Explanatory models and openness about dementia in migrant communities: A qualitative study among female family carers.
Background The prevalence of dementia is increasing among people with a Turkish, Moroccan and Surinamese-Creole background. Because informal care is very important in these communities, it is pertinent to see what explanations female family carers have for dementia and whether they can discuss dementia openly within the community and the family. Method Forty-one individual interviews and six focus group interviews ( n = 28) were held with female Turkish, Moroccan and Surinamese Creole family carers who are looking after a close relative with dementia, and who live in The Netherlands. Qualitative analysis has been carried out, supported by the software MaxQda. Results The dominant explanations of dementia given by the female family carers interviewed are in line with what Downs et al. describe as the explanatory models 'dementia as a normal ageing process' and 'dementia as a spiritual experience'. In addition, some female family carers gave explanations that were about an interplay between various factors. Turkish and Moroccan informal caregivers ascribe the causes of dementia relatively often to life events or personality traits, whereas Surinamese Creole caregivers frequently mention physical aspects, such as past dehydration. However, the explanatory model 'dementia as a neuropsychiatric condition', which is dominant in Western cultures, was rarely expressed by the informal caregivers. The female family carers generally talked openly about the dementia with their close family, whereas particularly in the Turkish and Moroccan communities open communication within the broader communities was often hampered, e.g. by feelings of shame. Conclusions Female family carers of Turkish, Moroccan or Surinamese Creole backgrounds often consider dementia as a natural consequence of ageing, as a spiritual experience, and/or as an interplay between various factors. They feel they can talk openly about dementia within their close family, while outside the close family this is often more difficult.
Dutch Alzheimer Association, Amersfoort, the Netherlands.
Nienke
N
van Wezel
Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands; Department of Public and Occupational Health, EMGO+/VUmc, Amsterdam, the Netherlands.
Anneke L
AL
Francke
Department of Medical Psychology, VU University medical center, Amsterdam, the Netherlands.
Emine
E
Kayan Acun
Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands; Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, the Netherlands; Pharos Knowledge and advisory center, Utrecht, the Netherlands.
Walter Ljm
WL
Devillé
Pharos Knowledge and advisory center, Utrecht, the Netherlands.
Nies J
NJ
van Grondelle
Alzheimer Nederland, Amersfoort, the Netherlands.
Marco M
MM
Blom
D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D003704:Dementia / Q000208:ethnology* / Q000451:nursing; D054242:Emigrants and Immigrants / Q000523:psychology*; D005190:Family / Q000208:ethnology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D008875:Middle Aged; D009018:Morocco / Q000208:ethnology; D009426:Netherlands / Q000208:ethnology; D036301:Qualitative Research; D013532:Suriname / Q000208:ethnology; D014421:Turkey / Q000208:ethnology; D014930:Women / Q000523:psychology*
communication; dementia; explanatory models; family care; immigrants; openness