How culture may impact behaviours of people with dementia

Key points:

• Researchers found differences in dementia-related behaviours, depending on whether the participant was an immigrant or not
• Sixty percent of Australians with dementia display inappropriate verbal or motor behaviours
• Incorporating different cultures into Australian aged care homes could help provide appropriate support for people with dementia

Results from an Edith Cowan University study suggest that immigrants with dementia may be more likely to show aggressive and agitated behaviours, compared to people with dementia who have not immigrated. However, the study of almost 24,000 people also found that non-immigrants were more likely to experience delusions and hallucinations. 

Sixty percent of Australians with dementia display inappropriate verbal or motor behaviours, such as agitation and aggression, but researchers now suggest that there could be cultural and communication elements that affect this.

Study participants were given access to free programs from Dementia Support Australia, funded by the Australian Government. These are available to people with dementia and anyone who needs support in caring for them. 

Behaviours and psychological symptoms of dementia fall into two categories, namely non-aggressive and aggressive behaviours. 

An example of a verbal agitation may be expressed as:

• asking for attention or complaining: non-aggressive;
• swearing: aggressive.

An example of a physical agitation may be expressed as:

• moving arms repeatedly: non-aggressive;
• hitting: aggressive.

Reasons for such behaviours can include being in pain or experiencing physical illness, disorientation, depression or unmet needs which could be a result of language barriers.

With the increase of migrants to Australia, there is no doubt that the diversity in languages is continuing to grow. However, almost one in two older people born in North-East Asia require translation services. This is comparatively higher than the general migrant population — one in eight older people require such services.

In another study, researchers observed that in some people with dementia who speak more than one language, ‘a striking loss of second language’ occurred as the participants’ conditions declined. This loss of language was seen to affect both the participants’ understanding and ability to communicate in the second language.

Researchers made it clear that further studies must be undertaken to gain further insight into the implications of this research and to confirm their conclusions.

In a different study published in 2016, researchers were able to determine that monolingual ‘nursing staff could provide qualitative and equitable care, but the challenge was greater for them than for the bilingual nursing staff who spoke the same language as the residents’. 

However, caring for someone with dementia who identifies with another culture extends further than being able to speak the person’s preferred language. Research has also shown that incorporating ‘spirituality, singing and tangible aspects of traditional culture like clothes and food constitute important aspects of culture-appropriate care.’

Increasing awareness about the impact that culture and language can have on people with dementia could help better cater for people in aged care homes, depending on the type and severity of behaviours shown.

With more people immigrating from other countries, regardless of their age, the aged care sector will need to provide options to suit the ageing population of Australia. Not only does this indicate the need for aged care homes to be appropriately staffed with people who speak multiple languages, but it also raises the essentiality of incorporating different cultures into Australian aged care homes. 

Do you know someone with dementia who struggles to express their needs?

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