Embracing Cultural Diversity – Leadership Perspectives on Championing Meaningful Engagement for Residents Living with Advanced Dementia

Abstract

Introduction:Resource constraints and high staff turnover are perceived as substantial barriers to high quality residential aged care. Achieving relationship-focused, person-centered care (PCC) is an ongoing challenge. This paper reports on an international project that explored how residential care leadership understand meaningful engagement for residents with dementia from culturally and linguistically diverse (CALD) backgrounds.Method: This paper critically appraises the process, and outcomes, of an adapted Delphi method. Participants were the residential care leadership (i.e. staff in supervisory capacity) from four international facilities.Findings: Participation in the Delphi process was limited even though surveys were designed to require minimal time for completion. No participants opted for the alternative option of being interviewed. Findings indicate that residential care leadership recognised the importance of meaningful engagement for residents from CALD backgrounds. Limitations of time, resources and policy infrastructure were cited as barriers to achieving PCC. Conclusion:These findings suggest that facility leadership understand the importance of PCC, but identify multiple barriers rather than enablers for delivering PCC. Alternative methods, such as collecting data in interactive sessions allowing real-time discussion should be initiated to more effectively engage residential care leaders for a collaborative approach to explore PCC practices.

The needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care: An integrative review

“…A total of 15 studies were included in this integrative review. Four studies used quantitative method (Kim et al, 2014; Runci et al, 2005, 2012, 2014); nine studies used qualitative method (Chin et al, 2019; du Toit et al, 2020; Kokorelias et al, 2017; Kong et al, 2010; MacKinlay, 2009; Rosendahl et al, 2016; Söderman et al, 2018; Söderman & Rosendahl, 2016; Strandroos & Antelius, 2017); and another two studies used mixed methods design (Cooper et al, 2018; du Toit & Buchanan, 2018). The studies in this review were conducted from different countries, Australia ( n = 4), Sweden ( n = 4), the United States of America ( n = 2), Canada ( n = 1), England ( n = 1), Singapore ( n = 1) and South Africa ( n = 1).…”

Understanding Capacity and Optimizing Meaningful Engagement among Persons Living with Dementia

“…Research involving quantitative methods, larger individual participant and site samples, other care setting types and geographic areas, would enhance knowledge. Additional research focused on how social and cultural factors influence meaningful engagement (du Toit et al, 2020) is needed.…”

“…Potential limitations to meaningful engagement in AL include those related to residents’ physical and cognitive function, staff shortages and turnover, limited skills and training of care partners (i.e., staff, family members, friends, and other care providers), obstacles related to the physical environment (e.g., crowding, noise, inaccessible public space, limited privacy) and lack of individualized activity programming (Bender et al, 2021; Holopainen et al, 2019; Mmako et al, 2020; Vandenberg, et al, 2018). In some cases, staff receive training but lack the resources to develop and engage residents in meaningful activities (du Toit et al, 2020). In addition, social environments can contribute to exclusion and marginalization of some residents with dementia especially as their cognitive function declines (Kemp et al, 2012; Perkins et al, 2012).…”

Providing culturally appropriate residential dementia care for older adults with an Indian heritage: Perspectives from Sydney‐based stakeholders

“…Resident CaLD demographics change over time, as do care staff demographics. Training programmes need to keep abreast of the cultural makeup of present‐day resident populations, who migrated historically to specific geographic areas, in comparison to the CaLD groups represented by the present‐day care staff populations, who migrated more recently (Du Toit et al, 2020). Additional culturally specific information is needed to gain a deeper understanding of residents' beliefs, values, and interests.…”

“…The number of older immigrants (someone living permanently in a country not of their birth), including those living with dementia, is increasing internationally (Kong et al, 2010). Populations of ageing migrants and non‐English speaking older persons with dementia are rapidly growing in developed economies where the majority of people speak English (du Toit et al, 2020).…”