What Are Some Of The Major Dementia Care Challenges In Minority Groups?
Dementia, a condition that typically affects thinking and memory later in life, can impact people from any background. However, even though there are several ways to treat and manage it, not everyone may have equal access to quality dementia care. People with dementia from minority backgrounds may face unique challenges related to diagnosis and treatment, and they may also experience more difficulty finding a culturally sensitive care provider. Resources like online therapy platforms may make it easier to find a suitable mental health professional.
Dementia explained
Dementia can be a common concern among older adults, and it’s estimated to affect around one-third of people over age 85.
It can be important to note that dementia isn’t a specific illness. It can be seen as a set of symptoms that may result from several illnesses affecting a person’s memory, communication, and thinking. Alzheimer’s disease tends to be the most common form, but there are others, too, like Lewy body dementia and vascular dementia.
Common signs and symptoms of dementia
These conditions are usually progressive, meaning that their symptoms often worsen over time. Some common signs of dementia include the following:
- Trouble reading, writing, or following conversations
- Trouble learning and remembering information
- Trouble making decisions and solving problems
- Trouble moving around
- A loss of interest in relationships and activities
- Changes in personality
- Symptoms of depression
In general, dementia is not a part of normal aging. While it can become more likely with age, it is not inevitable. According to the CDC, it may be possible to delay or prevent up to 40% of dementia cases.
Common dementia risk factors
Some common dementia risk factors include those listed below:
- Age
- Genetics
- High blood pressure
- Lack of exercise
- Social isolation
- Smoking
- Excessive alcohol use
- Hearing loss
- Traumatic brain injuries
Mild cognitive impairment (MCI) is another possible risk factor. A person with MCI might have minor challenges with thinking or memory, but not to the extent of someone with dementia. MCI can sometimes progress to full dementia, but this doesn’t always happen. Some people with MCI will never develop dementia.
What is involved in managing dementia?
As of now, there isn’t a cure for dementia. That said, dementia can often be managed with proper treatment. The right care strategy can depend on the person, but it may involve the following interventions:
Medications
Health care professionals may recommend various medications to treat certain types of dementia. These may improve symptoms and slow the progression of the illness.
Therapy
Although dementia usually can’t be reversed, several therapies may be helpful for people with dementia. These may help people with memory loss preserve their mental abilities and important life skills.
Ongoing support
Dementia can make it harder to function in daily life, but having support may help. People with dementia may be able to stay independent for a longer period of time with the help of professional or family caregivers.
Beyond these strategies, people with dementia may also benefit from lifestyle changes like regular exercise and improved nutrition. Combined, these care options may reduce patients’ symptoms and improve their quality of life.
Understanding dementia care challenges in minority groups
There can be a wide range of options for treating and managing dementia. However, dementia research has found that not everyone has equal access to these treatment options. Minority racial and ethnic groups may face differences in dementia diagnosis, treatment, and more. Let’s take a closer look at what the research says.
Dementia healthcare disparities may start as early as the diagnostic stage. In 2024, researchers from UC Davis and OHSU performed a systematic review of 71 studies from the years 2000 to 2022. They found that people with dementia from ethnic minority groups usually took longer to receive a diagnosis. People from Black and Hispanic backgrounds tended to be less likely to be referred for specialized cognitive testing. Meanwhile, older adults from Asian American backgrounds were typically less likely to be tested for cognitive impairment, which can lead to dementia.
Dementia care challenges in minority groups: Barriers to proper diagnosis and treatment
Minorities may also face barriers due to a lack of knowledge of dementia. In a review from 2017, researchers analyzed existing data from 28 different studies. They found that among minority ethnic groups, dementia is often seen as a normal part of aging. They also found that mental health stigma—negative beliefs about people with mental illness—can lead to a sense of shame and denial in minority communities. These factors, combined with challenges navigating the healthcare system due to language barriers, may prevent people from seeking the care they deserve.
