How to adapt caring services to migration-driven diversity? A qualitative study exploring challenges and possible adjustments in the care of people living with dementia

Research on how services can be adapted to meet the needs of people with dementia with an immigrant or minority ethnic background is scarce. Several approaches have been discussed: offering services adapted to language and culture, adding bilingual staff to mainstream services, and providing cultura...

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Bibliographic Details
Published in:PloS one 2020-12, Vol.15 (12), p.e0243803-e0243803
Main Authors: Sagbakken, Mette, Ingebretsen, Reidun, Spilker, Ragnhild Storstein
Format: Article
Language:English
Subjects:
Bilingualism
Biology and Life Sciences
Birth rate
Care and treatment
Cognitive ability
Context
Continuity
Cultural Competency
Cultural differences
Cultural Diversity
Culture
Dementia
Dementia disorders
Emigrants and Immigrants - statistics & numerical data
Families & family life
Food
Humans
Immigrants
Interpreters
Language
Linguistics
Medical personnel
Medicine and Health Sciences
Migration
Minority & ethnic groups
Minority Groups
Noncitizens
Nursing homes
Older people
Patient Care - statistics & numerical data
People and Places
Personnel
Population
Public health
Qualitative research
Social Sciences
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Summary:Research on how services can be adapted to meet the needs of people with dementia with an immigrant or minority ethnic background is scarce. Several approaches have been discussed: offering services adapted to language and culture, adding bilingual staff to mainstream services, and providing cultural awareness and sensitivity training to health personnel in mainstream services. This study seeks to develop more knowledge of challenges and possible adjustments related to receive and provide public care for people living with dementia with an immigrant or minority ethnic background. Through a qualitative design, including 19 single interviews, 3 dyad interviews and 16 focus groups with older immigrants, relatives of immigrants with dementia, and health personnel, we explored experiences and perceptions related to receive and provide care for people with immigrant backgrounds living with dementia in Norway. The analysis were conducted inspired by Kvale and Brinkmann's three contexts of interpretations. Challenges related to language and communication were emphasized as the most fundamental barrier to provide adjusted care; exemplified through cases of isolation and agitation among patients not able to communicate. Care services framed by the majority culture creates feelings of alienation and exclusion. Not having access to specific types of food and the possibility to listen to songs, music, literature or TV programs representing a familiar and homely context may prevent use of public dementia care. Findings also point to differences in moral views regarding life-prolonging treatment in advanced stages of dementia. This study argues that to be able to address challenges related to migration-driven diversity one needs holistic care services that addresses individual as well as socio-cultural needs. A linguistically and culturally diverse workforce may represent an important resource, potentially reducing some of the problems related to communication. On a structural level, it seems necessary to allocate more time and resources, including the use of interpreters, when assessing and getting to know persons with dementia with another linguistic and cultural background. However, shared language does not guarantee understanding. Rather, one needs to become familiar with each person's way of being ill, on a cultural and individual level, including changes occurring living with progressive dementia. Getting to know a person and his/her family will also facilitate the
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0243803