How do race and cultural beliefs affect the care and management of Alzheimer’s disease?
Culture beliefs about Alzheimer’s vary widely between races and ethnicities and might affect the care and management of the disease. Research shows that more than half of Black Americans, Hispanic Americans and Asian Americans are more likely to write off memory deficits as natural symptoms of aging rather than recognizing that it could be early signs of dementia. This can lead to delays in diagnosis and treatment, and ultimately worsen the outcome in the long run.
According to the Alzheimer’s Association, Black people are twice as likely to get Alzheimer’s as White people are, and more than 6 in 10 members of the Black community know someone with dementia. Research indicates that Black people may not trust medical institutions due to historical discrimination and culturally insensitive treatment by medical professionals.
Older Hispanic Americans are about 1½ times as likely as older White people to develop Alzheimer’s and other dementias. Because of strong family ties within the community, when elders begin showing signs of dementia, it is mostly thought to be aging, and a close relative takes over the caregiving. Most Hispanics face cultural and language barriers, expressing that they need doctors to carefully consider and understand their ethnic background and experiences when they need care.
Asian Americans are less likely to develop Alzheimer’s than any other racial or ethnic group. Generally, there is very little knowledge about Alzheimer’s in most Asian communities and most Asian languages do not have a word to describe this condition; thus translations may describe dementia as “crazy” or “state of confusion.” Additionally, in most Asian cultures, the respect for elderly is a deep-rooted custom in which it is one’s duty and obligation to care for parents or close relatives if they get sick, which means most people will not get professional help until it is absolutely needed, which again, worsens the outcome.
Older people within the Native American community are called “Elders” out of respect for their age and wisdom. Research shows that as many as 1 in 3 Native American Elders will develop Alzheimer’s or other dementia. Because Elders are held in high esteem, they are more likely to get home care if they are having cognitive decline. This creates delays in early detection and also worsens the outcome. And, like Asian Americans, Native Americans do not have a specific word to describe dementia. The lack of knowledge about the disease and various cultural ideas surrounding the loss of memory hinder awareness of symptoms and the condition is often mistaken for normal aging or as a transition to the next world.
In order to better serve different racial and ethnic communities affected by Alzheimer’s and improve access and quality of care, health care providers should plan for culturally competent person-centered planning, such as educating the family about the condition, work with a community member to fill in gaps in communication and hire medical staff to reflect the ethnic community they serve.