Finally, people from minority groups may have a hard time finding dementia caregivers who understand cultural and ethnic differences. For example, a recent report from the Alzheimer’s Association looked at the current state of dementia care for patients and caregivers. It found that only 48% of Black Americans, 59% of Hispanic Americans, 63% of Asian Americans, and 47% of Native Americans believe they can find culturally sensitive dementia care providers. A lack of cultural understanding may make it harder for minority patients to build relationships with their caregivers, and this may affect their care outcomes.
Getting support for dementia
Having the right mental health support may help people with dementia manage their symptoms and improve their well-being. For example, there is evidence showing that therapy may help dementia patients reduce symptoms of depression. However, minority groups may have a harder time getting that support.
Addressing these inequalities may take time and action from governments and health care providers. In the meantime, people with dementia may benefit from internet-based treatment options. Online therapy generally enables you to work with a therapist from the comfort of your home and change therapists for any reason, potentially making it easier to find a therapist who shares or understands your cultural background.
Studies show that online therapy can be as effective as in-person therapy at treating a range of mental health concerns, although more research may be needed on the efficacy of online therapy specifically for dementia. In 2023, researchers looked at health data on over 27,000 patients in the UK with a mood or anxiety disorder. They found that online therapy typically had similar effectiveness as face-to-face therapy, with shorter treatment times.
Takeaway
Frequently asked questions
What are the dementia care challenges in minority groups, and how can they be addressed effectively?
Generally, minority groups often face challenges like cultural misunderstandings, language barriers, and mental health stigmas, which can be addressed by providing culturally sensitive care, improving language support, and increasing awareness about dementia.
Recent research has estimated that the number of clinical cases of Alzheimer’s, the most common type of dementia, is expected to affect as many as 14 million people by 2060, with the largest increases expected to be in ethnic minority groups. However, these different groups can face several challenges when it comes to receiving care. These can include the previously mentioned issues of cultural misunderstandings and language barriers, as well as negative social attitudes toward people of certain races and ethnicities and inequality in dementia research and clinical trials.
Community factors, like limited awareness and understanding, barriers to accessing dementia care, challenges in getting a proper diagnosis, and unequal treatment of caregivers, can also contribute to care disparities. The CDC reports that at least half of caregivers said they faced discrimination and were concerned that care providers did not listen to them because of their ethnicity or race.
To address disparities, the CDC recommends multiple interventions, including preparing the workforce to care for an older population of racially and ethnically diverse patients, increasing diversity among healthcare providers, recruiting and retaining diverse populations for clinical trials and medical research, and improving access to health services.
What are the challenges of caregiving for dementia patients?
Caregivers may struggle with emotional exhaustion, balancing care with their personal life, and dealing with the complex symptoms of dementia, often without adequate support or resources.
What are the barriers to mental health for minorities?
Minorities face barriers and health care disparities such as stigmas around mental illness, lack of culturally competent care, and difficulty accessing services due to language or socioeconomic factors.
According to the American Psychiatric Association, additional barriers to care for non-white Americans can include a lack of adequate health insurance, a lack of diversity among healthcare professionals, and a lack of mental health care in safety-net settings. The stigma surrounding mental health is also often greater in ethnic minority populations.
Another barrier may be that minority populations and underserved communities tend to have a greater distrust of the healthcare system. For example, two-thirds of African Americans surveyed in the Race, Ethnicity and Alzheimer’s in America report reported believing that it was harder for them to get excellent care for Alzheimer’s and related dementias. Thirty-nine percent of Hispanic Americans, 40% of the American Indian population, and a third of Asian Americans also reported believing their ethnicity makes it more difficult for them to receive care than for white populations.
What are the barriers to dementia care?
Common barriers to dementia care include limited access to healthcare services, high costs, and a lack of awareness or understanding of dementia, particularly in marginalized communities.
What is minority mental health awareness?
Minority mental health awareness highlights the unique mental health challenges faced by minority communities, focusing on reducing stigmas, improving access to different healthcare services, and promoting culturally competent treatment.
