Stigma and shame

Stigma and cultural expectations can influence the willingness of CALD older people and their carers to access health services and supports.

Stigma may lead to a reluctance to use health of older people services in case this results in a person’s dementia becoming public. Carers may find that they experience stigma because of their association with the person with dementia. In communities where there are arranged marriages, the knowledge that a family includes a person with dementia may jeopardise children’s marriage prospects (SCIE, 2011).

CALD families may be reluctant to seek external help out of fear that the discovery of an illness might bring “shame” to the family; and from the need to protect family and friends from the burden of the older person’s health problems (Lai & Chau, 2007).

Note: For this particular scenario, the family of the older person with dementia was referred by the GP to the Mental Health Service Older People. Generally GPs usually refer older people with dementia to a geriatrician rather than to a mental health service. This scenario is focusing on how the mental health practitioner addresses the family’s perspectives of the client’s behaviors that may be cultural related as well as addressing the feeling of shame by the client after being diagnosed with dementia. Please note that the scenario is not about the referral pathway.