Author Identifier

Pelden Chejor

https://orcid.org/0000-0001-6713-7421

Date of Award

2024

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Nursing and Midwifery

First Supervisor

Davina Porock

Second Supervisor

Patricia Cain

Third Supervisor

Mustafa Atee

Abstract

The ageing immigrant population and rising dementia cases underscores the need for culturally appropriate dementia care services. However, accessing dementia care services can be challenging for immigrants due to cultural and linguistical differences including their health beliefs. Understanding the experiences and concerns of older immigrants living with dementia is imperative for the planning and delivery of culturally and linguistically appropriate care. The aim of this thesis was to explore and describe the experiences of older immigrants living with dementia, as well as to describe and compare (against non-immigrants living with dementia) the characteristics (neuropsychiatric symptoms and pain characteristics) of older immigrants living with dementia.

Using a pragmatist epistemology, this thesis used secondary data to explore the characteristics and experiences of older immigrants living with dementia. This thesis is made up of four studies. The first study synthesised the evidence on the experiences of older immigrants living with dementia and their caregivers using the published literature as a secondary data. The second study explored and described the dementia care experiences of older immigrants living with dementia using qualitative secondary data from the Australian Royal Commission into Aged Care Quality and Safety. The third and fourth study compared the neuropsychiatric symptoms and pain characteristics, respectively for immigrant and non-immigrant older adults living with dementia in Australian residential aged care homes using secondary quantitative data extracted from the Dementia Support Australia database.

Living with dementia in a foreign culture is not easy for many older immigrants nor is it easy for their families or caregivers. Challenges such as language barriers, lack of culturally inappropriate care, lack of dementia knowledge, and dementia-related stigma impeded their access to dementia care services and negatively impacted their health and well-being. When compared to non-immigrants, the experiences of neuropsychiatric symptoms and pain characteristics appear to differ in immigrants particularly where immigrants come from non-English-speaking backgrounds. Moreover, cultural factors and language barriers frequently contributed to neuropsychiatric symptoms for immigrants highlighting the potential impact of culture and language background of an individual on their experience of living with dementia. The thesis suggests the need to recognise secondary data as a rich source of information for dementia care research, given the current challenges of involving people living with dementia for research. This thesis also argues for the need to have standard protocols and guidelines for conducting and reporting studies that use secondary data.

It is the responsibility of the country of destination to ensure that all people living with dementia and their families receive the care and support they need at all life stages. This thesis is expected to contribute to advancing knowledge and raising awareness of dementia and migration by examining various issues from multiple perspectives using different sets of secondary data. This thesis provides recommendations for policy and practice, and research direction that will help improve dementia care and ensure person-centred care for all people living with dementia and their families.

DOI

10.25958/t18x-jd23

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