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How cultural background affects dementia care

In high-income countries like Australia, nursing and aged care workforces are increasingly multicultural. In Australia it is estimated that 32 per cent of RACF workers were born overseas. In similar nations, such as the UK, figures are as high as 40 per cent.

These workers have been essential to the aged care workforce, filling significant staff shortages and reflecting the multicultural make-up of aged care residents.

However, migrant workers bring with them differing levels of dementia understanding and this can affect many facets of care.

Some literature has found differing perceptions of dementia in different cultures. For example, some cultures view dementia as an embarrassment or dishonourable, or even just a part of normal ageing.

Some cultures, such as those in the Middle East, have no definitive definition of dementia at all.

Bola Adebayo, a migrant herself and Curtin University academic, has recently published a paper looking into the dementia care experiences of the migrant workforce.

“The culture and perception of someone having dementia is very different to the perception in the Australian setting. People think people with dementia are witches, or it’s a normal ageing process,” she said.

“But when I migrated to Australia, I thought it’s very different. Dementia is really a medical condition… and relating back to my experience in Africa and with people I’ve talked to, I realised that culture might affect the way people provide care.”

Through a series of interviews for her PhD, Adebayo found that some migrant aged care workers had no prior knowledge of dementia as a formal medical condition and as well as affecting the level of care they are able to give, can frustrate the worker and cause migrant workers to leave the sector.

“When they are frustrated, and they lack the knowledge, they don’t really know how to work with someone with dementia. This can lead to frustration and can affect their retention, their turnover in residential age care facilities,” Adebayo said.

Some migrant workers also experience challenges adjusting to workplace cultures, and they can often face discrimination from other staff and residents.

The paper referenced a study that found “21 of 35 participants who were migrant care workers employed in Australian RACFs had experienced negative reactions from the residents with dementia due to their visible differences, particularly workers from African backgrounds”.

Language and accents also act as barriers to care for these group of workers, as it can make understanding and communication with colleagues difficult.

Adebayo suggests more needs to be done to provide support for migrant workers. Her study found that organisational resources to support migrant workers was strongly linked to retention.

“I think we need to be majorly providing language support and educating not only the migrant care workers but the native-born care workers from the mainstream communities to be tolerant, to be patient,” she said.

“And also, the age care management providing support will diffuse the issue of communication difficulties in the age care sector.”

Providing this support and education is key to improving retention of this vital aged care resource. Adebayo’s study found that migrant workers bring with them positive and desirable cultural norms too, such as “caring for and respecting elders”.

“There are cultural norms of caring, cultural values of caring for people. This really impacts on how they work… being kind, being gentle to them. So, in that cultural value, it’s a good factor.”

And through her research she has found that some residents prefer migrant workers as they are from similar backgrounds and share cultural identities.

The research also reported that employers like to hire migrant workers due to “good work ethic, loyalty to the organisation, and a willingness to work all shifts”.

Overall, Adebayo and her colleagues believe it is imperative for the sector to improve dementia and cultural diversity training of all staff, including its migrant workforce.

“Studies have shown and people have seen that migrant care workers bring different value and contribution to each care centre,” Adebayo said.

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