A survey of issues of ethnicity and culture in nursing homes in an English region: nurse managers’ perspectives

Badger, Frances; Clarke, Laura Hurd; Pumphrey, Rachel; Clifford, Collette

doi:10.1111/j.1365-2702.2011.03880.x

Cited by 17 publications

(22 citation statements)

References 25 publications

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“…However, Gerrish et al [43] have highlighted that both nursing personnel and doctors need training in how to collaborate with interpreters, so the communication can run smoothly between the triad of patient, professional and interpreter. Other ways to aid communication with minority ethnic groups in health care has been described such as including family members who can translate and write down usable words and phrases [44] , or using multilingual staff in nursing homes [45] . Samarasinghi and co-workers [28] suggested a family-focused care with a supportive conversation with the members of the family as a means of improving the care of immigrants.…”

Section: Discussionmentioning

confidence: 99%

“…This is in accordance with what Gerrish and co-workers [43] reported, and they also found that professionals in health-care were reluctant to use interpreters in the encounter with minority ethnic groups. Even if the presence of family members is important for supporting older immigrants in their contact with the health care system [44] , the utilization of professional interpreters is also of outmost importance [37] . However, Gerrish et al [43] have highlighted that both nursing personnel and doctors need training in how to collaborate with interpreters, so the communication can run smoothly between the triad of patient, professional and interpreter.…”

Section: Discussionmentioning

confidence: 99%

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Experiences of health and care when growing old in Norway - From the perspective of elderly immigrants with minority ethnic backgrounds

Thyli¹,

Hedelin²,

Athlin³

2014

Clinical Nursing Studies

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Background: Along with the growing population in Norway of older people with immigrant backgrounds from countries in Asia, Africa and Eastern Europe there is a need for a better understanding of trans-cultural aging, illness experiences and care preferences among minorities and their families.Aim: This study explored older ethnic minority immigrants' experiences of growing old in Norway with a focus on health and care.Design: An explorative, descriptive design with a grounded theory approach was used. Method:The data was collected in Norway by means of open-ended interviews with nine ethnic minority immigrants representing an age span from 63 to 85 years. In total 15 interviews were conducted, with the sampling, data collection and analysis carried out simultaneously and guided by the constant comparative method.Results: This study showed that the most important issue when growing old in a new homeland as an ethnic minority immigrant was to be surrounded by one's family. When the needs for care increased due to changes in age and health, the family was seen as the only possible solution. Feelings of fear and distrust, language barriers, and preferences for the familiar care were reasons for this. Due to cultural rules it was taken for granted that the younger generation took on responsibility for their older parents/relatives in need of care, which led to feelings of dependency and being a burden. A high price had been paid for finding a new homeland. Conclusions and Implications for Practice:The elderly immigrants' expectations of care was found to be strongly connected with traditions from their native country, where it was taken for granted that the younger generation took the responsibility for their older parents/relatives in need of care. Our findings highlighted the dilemma of culturally determined controversies, as elderly immigrants' beliefs and values about care within the family may be rather difficult to unite with a life in a new Western society. Nursing practice needs to implement a more family-oriented care perspective in order to meet the needs of elderly people with ethnic minority and immigrant backgrounds. Further it is important to increase elderly immigrants' feelings of trust and cultural safety towards health-care services.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Experiences of health and care when growing old in Norway - From the perspective of elderly immigrants with minority ethnic backgrounds

Thyli¹,

Hedelin²,

Athlin³

2014

Clinical Nursing Studies

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“…Possible explanatory factors include expectations among family carers that services will be culturally inappropriate (in terms of language and food), and a greater sense of filial piety and obligation . Care home staff have reported challenges providing culturally appropriate care, for example appropriate diets and translation services, and in day to day communication . With the number of BME care home residents with dementia projected to increase due to demographic trends, it is important to consider how care homes can best provide culturally competent care.…”

Section: Introductionmentioning

confidence: 99%

Relationship between speaking English as a second language and agitation in people with dementia living in care homes: Results from the MARQUE (Managing Agitation and Raising Quality of life) English national care home survey

