried out among 17 primary care physicians to discuss this topic further, and identify possible solutions and recommendations to improve dementia care. Results GPs experience many obstacles in the care for the immigrant patient with dementia, namely in the diagnostic process, early detection, and assessment of care needs. Strong collaboration between primary care, community care organisations, specialised memory clinics, and municipalities is needed to optimise healthcare information provision, the availability of culturally sensitive facilities, and the enhancement of healthcare professionals' training and education. Conclusion Important barriers were identified and recommendations were formulated for future healthcare policy. To be prepared and guarantee optimal care for the rising number of immigrant patients with dementia, recommendations should be implemented and effectiveness should be evaluated as soon as possible.
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Brooke J, Cronin C, Stiell M, Ojo O. The intersection of culture in the provision of dementia care: A systematic review. J Clin Nurs 2017; 27:3241-3253. [PMID: 28793378 DOI: 10.1111/jocn.13999] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To understand the intersection of healthcare professionals' and care workers' culture and their provision of person-centred care for people with dementia. BACKGROUND Due to the nature of global immigration and recruitment strategies, health care is provided by a culturally diverse workforce. Consequently, there is a need to understand healthcare professionals' and care workers' cultural values of illness, disease and dementia. Cultural values and beliefs regarding dementia and care of the older person differ, and currently, there is a lack of clarity regarding the intersection of culture in the provision of person-centred dementia care. METHOD A search of the following databases was completed: Medline, CINAHL, Psychology and Behavioural Sciences, PsycINFO and PubMed for papers published from 1st January 2006 to 31st July 2016. RESULTS A total of seven qualitative studies met the inclusion and exclusion criteria, all explored the impact of healthcare professionals' and care workers' culture in relation to their provision of person-centred dementia care. A meta-synthesis of the data from these studies identified four themes: cultural perceptions of dementia, illness and older people; impact of cultural perceptions on service use; acculturation of the workforce; and cross-cultural communication. CONCLUSION Limited evidence was found on the impact of healthcare professionals' and care workers' culture on their provision of person-centred dementia care. The intersection of culture and dementia included the understanding of dementia, care and family roles. Acculturation of migrant healthcare workers to the culture of the host country, workplace, and support with the communication was identified as necessary for the provision of person-centred dementia care. RELEVANCE TO CLINICAL PRACTICE Open access education and training to support communication is required, alongside the development of robust interventions to support the process of acculturation of migrant healthcare professionals and care workers to provide culturally competent person-centred dementia care.
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Affiliation(s)
- Joanne Brooke
- Complex Older Persons Care, Faculty of Health and Life Sciences, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, The Colonnade, Headington, Oxford, UK
| | - Camille Cronin
- School of Health and Human Sciences, University of Essex, Southend-on-Sea, UK
| | - Marlon Stiell
- Paramedic Science, Faculty of Education and Health, University of Greenwich, London, UK
| | - Omorogieva Ojo
- Primary Care, Faculty of Education and Health, University of Greenwich, London, UK
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Kenning C, Daker-White G, Blakemore A, Panagioti M, Waheed W. Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies. BMC Psychiatry 2017; 17:316. [PMID: 28854922 PMCID: PMC5577676 DOI: 10.1186/s12888-017-1474-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/22/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND It is estimated that there are about 25,000 people from UK ethnic minority groups with dementia. It is clear that there is an increasing need to improve access to dementia services for all ethnic groups to ensure that everyone has access to the same potential health benefits. The aim was to systematically review qualitative studies and to perform a meta-synthesis around barriers and facilitators to accessing care for dementia in ethnic minorities. METHODS Databases were searched to capture studies on barriers and facilitators to accessing care for dementia in ethnic minorities. Analysis followed the guidelines for meta-ethnography. All interpretations of data as presented by the authors of the included papers were extracted and grouped into new themes. RESULTS Six hundred and eighty four papers were identified and screened. Twenty eight studies were included in the meta-synthesis. The analysis developed a number of themes and these were incorporated into two overarching themes: 'inadequacies' and 'cultural habitus'. CONCLUSIONS The two overarching themes lend themselves to interventions at a service level and a community level which need to happen in synergy. TRIAL REGISTRATION The review was registered with PROSPERO: CRD42016049326 .
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Affiliation(s)
- Cassandra Kenning
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Gavin Daker-White
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Amy Blakemore
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Maria Panagioti
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Waquas Waheed
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
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Ramsay SC, Montayre J, Egli V, Holroyd E. Migrant caregiving for family members with mild cognitive impairment: an ethnographic study. Contemp Nurse 2017. [PMID: 28643615 DOI: 10.1080/10376178.2017.1346480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Migrant families caring for family members with mild cognitive impairment (MCI) face considerable socioeconomic burden and isolation. AIM To examine the cultural needs, beliefs and health seeking behaviours of migrant Turkish family member caregivers. DESIGN An ethnographic approach was used employing in depth interviews. METHODS Turkish caregivers residing in Melbourne, Australia were purposively sampled. Ten participants undertook face-to-face interviews in Turkish and English, followed by coding, transcription and thematic analysis. RESULTS Common themes were: (i) characteristics of MCI; (ii) care complicates our lives; (iii) beneficial coping strategies; (iv) adherence to cultural beliefs; (v) an uncertain future; (vi) interfacing with community health providers: need to understand Turkish culture (vii) need for long-term support. Migrant caregivers voiced undergoing considerable stress exacerbated by their cultural obligations. CONCLUSIONS Establishing ethnically appropriate community support groups and advocating for a health workforce tier of representative migrant health care workers is recommended as a new role for community nurses.
