Dementia

Dementia is the term used when a person experiences a gradual loss of brain function and cognitive abilities due to physical changes in the structure of their brain. Dementia is a neurodegenerative condition and is not part of normal ageing. Although it is a diagnosis more common for people over the age of 65, dementia can affect people in their 40s and 50s.

There are many types of dementia, but the most common is Alzheimer’s disease. Other types include vascular dementia, dementia with Lewy bodies and fronto-temporal dementia. A person can have a combination of types of dementia. In general, each type of dementia affects particular areas of the brain (although with vascular dementia, any part of the brain can be affected) causing changes in behaviour, cognition, personality and mood (Ministry of Health, 2013).

The differential diagnosis of dementia, in the presence of depression and/or delirium can be particularly complicated in patients from culturally and linguistically diverse backgrounds (Johnson, Sims & Gottlieb, 1994).

People with dementia from culturally diverse backgrounds and their carers face difficulties accessing services and being able to choose care and support in the forms that they would like (SCIE, 2011). These difficulties arise from lower levels of awareness about dementia and greater levels of stigma in some communities (Sun, Gao & Coon, 2013; SCIE, 2011). These factors influence the ways in which families seek support.

Asian communities may consider dementia a normal part of ageing, a form of mental illness, a source of shame, or even the result of fate and are less likely to seek services during the early stages of the disease (Alzheimer’s Association, 2009; Punchihewa & Lou, 2013). Family’s perceptions of the causes of dementia influence the time to presentation to medical and psychiatric care (Trinh & Ahmed, 2009). As Punchihewa and Lou’s (2013, p.11) state, “as symptoms progress and become more severe, dementia is also often viewed by families as a form of insanity”.

The literal translation of the term “dementia” can also perpetuate the stigma, for example, in Chinese, dementia commonly translates as “crazy catatonic“. Family members may ignore memory difficulties to “save face” for their elderly relatives. Caregivers may not seek outside support and interventions out of respect for and duty towards their older relative.