Cooper

Rapaport

Robertson

et al. 2017

Int J Geriat Psychiatry

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ObjectiveAs not speaking English as a first language may lead to increased difficulties in communication with staff and other residents, we (1) tested our primary hypotheses that care home residents with dementia speaking English as a second language experience more agitation and overall neuropsychiatric symptoms, and (2) explored qualitatively how staff consider that residents' language, ethnicity, and culture might impact on how they manage agitation.MethodsWe interviewed staff, residents with dementia, and their family carers from 86 care homes (2014–2015) about resident's neuropsychiatric symptoms, agitation, life quality, and dementia severity. We qualitatively interviewed 25 staff.ResultsSeventy‐one out of 1420 (5%) of care home residents with dementia interviewed spoke English as a second language. After controlling for dementia severity, age, and sex, and accounting for care home and staff proxy clustering, speaking English as a second language compared with as a first language was associated with significantly higher Cohen‐Mansfield Agitation Inventory (adjusted difference in means 8.3, 95% confidence interval 4.1 to 12.5) and Neuropsychiatric inventory scores (4.1, 0.65 to 7.5). Staff narratives described how linguistic and culturally isolating being in a care home where no residents or staff share your culture or language could be for people with dementia, and how this sometimes caused or worsened agitation.ConclusionsConsidering a person with dementia's need to be understood when selecting a care home and developing technology resources to enable dementia‐friendly translation services could be important strategies for reducing distress of people with dementia from minority ethnic groups who live in care homes.

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“…It is also likely that some of the problems of trials in these patients—such as the assessment of side-effects—would be best moderated by the ability of staff to withdraw assent if necessary. However, the increasing heterogeneity of ethnicity and culture among staff and residents in care home settings (ref Badger)12 may interfere with this process, especially if there are significant language barriers, as will low levels of understanding and recognition of dementia (Macdonald and Carpenter,13 Macdonald and Woods) 14. Qualified care staff may not know the patients as well as unqualified care workers, but the latter are among the lowest paid15 and poorly educated and trained16 employees in the UK.…”

Section: Discussionmentioning

confidence: 99%

Impact of the demand for ‘proxy assent’ on recruitment to a randomised controlled trial of vaccination testing in care homes

Whelan¹,

Walwyn²,

Gaughran

et al. 2012

J Med Ethics

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Legal frameworks are in place to protect those who lack the capacity to consent to research, such as the Mental Capacity Act in the UK. Assent is sought instead from a proxy, usually a relative. However, the same legislation may, perversely, affect the welfare of those who lack capacity and of others by hindering the process of recruitment into otherwise potentially beneficial research. In addition, the onus of responsibility is moved from those who know most about the study (ie, the scientific community) to those who know less (the proxies). In this paper, we describe the characteristics of a sample at different stages of the recruitment process of an influenza vaccine-based randomised control trial in elderly care home residents (the FEVER study). 62% (602/968) of potential subjects lacked capacity but only 29% (80/277) of those actually randomised. Older age, being female and living in an Elderly Mentally Ill care home were the only variables associated with lacking capacity. Considering this was a study based in a care home setting where the prevalence of dementia approximates 80%, the trial, like many others, was thus significantly biased. We believe that difficulties seeking proxy assent contributed significantly to this problem. Further thought should be given to how assent to enter research for those who lack capacity should be provided, and we suggest avenues for further discussion such as independent risk/benefit expert panels.

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A survey of issues of ethnicity and culture in nursing homes in an English region: nurse managers’ perspectives

Abstract: Nursing homes in England are increasingly diverse communities, and staff training needs must be addressed to promote quality care for all residents.

Cited by 17 publications

References 25 publications

Experiences of health and care when growing old in Norway - From the perspective of elderly immigrants with minority ethnic backgrounds

Experiences of health and care when growing old in Norway - From the perspective of elderly immigrants with minority ethnic backgrounds

Relationship between speaking English as a second language and agitation in people with dementia living in care homes: Results from the MARQUE (Managing Agitation and Raising Quality of life) English national care home survey

Impact of the demand for ‘proxy assent’ on recruitment to a randomised controlled trial of vaccination testing in care homes

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