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P6. Minority ethnic groups

Detailed programme and abstracts

P6.1. What are barriers and facilitators to provide culturally sensitive care to older migrants with dementia?

CLAEYS Ann1, CLAEYS Ann2, BERDAI-CHAOUNI Saloua2, TRICAS-SAURAS Sandra3, DE DONDER Liesbeth4

1Erasmushogeschool, Brussels, Belgium, 2EHB, VUB, Brussels, Belgium, 3ULB, EHB, Brussels, Belgium, 4VUB, Brussels, Belgium

Background: Research suggest that culturally-sensitive care is essential to meet the needs of persons with a diagnosis of dementia (PwD) and with a migration background) in order to provide excellent care. Scientific evidence also shows that healthcare (HC) providers struggle with the implementation of culturally sensitive care. Yet, it is unclear though why this approach to care is so difficult to implement in practice. Therefore, the aim of this research is to identify the potential barriers but also the facilitators that HC providers experience when delivering care to PwD with a migration background.

Methods: A total 6 focus groups (n = 37) and 12 in-depth interviews were conducted with HCproviders (i.e. doctors, nurses, social workers, occupational therapists, nursing and medical students). Thematic content analysis was used to analyse the data.

Results: First, the results show that HCproviders narrate about people with a migration background and their families as “the other”. This “othering” runs like a thread through the barriers that HCproviders experience in providing culturally sensitive care. Respondents narrate about the person with a migration background as someone with limited health skills, with a language barrier, with financially limited resources and who refuses care. Second, this anticipated problematization of older migrants with dementia renders the HCproviders feeling incompetent and insecure to provide care to these perceived ‘others’. Third, organizational aspects at the exo level, such as time pressure or economic restrictions, are also perceived as a barrier by HCproviders in the provision of culturally-sensitive care.

Conclusion: HCproviders experience barriers in the provision of culturally-sensitive care to PwD with a migration background. Eliminating these barriers should mainly have to focus on conceptualisation, because “othering” appears to be an important cause of various barriers. This study is part of the Diverse Elderly Care project on culturally sensitive dementia care in Brussels.

P6.2. Cross-cultural neuropsychological assessment in the European Union: a Delphi expert study

FRANZEN Sanne1, VAN DEN BERG Esther1, PAPMA Janne1, NIELSEN Rune2

1Erasmus University Medical Center, Rotterdam, Netherlands, 2Danish Dementia Research Center, Copenhagen, Denmark

Objective: The increasing diversity in the European Union (EU) calls for adaptations to neuropsychological assessment practices. The aims of this study were to examine the current state of cross-cultural neuropsychological assessment in the EU and to provide recommendations for researchers and policy makers on this topic.

Methods: Twelve experts from nine EU countries participated in a Delphi consensus study involving two sequential rounds of web-based questionnaires and an in-person consensus meeting. The experts individually rated on the basis of importance (scale 1-10). The degree of consensus was determined by assessing quartiles and medians.

Results: Across the EU, several cross-cultural (adaptations of) neuropsychological tests are available, as well as a limited number of initiatives for the training of professionals. The main priorities that were identified were the development of tests (median importance rating 10, Q1-Q3: 9-10) and norms (median importance rating 9, Q1-Q3: 8-10), as well as training, awareness, and knowledge regarding cross-cultural assessment among European neuropsychologists (median importance rating 9, Q1-Q3: 8-10). The focus should be on tests of social cognition (median 9, Q1-Q3: 8-10) and language (median 9, Q1-Q3: 7-10), closely followed by other domains, particularly executive functioning (median 8, Q1-Q3: 8-10). A list of recommendations was generated describing essential skills and knowledge necessary for cross-cultural neuropsychological assessment.Conclusions:The development and availability of cross-cultural tests and norms should be prioritized, as well as the development and implementation of training initiatives across the EU. Furthermore, EU guidelines could be established for working with interpreters in a neuropsychological assessment.

P6.3. Comparing national dementia plans and strategies in Europe – Is there a focus of care for people with dementia from a migration background?

SCHMACHTENBERG Tim1, MONSEES Jessica1, HOFFMANN Wolfgang1, VAN DEN BERG Neeltje2, STENTZEL Ulrike2, THYRIAN René1

1German Center for Neurodegenerative Diseases, Greifswald, Germany, 2University Medicine Greifswald, Institute for Community Medicine, Greifswald , Germany

Background: People with migration background (PwM) and dementia are a vulnerable group. Providing care for this group is a public health challenge in Europe. An increasing number of countries are issuing national dementia plans (NDPs), but a systematic overview of NDPs of European countries focusing on care for PwM is lacking. This study aims to illustrate how European countries identify the dementia-related needs of PwM and whether there are specific healthcare services for them at the national level.

