Help seeking in older Asian people with dementia in Melbourne: Using the Cultural Exchange Model to explore barriers and enablers

Haralambous, Betty; Dow, Briony; Tinney, Jean; Lin, Xiaoping; Blackberry, Irene; Rayner, Victoria; Lee, Sook-Meng; Vrantsidis, Freda; Lautenschlager, Nicola T.; LoGiudice, Dina

doi:10.1007/s10823-014-9222-0

Cited by 27 publications

(63 citation statements)

References 16 publications

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“… No indication of type or severity Arabic, Chinese, Italian, Spanish (language speakers) Focus groups (carers) & interviews (health workers) Dates not reported Thematic analysis 25 Boughtwood et al, 2013 [ 43 ] Australia (not specified) Multicultural workers (24) Employed to promote access to dementia services in CALD communities. na Interviews Dates not reported Content and thematic analyses 26 Haralambous et al, 2014 [ 44 ] Australia (not specified) Caregivers (13)Community workers (11)Health professionals (39) Carers of people with dementia. No indication of type or severity Chinese, Vietnamese Interviews & focus groups Dates not reported Thematic analysis.…”

Section: Resultsmentioning

confidence: 99%

Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies

et al. 2017

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BackgroundIt 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.MethodsDatabases 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.ResultsSix 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’.ConclusionsThe two overarching themes lend themselves to interventions at a service level and a community level which need to happen in synergy.Trial registrationThe review was registered with PROSPERO: CRD42016049326.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1474-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies

et al. 2017

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“…Further barriers specific to access to secondary care, compared to primary care, may be: unfamiliarity with the service; a complex booking system based on letters written in English; the need to be accompanied by a caregiver; or the stigma associated with mental healthcare hospitals. The latter may disproportionately affect ethnic minorities, as suggested by an Australian study on Asian caregivers …”

Section: Discussionmentioning

confidence: 99%

Ethnic disparity in access to the memory assessment service between South Asian and white British older adults in the United Kingdom: A cohort study

Ogliari

Turner

Khalique³

et al. 2020

Int J Geriat Psychiatry

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Background Equality of access to memory assessment services by older adults from ethnic minorities is both an ethical imperative and a public health priority. Objective To investigate whether timeliness of access to memory assessment service differs between older people of white British and South Asian ethnicity. Design Longitudinal cohort. Setting Nottingham Memory Study; outpatient secondary mental healthcare. Subjects Our cohort comprised 3654 white British and 32 South Asian older outpatients. Methods The criterion for timely access to memory assessment service was set at 90 days from referral. Relationships between ethnicity and likelihood of timely access to memory assessment service were analysed using binary logistic regression. Analyses were adjusted for socio‐demographic factors, deprivation and previous access to rapid response mental health services. Results Among white British outpatients, 2272 people (62.2%) achieved timely access to memory assessment service. Among South Asian outpatients, fourteen people (43.8%) achieved timely access to memory assessment service. After full adjustment, South Asian outpatients had a 0.47‐fold reduced likelihood of timely access, compared to white British outpatients (odds ratio 0.47, 95% confidence interval 0.23‐0.95, P value = .035). The difference became non‐significant when restricting analyses to outpatients reporting British nationality or English as first language. Older age, lower index of deprivation and previous access to rapid response mental health services were associated with reduced likelihood of timely access, while gender was not. Conclusions In a UK mental healthcare service, older South Asian outpatients are less likely to access dementia diagnostic services in a timely way, compared to white British outpatients.

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“…A survey of clinical dementia centres across Europe found varying levels of access by BME patients and that where these patients did access services, diagnostic evaluation was more challenging owing to language barriers and the availability only of cognitive assessment tools validated in Western cultures. 37 Older Chinese and Vietnamese patients in Australia were believed to present to memory services at a more advanced stage of cognitive impairment 38 and linguistic and cultural complexities may have contributed to longer waits for diagnosis in primary care. 39 BME populations were diagnosed with dementia at an earlier age in one Danish study, 40 and similar barriers to help-seeking for carers of BME patients with dementia were evident in research from both Australia 38 , 39 and the USA.…”

Section: Discussionmentioning

confidence: 99%

Dementia in a Black and minority ethnic population: characteristics of presentation to an inner London memory service

Tuerk

Sauer

2015

BJPsych Bull

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Aims and method To examine data on referrals to an inner-city London memory service to explore any differences in referral rates, cognitive assessments and stages of dementia at presentation between ethnic groups.Results African–Caribbean patients were well represented in the memory service. They were diagnosed with dementia on average 4.5 years younger than their White British counterparts and were more likely to be diagnosed with a vascular or mixed type dementia. However, scores on initial cognitive testing were significantly lower in the African–Caribbean group, possibly representing more advanced disease at presentation.Clinical implications Initiatives to access Black and minority ethnic populations earlier in the course of their illness should be considered. Professionals need to consider the potential for cultural bias in memory testing and diagnosing dementia in these populations, and the importance of cultural competency in assessments.

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Help seeking in older Asian people with dementia in Melbourne: Using the Cultural Exchange Model to explore barriers and enablers

Cited by 27 publications

References 16 publications

Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies

Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies

Ethnic disparity in access to the memory assessment service between South Asian and white British older adults in the United Kingdom: A cohort study

Dementia in a Black and minority ethnic population: characteristics of presentation to an inner London memory service

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