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Supporting the migrant workforce
How cultural background
affects dementia care.
By Conor Burke
I
n high-income countries like Australia,
nursing and aged care workforces are
increasingly multicultural. In Australia,
about 32 per cent of RACF workers were
born overseas. In similar nations, such as
the UK, figures are as high as 40 per cent.
These workers have been essential to the
aged care workforce, filling significant staff
shortages and reflecting the multicultural
make-up of aged care residents.
However, migrant workers bring
with them differing levels of dementia
understanding, and this can affect many
facets of care.
Some literature has found differing
perceptions of dementia in different cultures.
For example, some cultures view dementia
as an embarrassment or dishonourable, or
even just a part of normal ageing.
Some cultures, such as those in the
Middle East, have no definitive definition
of dementia at all.
Bola Adebayo, a migrant herself and
Curtin University academic, has recently
published a paper looking into the dementia
care experiences of the migrant workforce.
“[In some cultures] the perception of
someone having dementia is very different
to the perception in the Australian setting.
People think people with dementia are
witches, or that it’s a normal ageing
process,” she said.
“But when I migrated to Australia, I
thought it’s very different. Dementia is
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really a medical condition … and relating
back to my experience in Africa and with
people I’ve talked to, I realised that culture
might affect the way people provide care.”
Through a series of interviews for her
PhD, Adebayo found that some migrant
aged care workers had no prior knowledge
of dementia as a formal medical condition.
And as well as affecting the level of care
they are able to give, it can frustrate the
worker and cause migrant workers to leave
the sector.
“When they are frustrated, and they lack
the knowledge, they don’t really know how
to work with someone with dementia. This
can lead to frustration and can affect their
retention, their turnover in residential aged
care facilities,” Adebayo said.
Some migrant workers also experience
challenges adjusting to workplace cultures,
and they can often face discrimination
from other staff and residents.
The paper referenced a study that found
“21 of 35 participants who were migrant
care workers employed in Australian RACFs
had experienced negative reactions from
the residents with dementia due to their
visible differences, particularly workers
from African backgrounds”.
Language and accents also act as
barriers to care for these group of
workers, as it can make understanding and
communication with colleagues difficult.
Adebayo suggests more needs
to be done to provide support for
migrant workers. Her study found that
organisational resources to support
migrant workers were strongly linked
to retention.
“I think we need to be majorly providing
language support and educating not only
the migrant care workers but the native-
born care workers from the mainstream
communities to be tolerant, to be patient,”
she said.
“And also, the aged care management
providing support will diffuse the issue of
communication difficulties in the aged
care sector.”
Providing this support and education
is key to improving retention of this vital
aged care resource. Adebayo’s study
found that migrant workers bring with
them positive and desirable cultural
norms too, such as “caring for and
respecting elders”.
“There are cultural norms of caring,
cultural values of caring for people. This
really impacts on how they work … being
kind, being gentle to them. So, in that
cultural value, it’s a good factor.”
And through her research, she has found
that some residents prefer migrant workers
who are from similar backgrounds and who
share cultural identities.
The research also reported that employers
like to hire migrant workers due to their
“good work ethic, loyalty to the organisation,
and a willingness to work all shifts”.
Overall, Adebayo and her colleagues
believe it is imperative for the sector
to improve dementia and cultural
diversity training of all staff, including its
migrant workforce.
“Studies have shown and people have
seen that migrant care workers bring
different values and contributions to each
care centre,” Adebayo said. ■