African American/Black communities comprise 12.2% of the U.S. population, with a COVID-19 infection rate of more than 18% and marginal access to healthcare services. This scoping review synthesizes the emerging evidence on healthcare accessibility among older African American adult communities with dementia and COVID-19, as well as the resource requirements for this population during the pandemic. Searches of different databases for empirical studies and other sources on dementia and COVID-19 among older African American adults yielded 13 studies that met the following inclusion criteria: (a) focus on dementia and COVID-19, (b) sampled older African American adults,(c) investigated healthcare accessibility and resources, and (d) published between 2019 and 2022. Following the initial selection of the studies, eight were selected for relevance based on the Population, Concept, and Context (PCC) inclusion and exclusion criteria. Thematic analysis indicated that older African Americans with dementia and COVID-19 experienced longer delays in accessing timely healthcare, including transportation, intensive care units (ICUs), and mechanical ventilation. They also had reduced healthcare resources associated with a lack of health insurance, low financial resources, and an increased length of hospital stay, which further aggravated the negative effects of comorbid dementia and COVID-19 infections. Evidence showed that racial and age disparities affected older African American adults with dementia and COVID-19, resulting in lower healthcare access and marginal resources. This is consistent with historical and systemic inequities in meeting the healthcare needs of people of color in the United States, which was compounded for older African Americans during the COVID-19 pandemic.
African American /Black caregivers make up 13% of the total number of adult caregivers in the United States and 41% more likely to provide help greater than three activities of daily living than other ethnicities. How they perceive socio-cultural factors to influence their care giver roles is less documented. This study aims to synthesize the evidence on the role of culture and social factors in African American caregiver perceptions delivering care to older adults with dementia and COVID-19. Searches of the Ageline, Medline, PsycInfo, Academic search complete Psychology and Behavioral science collection and Google scholar for empirical study publications on socio-cultural factors for dementia care and COVID-19 among African American caregivers yielded six studies. To be included, studies met the following criteria (a) focus on African American caregivers of older adults with dementia and focus on Covid-19 (b) socio-cultural factors (c) perceptions and practices. (d)published between 2019–2022. Studies indicate compassionate care practices by African American caregivers of persons with dementia and Covid-19. African American care givers of persons with dementia and COVID19 perceive caregiving as a responsibility they owe and not a job. They also perceived to be guided by their racial identity and faith beliefs, integrating family values and culture into caregiving. African American carers of persons living with dementia and COVID-19 have compassion and resilient care self-perceptions in caregiving to people with Dementia and COVID-19. Supporting compassionate care delivery by African American carers requires understanding social and cultural factors driving their commitment to quality care.
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