Family perceptions of dementia

Caregivers of Asian older people may have an understanding of dementia that reflects more traditional views of ageing. In a study of adult family caregivers, Asian American caregivers were the most likely to adhere to ‘folk models’ of dementia, which attribute dementia-related changes as a result of psychosocial stress in combination with ‘normal’ ageing processes (Hinton et al., 2005). This difference in the family’s perception of the aetiology of the illness may influence the time to presentation to medical and psychiatric care. In addition, the family may not recognise their ailing relative’s difficulties.

In a study of Japanese older people , family members failed to notice problems with memory, and the majority of subjects with dementia had not received medical evaluation for their illness (Ross et al., 1997). Participant’s lack of access to information about dementia was the main factor in their inability to recognise dementia in their elderly relatives. In addition, out of respect, family members reported trying to ignore memory difficulties to ‘‘save face’’ for their elderly relatives.

The idea that caregivers would not seek outside support and interventions out of respect for and duty toward elders is a theme that recurs in the cross-cultural literature on the care of older people (Dilworth-Anderson & Gibson, 2002).