Are the assessment and service provision needs of black African and afro-Caribbean older women living in UK with dementia culturally met?

By

TABLE OF CONTENTS

ABSTRACTiv

CHAPTER 1: INTRODUCTION1

Background of the Study1

Problem Statement2

Purpose of the Study3

Aims and Objectives3

Research Questions4

Rationale of the Study4

Significance of the Study6

CHAPTER 2: LITERATURE REVIEW7

Theoretical Framework7

Dementia8

The Afro-Caribbean Experience9

Culture and Values9

Family and Religious Beliefs10

Chronic Illnesses/Disparities11

Institutionalisation12

Involvement in medical/health research13

Racism13

Social workers and Disruptive Behaviours14

Afro-Caribbean and Dementia Caregiving Services17

British Government Regulations for Dementia Social Workers17

Correlation between Findings and Literature Review19

CHAPTER 3: METHODOLOGY22

Qualitative Method22

Data Collection22

Instrument23

Analysing Data24

REFERENCES25

ABBREVIATIONS29

Acronyms and Abbreviations29

ABSTRACT

The problem of denial of care is what all social workers should be familiar with in their work with demented people. Dementia is a syndrome which is usually caused as a result of a chronic or progressive brain disorder with disturbance of multiple higher cortical functions, including memory; thinking; orientation, and comprehension, calculation, learning capacity, language and discernment. The Afro-Caribbean people, especially women are being neglected proper healthcare services. The discriminatory practices in the provision of dementia care continue to haunt the African Caribbean people even today. This paper presents a literature review on the assessment and service provision needs of black African and afro-Caribbean older women.

CHAPTER 1: INTRODUCTION

Background of the Study

Dementia can be classified as an organic mental syndrome (Yaffe, 2009, 121). Organic psychological syndrome was defined as a constellation of cognitive, behavioural, and emotional symptoms resulting from underlying factors (Whall, 2007, 286). Interdisciplinary team members emphasise the importance of differential diagnostic criteria in the evaluation of dementia to provide essential information during treatment planning. Herein, we review the differential diagnoses, etiologies, functional implications of the disease process, and advances in health care delivery to assist the reader in establishing a common knowledge base for all interdisciplinary team members (Shea, 2011, 14).

Dementia has been described as having a biological etiology characterised by cognitive deficits (Unverzagt, 2006, 134). Specifically, Alzheimer's disease results in general atrophy of the cerebral cortex as neurons are lost. The cerebellum, spinal cord, and sensory areas of the cortex are less involved (Hughes, Louw, Sabat, 2006, 31). Although dementia is a global disorder without localised brain damage, subcortical, cortical, mixed, frontal, and temporoparietal dementia are terms used to characterise common deficits that are correlated with artificial brain pathology.

Approximately one third of people with dementia reside in the long term care settings, while the remaining majority reside in the home or community setting receiving care from over one million social workers (Darity, 2008, 899). Dementia care giving has gained increasing attention due to the unique burden associated with functional impairment, the economic impact on social workers, and the strain on the health care system (Edwards, 2007, 489). Consciousness is not clouded (Cotter, 2007, 193). The cognitive impairments are typically developed by deterioration of emotional control, social behavior or accompanied motivation. Recently, emerging literature has suggested higher prevalence and risk for racially diverse elders where the combination of the geriatric population growth and dementia risk are of concern. Disruptive behaviours raise safety concerns, interfere with everyday functioning, and normally occur within mid-to-late stages of dementia (Flores, 2007, ...