Methods: A qualitative analysis of NDPs of the EU and EFTA countries was carried out. Using the discourse analysis model according to Keller (2011), documents were systematically screened for their relation to migration via keyword and context analysis. The content of the migration-related sections was analyzed using the methods of paraphrasing, memos, comments, and open coding.

Results: Twenty-three of the 35 EU and ETFA countries have a national dementia plan, ten of them refer to migration and one country (Austria) has a national dementia plan with a chapter on migration. Eight NDPs identify that PwM and dementia have special needs, and actions to care for this group are planned in nine countries. However, only Norway, Northern Ireland, and the Netherlands refer to available healthcare services for PwM. Overall, the topic of migration plays a subordinate role in the NDPs of European countries.

Conclusions: The current lack of migrant-specific healthcare services in almost all European countries may lead to denying the right to appropriate care to a growing population. The topic of migration must be given greater attention in NDPs. European countries should develop strategies with specific services that address the needs of PwM. To improve comparability at the European level, a common definition of migration is needed.

P6.4. Providing suitable care to older migrants with dementia in Belgium: perspective of family caregivers on accessibility and acceptability of professional dementia care.

BERDAI CHAOUNI Saloua1-2, CLAEYS Ann1-2, DE DONDER Liesbeth2

1Erasmus University College, Brussels, Belgium, 2Vrije Universiteit Brussel, Brussels, Belgium

Workers from Italy, Morocco and Turkey travelled towards Belgium within the context of labour migration during the ’50 and ’60 and are now ageing in cities and regions hosting these labour migrants such as Brussels. At present, Moroccan, Turkish and Italian older persons are large groups of 65+ with a migration background living in Brussels. An increasing group among this older population is facing dementia. Family and professional caregivers are challenged to provide suitable care to these older migrants. This study explores the service use by family caregivers of older labour migrants. Which services do they use? What are the underlying reasons to use, keep using or not to use these services? Thirty four family caregivers with Italian, Moroccan and Turkish origin are interviewed about their experience with professional dementia care. Results indicate that although aging at place is preferred by the family caregivers, use of different dementia care services is inevitable and starts during the diagnostic phase. Family caregivers experience a poor accessibility of the professional dementia care which enhances their care burden. Reasons not to use professional care are the lack of person-centered care and the insensitivity of professional care to the care-recipients’ ethnic, religious and social background. Family caregivers encounter different barriers in their search for suitable care for their older family members with dementia. The current used care solutions are based on their perseverance and creativity. A supporting professional dementia care, that is sensitive to the intersection of the identities of these older persons and their family caregivers, is required.

P6.5. Cultural-sensitive memory work in Finland: The Memory Interpreter training program

JAAKSON Siiri

Society for Memory Disorders Expertise in Finland/ ETNIMU-activity, Helsinki, Finland

Aim: The aim of ETNIMU activities is to secure that people from ethnic minority backgrounds with dementia get timely and accurate diagnosis

Background: The MMSE is the memory test most commonly used with people from ethnic minority backgrounds in Finland. The test is well suited to the native populations, but it falls short when used to map the situations of people from diverse ethnic minority backgrounds. To get the necessary information, the test needs to screen also for background information f.ex. about a person's daily life, skills and social activities. Difficulties in language and insufficient understanding of the cultural specificities pose the biggest challenges to mapping. The social and health care professionals would benefit of an interpreter who can help them perceive the client’s possible memory problems and provide them assistance in memory test situations.

Method: The pilot group of the Memory Interpreter training program has 17 participants of Estonian, Russian, Arabic, Chinese and Roma backgrounds. All participants are volunteers. The training program consists of a theory part that covers f.ex. general information about dementia, interpreting skills, confidentiality and GDPR. The training is completed by a practical session at a Memory Clinic. After completing the training, the memory interpreters act independently as interpreters in memory test situations and help the social and health care professional in their interactions with clients from different ethnic minority backgrounds.

Results: ETNIMU activities have developed a unique training program in Finland that supports culturally sensitive memory work in co-operation with memory clinics, universities, as well as experts working in various fields. The Memory Interpreter training program and the working tools can be adapted to work with different language and cultural backgrounds and so help to secure timely and accurate diagnosis of dementia.

 

 
 

Last Updated: Tuesday 30 June 2020

 

 
  • Acknowledgements

    The 30th AE Conference received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe gratefully acknowledges the support of all conference sponsors.
  • European Union
  • Roche
 
 

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