Dementia and Migration: Family Care Patterns Merging With Public Care Services

Sagbakken, Mette; Spilker, Ragnhild Storstein; Ingebretsen, Reidun

doi:10.1177/1049732317730818

Cited by 46 publications

(109 citation statements)

References 33 publications

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“…This study is the first to consider in more detail the organization of family dementia care in Turkish, Pakistani, and Arabic speaking minority ethnic families in Denmark. As in previous studies in minority ethnic communities in Europe (Baghirathan et al, 2018;Berdai Chaouni & De Donder, 2018;Hossain et al, 2018;Naess & Moen, 2015;Parveen et al, 2017;Sagbakken, Spilker, & Ingebretsen, 2018;Sagbakken, Spilker, & Nielsen, 2018;van Wezel et al, 2016), we found a preference for keeping dementia care within the family with limited support from formal care services but more details about how this was managed by the families.…”

Section: Discussionsupporting

confidence: 82%

Rotational care practices in minority ethnic families managing dementia: A qualitative study

Nielsen¹,

Waldemar

Nielsen

2020

Dementia

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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

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Section: Discussionsupporting

confidence: 82%

Rotational care practices in minority ethnic families managing dementia: A qualitative study

Nielsen¹,

Waldemar

Nielsen

2020

Dementia

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“…In a survey of healthcare use in Europe, migrants showed higher rates of consumption than native-born across countries. This was true for both physician visits and hospital stays, which is compatible with an aging migrant population with health deterioration (Solé-Auró, Guillén, & Crimmins, 2012). Similar migrant healthcare consumption trajectories seem probable in Norway.…”

Section: Discussionsupporting

confidence: 63%

“…Moreover, according to Elstad (2016), the world region origin, reason for migration and duration of residence are important sources for variations in migrants' utilization of healthcare services. Solé-Auró et al (2012) suggest that the observed differences on migrants' access to and use of healthcare across countries requires further exploration of the cultural, political and financial features affecting the propensity for use of healthcare consumption. Therefore, migrant patients' experience of inclusion or exclusion from healthcare consumption needs to be addressed.…”

Section: Discussionmentioning

confidence: 99%

“…Nursing homes constitute an essential part of PHC, but due to the proportion of older migrants in the Nordic countries still being low, relatively few use them (Plejert, Jansson, & Yazdanpanah, 2014;Sagbakken, Spilker, & Ingebretsen, 2018). Long-term institutional care for older or disabled people requires high cost-sharing and co-payment levels are income tested (Ringard et al, 2014).…”

Section: Primary Healthcarementioning

confidence: 99%

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4. Migrants’ Consumption of Healthcare Services in Norway: Inclusionary and Exclusionary Structures and Practices

Arora¹,

Bergland²

2019

Inclusive Consumption: Immigrants’Access to and Use of Public and Private Goods and Services

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Increase and diversification of the migrant population can have significant implications for the Norwegian Health Plan's commitment towards equitable access. Despite the generous nature of the welfare state in Norway and emphasis on culturally sensitive care, it is important to consider the various impediments that some migrants may experience in accessing and consuming healthcare services. We conducted a scoping review aimed to shed light on the extent of healthcare utilization and the socioeconomic barriers experienced by migrants. Our review illustrates that migrants' overall consumption of different forms of healthcare services is lower than that of the general population but varies between different migrant groups. Financial affordability has been found to influence use of services that more or less fall out of the publicly covered healthcare benefits, such as dental care, physiotherapy and private specialists' care. However, there is lack of information on how affordability influences use of primary healthcare, somatic specialist care, nursing homes and mental healthcare. While there is evidence of socioeconomic barriers at the patient level for utilization of primary healthcare services, including both pre-migration aspects and factors in the host country, the question of affordability often becomes subordinate in the context of the welfare state. Our review suggests further examination of pro-rich inequity in healthcare services, given the rising income inequality in Norway, and with migrants usually having lower incomes than the rest of the population. Furthermore, research needs to take into account different groups of migrants such as undocumented refugees, migrants awaiting residency and labour migrants in order to examine barriers encountered both in everyday experiences as well as structural barriers to healthcare consumption.

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“…They recommend, inter alia, that care providers should provide people with dementia and their relatives from ethnic minorities with speci c information and support services that take their cultural and linguistic background into account. Various studies also identify a large need for relief and support services for family caregivers of PwM with dementia, which must be oriented toward the individual and cultural needs of PwM and their relatives [26,[71][72][73][74][75]. In particular, the importance of mothertongue education about dementia and culturally sensitive treatment and support services [74], for example, through dementia hotlines [26], speci c counseling centers, or printed information materials [75], is emphasized.…”

Section: Discussionmentioning

confidence: 99%

How is migration background considered in the treatment and care of people? A comparison of national dementia care guidelines in Europe

Schmachtenberg

Hoffmann

Berg

et al. 2020

Preprint

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Background People with a migration background are vulnerable to dementia. Due to problems such as underdiagnosis or access barriers, the care of this population is a public health challenge in Europe. Many countries are issuing care guidelines, but a systematic overview of their references to migration groups is lacking. This study aims to analyze national dementia care guidelines regarding their focus on people with a migration background, what specific actions to ensure healthcare have been undertaken at the national level, and whether recommendations for action are made for this population.Methods This study is a systematic analysis of national dementia care guidelines of the EU and EFTA (European Free Trade Association) countries. Using the discourse analysis model by Keller (2011), 43 documents from 24 EU and 3 EFTA countries were systematically screened for migration references via keyword and context analysis. The content of the migration-related section was paraphrased, memos and comments were added, and the individual text passages were coded using the strategy of open coding.Results Twenty-seven of the 35 EU and EFTA countries have guidelines or similar documents on care for people with dementia, and twelve refer to migration. Norway, Sweden, and Northern Ireland refer to this topic in detail. The focus of the migration-related guidelines is on the early detection and diagnosis of dementia. The main message is that standardized diagnostic tools such as the MMSE (Mini-Mental State Examination) or the clock test are not suitable for linguistic minorities. Nine countries make recommendations for the care of people with a migration background and dementia, but only Norway, Sweden, and Denmark point to available healthcare services. A key recommendation is that the linguistic and cultural background of people should be considered when selecting diagnostic tests. Several countries refer to the validity of the RUDAS (Rowland Universal Dementia Assessment Scale) for migrants.Conclusions The topic of migration plays a subordinate role in the dementia care guidelines of European countries. Almost all countries lack appropriate diagnostic tools and healthcare services for people with a migration background. Consequently, this group is vulnerable to underdiagnosis and a lower level of care.

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Dementia and Migration: Family Care Patterns Merging With Public Care Services

Cited by 46 publications

References 33 publications

Rotational care practices in minority ethnic families managing dementia: A qualitative study

Rotational care practices in minority ethnic families managing dementia: A qualitative study

4. Migrants’ Consumption of Healthcare Services in Norway: Inclusionary and Exclusionary Structures and Practices

How is migration background considered in the treatment and care of people? A comparison of national dementia care guidelines in Europe

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