Health, Australia (Commonwealth Union) – A recent study conducted by Edith Cowan University (ECU) in collaboration with The Dementia Centre, HammondCare, has revealed that immigrants with dementia are prone to exhibiting agitation and aggression more frequently than their non-immigrant counterparts.
The research, carried out by experts from ECU’s Centre for Research in Aged Care and HammondCare’s The Dementia Centre, emphasizes that behaviors such as agitation and aggression are prevalent among individuals with dementia, but their manifestation can be influenced by cultural backgrounds.
Dementia is a complex neurological condition that affects millions of people worldwide, causing a decline in cognitive function and impacting daily life. Among the myriad challenges presented by dementia, one of the most difficult for both individuals with dementia and their caregivers is the manifestation of behaviors and psychological symptoms of dementia (BPSD). These symptoms can range from agitation and aggression to hallucinations and wandering, significantly impacting the quality of life for both patients and their loved ones. Dementia is characterized by the progressive degeneration of brain cells, leading to disruptions in neurotransmitter levels and brain function, which can manifest as BPSD. Environmental stressors, changes in routine, caregiver stress, and social isolation can exacerbate BPSD symptoms.
Many care givers for dementia have focused on adopting a holistic approach that addresses the individual’s unique needs and preferences, so they can strive to enhance their well-being and promote dignity and respect in dementia care.
Examining the clinical and demographic characteristics along with behaviors and BPSD, the study focused on immigrants and non-immigrants residing in residential aged care facilities, referred to Dementia Support Australia (DSA) programs. The findings highlighted that immigrants were more inclined to display agitation or aggression, whereas non-immigrants were more prone to experiencing hallucinations and delusions.
DSA, a government-funded dementia behavior support program in Australia, has provided assistance to over 60,000 clients and nearly all aged care facilities across the nation since its inception in 2016.
The study underscored the commonality of BPSD across both immigrant and non-immigrant groups, pointing out language barriers and cultural nuances as significant contributing factors, particularly affecting immigrants’ experiences.
Lead researcher Pelden Chejor indicated that in Australia, more than 400,000 individuals currently live with dementia, a figure expected to double by 2058. At least 54% of residents in residential aged care homes (RACHs) during 2019-2020 had been diagnosed with dementia.
“Over 31% of aged care residents were also born overseas, and 9.2% of people using aged care preferred a language other than English. In 2019 – 2020, 21% of people living with dementia in RACHs were immigrants from non-English speaking countries. International studies have reported that immigrants experience a higher prevalence of dementia due to differing life experiences including those related to trauma, low literacy, and socioeconomic status.”
Chejor and his team observed that loneliness, boredom, language barriers, and cultural factors played a significant role in contributing to Behavioral and Psychological Symptoms of Dementia (BPSD) among non-English-speaking immigrants when compared to non-immigrants. Among these factors, language barriers and cultural considerations showed the most substantial disparities. However, there were no discernible differences in the prevalence of these contributing factors between English-speaking immigrants and non-immigrants.
“Our findings indicated a significantly lower rate of hallucinations for immigrants and non-English-speaking immigrants compared to non-immigrants.
Chejor suggested that heightened levels of agitation or aggression are probably influenced by communication challenges, especially evident in cases where English-speaking immigrants exhibit no significant difference. Cognitive decline can hinder both the capacity to articulate and understand spoken language. Individuals with dementia, who have English as a secondary language may progressively lose their proficiency in English, resorting to their native language as their principal means of communication.
“Our study calls for increased awareness and education on the impact of culture and language for people receiving residential care and exhibiting BPSD. Future research should explore related factors such as length of stay in Australia and English language proficiency to learn more about BPSD presentations for different immigrant groups. By doing so, we can better manage these symptoms.”
Marie Alford, the Head of DSA, emphasized that the study underscores the significance of comprehending individuals living with dementia, encompassing their cultural heritage, personal experiences, preferences, and daily routines when addressing BPSD.
Alford highlighted, that effective communication with those living with dementia, coupled with a genuine effort to understand them, including their linguistic and cultural background, is crucial. Often, this entails providing supportive interventions without resorting to pharmacological measures.
