title: 'Gotta be sit down and worked out together': views of Aboriginal caregivers and service providers on ways to improve dementia care for Aboriginal Australians.
abstract: BACKGROUND
  Dementia is five-fold more prevalent among Aboriginal than non-Aboriginal Australians. Despite this, the quality of care available to people living with dementia in remote Aboriginal communities is poor. The objective of this study was to determine ways to overcome factors affecting the successful delivery of services to Aboriginal people with dementia living in remote communities, and to their families and communities.
  
  
  METHODS
  This qualitative research took place in the Kimberley Region of Western Australia. Data collection occurred in three stages: (1) interviews with service providers to identify the services available; (2) interviews with the caregivers of Aboriginal people living with dementia and community-based care workers; and (3) focus groups with community representatives and community care staff. Each stage was concluded when no new themes emerged. At each stage the transcribed information was analysed and joint interpretation identified common themes.
  
  
  RESULTS
  In total, 42 service providers, 31 caregivers and community-based care workers were interviewed and 3 focus groups were conducted. Obstacles to accessing quality care were mentioned and recommendations on ways to improve care were made. The key themes that emerged were caregiver role, perspectives of dementia, community and culturally-appropriate care, workforce, education and training, issues affecting remote communities and service issues. Detailed information on how each theme affects the successful delivery of dementia care is provided.
  
  
  CONCLUSIONS
  These research findings indicate that people living with dementia and their caregivers in remote Aboriginal communities are struggling to cope. They are requesting and require better community care. Implementing a culturally safe model of dementia care for remote Aboriginal communities that encompasses the recommendations made and builds on the strengths of the communities could potentially deliver the required improvements to dementia care for this population.
authors.affiliation: WA Centre for Health and Ageing, University of WA, Perth, Western Australia, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Smith
authors.forename: Leon
authors.initials: L
authors.lastname: Flicker
authors.forename: Geraldine
authors.initials: G
authors.lastname: Shadforth
authors.forename: Emily
authors.initials: E
authors.lastname: Carroll
authors.forename: Naomi
authors.initials: N
authors.lastname: Ralph
authors.forename: David
authors.initials: D
authors.lastname: Atkinson
authors.forename: Melissa
authors.initials: M
authors.lastname: Lindeman
authors.forename: Frank
authors.initials: F
authors.lastname: Schaper
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Lautenschlager
authors.forename: Dina
authors.initials: D
authors.lastname: LoGiudice
mesh_terms: D000223:Adaptation, Psychological; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D003156:Community Mental Health Services; D003704:Dementia / Q000628:therapy*; D006266:Health Education; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D019035:Rural Health Services; D012944:Social Support; D014904:Western Australia