Minority ethnic groups in dementia care: A review of service needs, service provision and models of good practice

Abstract

Sixty-seven English language articles were obtained for the review, the majority of which (44, 65.7%) had US origins. Broadly, the main issues covered in the literature were the under-utilization of services by minority ethnic groups; the prevalence of dementia in different ethnic groups; the experience of care giving in different racial groups and language as a factor in cognitive assessment. Although it has been argued that the instruments used to assess cognitive function are culturally biased, the available published evidence would seem to suggest that the fundamental issue is language ability, rather than minority group membership per se. Studies into the care giving experience amongst different ethnic or racial groups suffer from theoretical and methodological weaknesses. Studies of help-seeking among various ethnic groups in the US have found that many do not prioritize dementia as a health problem in the face of more pressing concerns. There was little consensus amongst the articles about whether services should be provided specifically for different ethnic groups, reflecting a lack of evidence concerning the efficacy of different models of service provision.

Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

“…Similarly, training staff in cultural awareness and sensitivity and conducting language-appropriate cognitive testing may help address some disparities (Daker-White et al, 2002).…”

Evolution of a Community-Based Participatory Approach in a Rural and Remote Dementia Care Research Program

“…36 Earlier research identified the importance of incorporating cultural values in dementia assessment and treatment protocols. 37,38 As a first step, researchers partnered with members of an Aboriginal Grandmothers group with experience in providing care to Aboriginal seniors. The group's coordinator at the community clinic attended some meetings and traveled with the researchers on northern visits.…”

Quality of Dementia Diagnostic Evaluation for Ethnic Minority Patients: A Nationwide Study

“…Patients from ethnic minorities often present symptoms in a different way than other patients [3], and valid tools for cross-cultural cognitive assessment are currently lacking in Europe [2], which may have contributed to the poor documentation of a history of progressive cognitive decline that was supported by cognitive test results. Based on previous studies that report significant challenges in cross-cultural cognitive assessment [2,4,21], we had a particular interest in the methods applied for cognitive testing. After a more in-depth evaluation of the methods applied for cognitive testing, we found that satisfactory cognitive testing was performed in no more than one third of the patients.…”

“…Although symptoms of dementia are similar across races and ethnicities, dementia may be difficult to diagnose in elderly patients from ethnic minorities. The patients often have limited linguistic abilities in the dominant language [1,2], they often present their dementia symptoms in a different way than other patients [3], and cross-culturally validated cognitive instruments and rating scales are lacking [2,4]. Moreover, there is a stigma and taboo attached to mental health problems in some ethnic minorities [5], which may affect the awareness and communication of problems.…”