Home > Spring 2010 Newsletter |
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| Diversity & Outreach Updates |
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Impact of Culture on Caregiving
As the number of elders continues to grow in
the population, so too does the incidence of
Alzheimer’s disease and the correlate component
of caregivers. According to census bureau data “those older
than 65 are projected to increase to 20% of the total U.S.
population by the year 2050. The percentage of racial
and ethnic minority elders will increase at a much higher
rate that that of non-Hispanic White elders over the next
50 years. The projections indicate that the White elderly
population will double and the African American elderly
population will quadruple. The Hispanic elderly population
will increase 7 times, and the Asian/Pacific Islander elderly
will increase 3.5 times their current numbers.”1
When planning services and care for each of these
groups it’s important to factor in that African Americans
are more at risk of developing dementia than other ethnic
groups and the Alzheimer’s Association (2004) estimates
there will be 1.3 million people of Hispanic-Latino origin
with Alzheimer’s disease by 2050. The Hispanic-Latino
caregivers are a particularly diverse group in that they
come from North America, South and Central America,
the Caribbean and Spain. The literature seems to have the
least information on the Chinese caregivers and persons
with dementia.
Given the anticipated changes in demographics, it is
critical that professional caregivers acquire an in-depth
understanding of how best to care for those with Alzheimer’s
and other dementias, especially in the fast-growing racially
and ethnically diverse groups. This includes an exploration
of cultural influences because culture affects understanding
of dementia, utilization of services and the psycho-social
experiences of family caregivers.
Researchers have stressed the particular need to evaluate
the effects of increasing ethnic diversity on family care
for elders with dementia. (Amanda & Knight; Gallagher-
Thompson, 2000). This is a very complex issue which
requires an eye for inclusiveness that captures the rich
diversity among these aging populations as our society
continues to change culturally as well as demographically.
In the meantime we have learned some very helpful
information from a study that was reported on in the Gerontologist in 2005 titled African American, Chinese, and
Latino Family Caregivers’ Impressions of the Onset and Diagnosis
of Dementia: Cross-Cultural Similarities and Differences. In
this study the researchers note a number of interesting
findings:
- A lack of knowledge about Alzheimer’s disease, rather
than culturally-influenced beliefs, was the major deterrent
to having an elder’s memory assessed. However, as
the symptoms of Alzheimer’s progressed cultural differences
emerged.
- Community physicians’ failure to recognize Alzheimer’s
disease or refer to specialists was more problematic than
language or ethnic differences.
- African American caregivers noted concerns about
racism which contributed to the reluctance of some
elders to seek medical care.
- Chinese respondents noted that the stigmatization
associated with mental illness in their culture extended
to Alzheimer’s disease.
- Within the Latino community, la familia supports a
family obligation to care for its member.
In the aforementioned study, the authors go on to say
that “clinicians should have knowledge of culture-specific
values, traditions and health beliefs, and the interpersonal
skills to communicate directly or through a translator with
appropriate cultural etiquette.”2
Additionally, there needs to be a sensitivity on the
clinician’s part to the tension that many caregivers may
experience in their attempt to deal with and reconcile the
differences between their cultural heritage, demands of
their present situation, and level of acculturation into this
society.
— Della Frazier-Rios
Senior Vice-President,
Director of Education & Outreach
1. Dilworth-Anderson, Williams, Gibson. Issues of Race, Ethnicity, and
Culture in Caregiving Research. The Gerontologist 42:237-272(2002).
2. Mahone, Cloutterbuck, Neary, Z. African American, Chinese, and
Latino Family Caregivers’ Impressions of the Onset and Diagnosis of
Dementia: Cross-Cultural Similarities and Differences. The Gerontologist,
45(6):783-792.
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