Maxcine C. Maxfield, PH.D,APRN,BC       Piedmont Geriatric Hospital
 An organized set of beliefs, values, and ideas  held by a group of people. (Wilson & Kneisl, 1983) The language, belief...
 Identify outreach strategies and  interventions that incorporate cultural  competencies Address cultural barriers that ...
 Dementia     as normal aging    expected consequence of normal aging. Dementia     as mental illness    may be viewed...
 Dementia as a disruption in social functioning    some cultures place greater emphasis on     performance of social rol...
   ACCESSIBILITY       utilize people who are culturally compatible with the        target population       conduct sen...
 MISTRUST  minorities  avoidance of formal health care   agencies is related to unfamiliarity with the   “culture of med...
 CULTURAL      RELEVANCE  Difficultywith access to services has been felt to   be due to lack of cultural relevance and ...
 DISCRIMINATION    Institutional bias and discrimination are     additional factors that increase the barriers to     ca...
.   RAPPORT    Develop a rapport with available members of the     caregiver network.   COMMUNICATION    Clarify with ...
 MEMORY     ENHANCERS    Encourage family members to consider     medications such as Aricept and to participate     in ...
 ALZHEIMER     SUPPORT GROUPS    ethnic minority caregivers usually do not attend     support groups.    Conducting sup...
 Value Diversity/Awareness and Acceptance of  differences Self Awareness Conscious of Dynamics when cultures  interact...
Consider each person as an individual, as well as a product of their country, religion, ethnic background, language, and ...
 Understand that families from different cultures consider and use alternatives to Western healthcare philosophy and prac...
 Understand  that a family’s culture impacts their choices regarding ethical issues, such as artificial nutrition, life s...
    Understand that families from different    cultures consider and use alternatives to    Western healthcare philosophy...
 Respect  cultural differences regarding  physical difference, eye contact and  rate/volume of voice Consider the cultur...
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Culturally competent dementia care

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Culturally competent dementia care

  1. 1. Maxcine C. Maxfield, PH.D,APRN,BC Piedmont Geriatric Hospital
  2. 2.  An organized set of beliefs, values, and ideas held by a group of people. (Wilson & Kneisl, 1983) The language, beliefs, values, norms, behaviors, and even material objects that are passed from one generation to the next. (Henslin, 1995) 2
  3. 3.  Identify outreach strategies and interventions that incorporate cultural competencies Address cultural barriers that are intended to improve access to services and efficacy of diagnosis and treatment 3
  4. 4.  Dementia as normal aging  expected consequence of normal aging. Dementia as mental illness  may be viewed by some families as a form of mental illness and are associated with substantial stigma and denial (Cox & Monk). Dementia as a culture specific syndrome  “worries” “spells” 4
  5. 5.  Dementia as a disruption in social functioning  some cultures place greater emphasis on performance of social role functions and affective functioning within the family than on cognitive functioning. 5
  6. 6.  ACCESSIBILITY  utilize people who are culturally compatible with the target population  conduct sensitivity training when ethnic minority staff are not available.(Valle 1990).  Locate dementia programs within the community of the persons needing care as much as possible DEMENTIA ASSESSMENT  culture-free assessment instruments with increased sensitivity and specificity and alternative strategies for detecting dementia in diverse ethnic populations( Teng 1990). KNOWLEDGE  caregivers maybe less knowledgeable about dementia assessment centers and the full array of available formal care services. 6
  7. 7.  MISTRUST  minorities avoidance of formal health care agencies is related to unfamiliarity with the “culture of medicine and lack of cultural sensitivity of medical professionals  Dissatisfaction with formal health care systems may be one of the factors that promotes the continued use of informal caregivers and alternative health care providers (e.g. folk healers) 7
  8. 8.  CULTURAL RELEVANCE  Difficultywith access to services has been felt to be due to lack of cultural relevance and inability to met unique culturally defined needs of patients and caregivers (Gallagher-Thompson 1994, Valle 1989). DIAGNOSIS  accurate assessment of dementia and referral to appropriate services is hampered by diagnostic instruments which are significantly affected by culture, education and literacy (Hart et. al. 1996). 8
  9. 9.  DISCRIMINATION  Institutional bias and discrimination are additional factors that increase the barriers to care for African American elders with dementia. (Falcone 1994, Belgrave 1993, Smith 1990). FINANCES  elders are often economically disadvantaged and uninsured their service utilization is limited to medical services provided by already overcrowded, underfunded public and county health care systems (Davis and Rowland 1983, Strauss 1988). 9
  10. 10. . RAPPORT  Develop a rapport with available members of the caregiver network. COMMUNICATION  Clarify with the caregivers what degree of detail that they want to know about the elder’s condition. 3. INFORMATION  Provide the family with books, pamphlets, videos and Internet sites about the cause and disease progression of dementia 10
  11. 11.  MEMORY ENHANCERS  Encourage family members to consider medications such as Aricept and to participate in clinical trials. LONG TERM CARE  Provide information related to long term care services such as day care, respite care, home care, support groups and individual and family counseling. 11
  12. 12.  ALZHEIMER SUPPORT GROUPS  ethnic minority caregivers usually do not attend support groups.  Conducting support group meetings in culturally neutral locations (e.g. churches) 12
  13. 13.  Value Diversity/Awareness and Acceptance of differences Self Awareness Conscious of Dynamics when cultures interact Cultural Knowledge must be expected Develop programs and services that reflect diversity 13
  14. 14. Consider each person as an individual, as well as a product of their country, religion, ethnic background, language, and family system. Understand the linguistic, economic and social barriers that individuals from different cultures face, preventing access to healthcare and social services. Try to provide services in a family’s native language. 14
  15. 15.  Understand that families from different cultures consider and use alternatives to Western healthcare philosophy and practice. Do not place everyone in a particular ethnic group into the same category, assuming that there is one approach for every person in the group. 15
  16. 16.  Understand that a family’s culture impacts their choices regarding ethical issues, such as artificial nutrition, life support and autopsies. Regard the faith community for various cultures as a critical support system. 16
  17. 17.  Understand that families from different cultures consider and use alternatives to Western healthcare philosophy and practice. Understand linguistic, economic and social barriers that different cultures face, preventing access to healthcare and social services. Try to provide services in individual’s native language 17
  18. 18.  Respect cultural differences regarding physical difference, eye contact and rate/volume of voice Consider the culture’s typical perceptions of aging, caring for the elderly and cognitive impairment 18
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