The CDC celebrates Minority Mental Health Awareness Month every year in July but states that “health equity is a priority year-round,” emphasizing the role of a public health response in prioritizing minority mental health. For example, it recommends ensuring that mental health programs and policies address best practices for overcoming systemic racism in healthcare and including the ideas and perspectives of various racial and ethnic minority groups.
What are the inequalities in dementia care?
A recent study reports significant racial and ethnic differences in the diagnosis and treatment of dementia in certain ethnic groups. Some of the key points were as follows:
- Minorities experienced delays in diagnosis, with some data showing it took 11% longer for African Americans and 40% longer for Hispanic Americans to receive a diagnosis.
- Black and Hispanic American patients were less likely to be referred for more extensive testing.
- Patients in an ethnic or racial minority received lower rates of prescriptions for dementia medication.
- Minority patients with dementia were less likely to be admitted to long-term care facilities with memory care units.
How are individuals with dementia discriminated against?
Research has determined that there are a variety of ways that people with dementia may be stigmatized or discriminated against.
This review found that there is a “surprising lack of global knowledge” about dementia, with about two-thirds of people believing that it is a normal stage of aging, including 62% of healthcare workers surveyed. This study also revealed that one in five people surveyed attributed dementia to bad luck, and a majority of Latino and Asian survey respondents consider Alzheimer’s an infectious disease with a cure.
According to this research, attitudes toward dementia can prevent people from seeking education, support, and medical care in the early stages that could improve their quality of life. The stigma surrounding dementia may prevent people with this condition or their caregivers from participating in activities and lead to an inaccurate understanding of how the condition impacts the person and their family and carers. According to this review, people from a family that includes someone with dementia may experience a sense of helplessness, fear, anger, shame, or a lack of self-esteem.
From a public health perspective, this stigma can affect the level of funding for care and support. Other studies have found that primary care physicians are reluctant to diagnose dementia in the early stages, leading to a delay in getting a timely diagnosis and beginning treatment.
What demographic is most affected by dementia?
Research has found that several demographics may be at higher risk for developing dementia. For example, among those aged 70 and older, about 16.1% of non-Hispanic Black adults and 16.4% of Hispanic adults were living with dementia, compared to 8.5% of non-Hispanic white adults.
How does socioeconomic status affect dementia care?
There are a variety of dementia services available and access to this care can mean earlier diagnosis of dementia symptoms. However, people with low socioeconomic status can face barriers to this care. There may be a variety of reasons for this, including varying access to health education, social support, and community organizations, but research also shows that there are cultural differences in how people view dementia.
In one study, a majority of respondents from the Latino community reported that they considered Alzheimer’s a curable infectious disease, while other groups consider the memory problems of dementia a normal part of aging. This information indicates that a lack of education may significantly contribute to some groups receiving care. One strategy to counter this may be to raise awareness about the higher prevalence of dementia in these communities and to lessen the stigma about this and other mental health problems by making it a public health priority.
That said, general education about a variety of health topics and expanding access to clinical care in local communities may also be beneficial. Research has found that low socioeconomic status is correlated with a greater risk of many conditions, including heart disease, diabetes, and obesity, as well as increased dementia risk, faster memory decline, and lower scores on cognitive tests at diagnosis. People in these communities may face several limitations when it comes to accessing mental and physical healthcare.
What is the best environment for dementia patients?
A primary factor in determining the best environment for dementia patients is safety. If you are worried about making your home safe for a family member with dementia, assess the site properly to ensure that there are no fall risks, like rugs, mats, or power cords that could cause an injury. It is also a good idea to provide adequate lighting, remove mirrors, and add labels and signs to help orient the person.
As the condition progresses, someone with dementia may require in-home care or be admitted to a long-term care facility, where help may be only a few seconds away. Memory care facilities are generally designed with safety in mind, making them suitable environments for these patients.
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