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Affiliation(s)
- Siena C Ramsay
- a Faculty of Science , The University of Melbourne , Parkville , VIC 3010 , Australia
| | - Jed Montayre
- b School of Clinical Sciences , AUT University , 90 Akoranga Drive, Northcote, Auckland , New Zealand
| | - Victoria Egli
- c Faculty of Health and Environmental Sciences , AUT University , Auckland , New Zealand
| | - Eleanor Holroyd
- d Professorial Fellow , School of Global and Population Health, University of Melbourne , Melbourne , Australia.,e Visiting Professor , National University of Singapore , Singapore , Singapore.,f CUHK Public Health, School of Clinical Sciences , AUT University , 90 Akoranga Drive, Northcote, Auckland , New Zealand
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"There isn't an easy way of finding the help that's available." Barriers and facilitators of service use among dementia family caregivers: a qualitative study. Int Psychogeriatr 2017; 29:765-776. [PMID: 28351450 DOI: 10.1017/s1041610216002532] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Family caregivers of people with dementia have significant unmet needs in regard to their caregiving role. Despite this, they are reluctant to utilize services to reduce their burden. The aim of this study was to examine the barriers and facilitators of service use among family caregivers of people with dementia. METHOD Semi-structured interviews were conducted with 24 family caregivers of community-dwelling people with dementia. Of these, 12 were partner caregivers (4 men, 8 women) and 12 were offspring caregivers (2 men, 10 women). The interviews were transcribed and analyzed using thematic analysis. RESULTS Six main barriers and three facilitators were identified. These barriers and facilitators were relevant across many types of services and supports. The barriers were: the inability to find information about relevant services or support, the poor quality or mistrust of the services, the inflexibility of services, caregivers' beliefs about their obligations to the caregiving role and resistance by the care recipient. Key facilitators were: having good communication with the care recipient, having an "expert" point of contact, and having beliefs about the caregiving role that enabled the use of services. CONCLUSION Given the significant changes in the aged care service-system, it is important to discuss the barriers faced by family caregivers of people with dementia. This will inform the development of targeted strategies to address the lack of service use among these family caregivers.
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Negin J, Coffman J, Connell J, Short S. Foreign-born aged care workers in Australia: A growing trend. Australas J Ageing 2016; 35:E13-E17. [PMID: 27245976 DOI: 10.1111/ajag.12321] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To address Australian aged care workforce challenges, a deeper understanding of the current care workforce is needed especially given estimated increases in demand. We provide a national picture of the aged care workforce in Australia focusing on country of birth. METHODS Data from the 2006 and 2011 Australian censuses. RESULTS The majority of care workers are Australia-born followed by those born in the United Kingdom, South-East Asia and South Asia. While the number of carers from all regions has grown, the increase from 2006 to 2011 has been highest for carers from South Asia (333% increase) and sub-Saharan Africa (145%). The state with the largest decrease in the proportion of Australian-born care workers is Western Australia where Australian-born workers dropped from 62% in 2006 to 49% in 2011. CONCLUSIONS Understanding the migration patterns of the aged care workforce in Australia is critical to health workforce planning given increasing demand.
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Affiliation(s)
- Joel Negin
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jenna Coffman
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - John Connell
- School of Geosciences, University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Short
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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Moreno JA, Nicholls E, Ojeda N, De los Reyes-Aragón CJ, Rivera D, Arango-Lasprilla JC. Caregiving in Dementia and its Impact on Psychological Functioning and Health-Related Quality of Life: Findings from a Colombian Sample. J Cross Cult Gerontol 2016; 30:393-408. [PMID: 26290365 DOI: 10.1007/s10823-015-9270-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Existing published studies about health-related quality of life (HRQOL) in caregivers of dementia patients living in Latin American countries are very limited. However, cultural aspects, personal values, and social structure may affect the way caregivers experience their role in different societies. The current study investigated the relationship between HRQOL and psychological factors using a cross-sectional design. The sample consisted of 102 informal caregivers of patients with dementia from Bogotá, Colombia, South America. Measures included the Patient Health Questionnaire (PHQ-9) for depression, the Satisfaction with Life Scale (SWLS), the Zarit Burden Interview, and the Short Health Questionnaire (SF36) for HRQOL. Canonical correlations revealed that there was a significant relationship between caregivers' mental health and HRQOL, such that caregivers with better satisfaction with life and less symptoms of depression had more vitality and better general health. There is a strong relationship between mental health and health-related quality of life in Colombian caregivers of dementia patients living in their country of origin. Specific aspects of mental health, including satisfaction with life and depression, need to be addressed in order to improve caregivers' quality of life. Given that mental health care resources may be scarce in Latin American countries, culturally appropriate interventions should focus on preventing/treating depression and promote life satisfaction, as a way to improve their quality of life.
