Making long term care multicultural

Care for British Columbia dementia patients needs to improve, says Habib Chaudhury. Right now, he says, the main focus is on physical health, on keeping patients fed and pain-free. But a patient, even an elderly one in care, is more than a body.

Person-centred care, a movement that started twenty-five years ago, look[s] at a person in a more holistic way, not only the physical, biological needs but also the psychosocial, spiritual care needs,” says Chaudhury, chair of the Department of Gerontology at Simon Fraser University and one of the organizers of an upcoming symposium on dementia patients. “The care model talks about the importance of personal dignity, choice, preference, [and] life history. These are considerations that need to be taken into account.”

The symposium, Person-Centred Care for Older Adults with Dementia in BC and Hong Kong, looks at the issue of this type of care in care homes in British Columbia as well as in the autonomous territory of Hong Kong. It will take place May 6 and 7 at downtown Vancouver’s SFU Harbour Centre.

Dementia and dignity

Within the care home population, 60–70 per cent of [those] who live in care homes have some level of dementia,” says Chaudhury.

Habib Chaudhury is one of the organizers of an upcoming symposium that will examine issues surrounding the care of dementia patients. | Photo courtesy of Health Ministry of Victoria

He also points out that care of these patients − rather than on helping to keep them calm and happy − has mainly focused on bio-medical problems, and feeding and clothing them.

“One of the techniques is understanding the psychological reality of the person,” continues Chaudhury. “Quite often people with dementia regress back in time. They may think they’re still working. If that is happening, [saying] ‘You are no longer working; you are in a care home.’ is not going to help at all. [You need to] connect with that person at his or her reality; say, ‘Yes, let’s wait for the bus.’ They may come back to the true reality.”

Staff in care homes must be better educated in these techniques and more aware of biographical information and life history including cultural and psychosocial issues, says Chaudhury.

“Vancouver has a large Chinese-Canadian population, which is reflected in care homes. People with dementia cannot communicate verbally,” says Chaudhury. “It’s important to know their preferences through their history, through working with the family [and] social circle.”

Dementia patients should be treated with dignity, says Chaudhury, and with an awareness of the language, food, cultural beliefs and issues that they have experienced throughout their lifetime.

“Some people may want to have a shower or bath before going to bed at night,” he notes. “Do we have flexibility to provide the bath at that time as opposed to our own routine? Can somebody sleep in and have breakfast at 10 am as opposed to 8 am?”

Residents and robots

The symposium gathers together researchers, policy-makers and practitioners to share ideas and research surrounding people with dementia, says Chaudhury. There is “work on falls in care homes, and flooring to reduce the impact [and on] mak[ing] the space more homelike. If I create a residential kitchen, the patients might try to do things they have done over many decades in kitchens, wash dishes, cut vegetables.”

There’s research on calming techniques as well, adds Chaudhury.

“PARO is a robot baby seal: the person with dementia may become calm as they pat the robot, and the robot responds in a positive way,” says Chaudhury.

Specific cultural issues will also be addressed.

“SFU has a partnership with Hong Kong Polytechnic University,” says Chaudhury. “We will create a platform between Hong Kong and Vancouver [to learn] what activities have worked in Hong Kong.”

This symposium will allow fruitful communication about person-centred care, says Chaudhury.

“If you talk with care staff they will tell you it’s important but there are practical challenges, lack of staffing, work that they have to do which doesn’t give much time for additional thinking,” he comments. “We are very excited about this event.”

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