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Affiliation(s)
- Jhon Alexander Moreno
- Center for Interdisciplinary Research in Rehabilitation-Centre de Réadaptation Lucie-Bruneau, Montréal, Québec, Canada. .,Département de Psychologie, Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Université de Montréal, Montréal, Québec, Canada.
| | | | - Natalia Ojeda
- Department of Psychology, University of Deusto, Bilbao, Spain
| | | | - Diego Rivera
- Department of Psychology, University of Deusto, Bilbao, Spain
| | - Juan Carlos Arango-Lasprilla
- Department of Psychology, University of Deusto, Bilbao, Spain.,IKERBASQUE, Basque Foundation for Science Bilbao, Bilbao, Spain
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Pound C, Greenwood N. The human dimensions of post-stroke homecare: experiences of older carers from diverse ethnic groups. Disabil Rehabil 2016; 38:1987-99. [DOI: 10.3109/09638288.2015.1107783] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Carole Pound
- Centre for Qualitative Research, Bournemouth University, Bournemouth, UK
| | - Nan Greenwood
- Faculty of Health, Social Care and Education, St George’s University of London and Kingston University, London, UK
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Haralambous B, Dow B, Tinney J, Lin X, Blackberry I, Rayner V, Lee SM, Vrantsidis F, Lautenschlager N, Logiudice D. Help seeking in older Asian people with dementia in Melbourne: using the Cultural Exchange Model to explore barriers and enablers. J Cross Cult Gerontol 2014; 29:69-86. [PMID: 24443007 DOI: 10.1007/s10823-014-9222-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The prevalence of dementia is increasing in Australia. Limited research is available on access to Cognitive Dementia and Memory Services (CDAMS) for people with dementia from Culturally and Linguistically Diverse (CALD) communities. This study aimed to determine the barriers and enablers to accessing CDAMS for people with dementia and their families of Chinese and Vietnamese backgrounds. Consultations with community members, community workers and health professionals were conducted using the "Cultural Exchange Model" framework. For carers, barriers to accessing services included the complexity of the health system, lack of time, travel required to get to services, language barriers, interpreters and lack of knowledge of services. Similarly, community workers and health professionals identified language, interpreters, and community perceptions as key barriers to service access. Strategies to increase knowledge included providing information via radio, printed material and education in community group settings. The "Cultural Exchange Model" enabled engagement with and modification of the approaches to meet the needs of the targeted CALD communities.
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Affiliation(s)
- Betty Haralambous
- National Ageing Research Institute, PO Box 2127, 34-54 Poplar Rd, Parkville, 3052, Australia,
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Mushi D, Rongai A, Paddick SM, Dotchin C, Mtuya C, Walker R. Social representation and practices related to dementia in Hai District of Tanzania. BMC Public Health 2014; 14:260. [PMID: 24642112 PMCID: PMC3994576 DOI: 10.1186/1471-2458-14-260] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 03/10/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND With the increasing number of people surviving into old age in Africa, dementia is becoming an important public health problem. Understanding the social dynamics of dementia in resource-poor settings is critical for developing effective interventions. We explored the socio-cultural beliefs surrounding dementia and the life experience of people with dementia (PWD) and their caregivers in the Hai District of Kilimanjaro, Tanzania. METHODS Cross-sectional qualitative design. Forty one PWD were purposively sampled from the Hai District of Kilimanjaro. Twenty five paired interviews with PWD and with caregivers, and 16 with caregivers alone, were conducted. Interviews were tape recorded, transcribed verbatim and analyzed using content analysis approach. RESULTS Forty one PWD (26 females), aged 70 years and older, were recruited but due to speech difficulties only 25 participated in the interviews. Married were 13, widow in 22 and widower 6. The majority, 33/41 were illiterate. PWD and carers perceived memory problems as a normal part of ageing. Dementia was commonly referred as "ugonjwa wa uzeeni" (disease of old people) or memory loss disease. The majority of PWD 13/12 and carers 7/16 did not know what dementia is or what causes it. Dementia was felt to be associated with stroke, high blood pressure, diabetes, old age, curse/witchcraft and life stress. Half of the participants had used modern care and alternative care such as herbs, prayers or traditional healers. Caregivers complained about the burden of caring for PWD and suggested that community organizations should be involved in addressing the problem. CONCLUSIONS Knowledge about dementia is low and the symptoms are accepted as a problem of old age. PWD and carers demonstrate pluralistic behaviour in seeking help from modern care, prayers and traditional healers. The disease adds significant burden to family members. Family and caregivers need more education on early recognition of symptoms and cost effective management of dementia at family level. Faith-based organizations could play an important role in dementia interventions. At a national level effective policy and improvement of the health care system to address the needs of PWD and their families are imperative.
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Affiliation(s)
- Declare Mushi
- Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania.
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