The experience of structural burden for culturally and linguistically diverse family carers of people living with dementia in Australia.

Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of 'structural burden' to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi-structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo-centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno-specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer-directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno-specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible.

Gilbert AS ，Antoniades J ，Croy S ，Thodis A ，Adams J ，Goeman D ，Browning C ，Kent M ，Ellis K ，Brijnath B ... -  《-》

A qualitative study into the use of formal services for dementia by carers from culturally and linguistically diverse (CALD) communities.

Shanley C ，Boughtwood D ，Adams J ，Santalucia Y ，Kyriazopoulos H ，Pond D ，Rowland J ... -  《BMC HEALTH SERVICES RESEARCH》

Health service access and utilisation amongst culturally and linguistically diverse populations in regional South Australia: a qualitative study.

Javanparast S ，Naqvi SKA ，Mwanri L 《Rural and Remote Health》

Development of a model of dementia support and pathway for culturally and linguistically diverse communities using co-creation and participatory action research.

To develop an inclusive model of culturally sensitive support, using a specialist dementia nurse (SDN), to assist people with dementia from culturally and linguistically diverse (CALD) communities and their carers to overcome barriers to accessing health and social care services. Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and stakeholders. An SDN support model embedded within a home nursing service in Melbourne, Australia was implemented between October 2013 and October 2015. People experiencing memory loss or with a diagnosis of dementia from CALD backgrounds and their carers and family living in the community setting and expert stakeholders. Reflections from the SDN on interactions with participants and expert stakeholder opinion informed the CALD dementia support model and pathway. Interaction with 62 people living with memory loss or dementia from CALD backgrounds, carers or family members receiving support from the SDN and feedback from 13 expert stakeholders from community aged-care services, consumer advocacy organisations and ethnic community group representatives informed the development and refinement of the CALD dementia model of care and pathway. We delineate the three components of the 'SDN' model: the organisational support; a description of the role; and the competencies needed. Additionally, we provide an accompanying pathway for use by health professionals delivering care to consumers with dementia from CALD backgrounds. Our culturally sensitive model of dementia care and accompanying pathway allows for the tailoring of health and social support to assist people from CALD backgrounds, their carers and families to adjust to living with memory loss and remain living in the community as long as possible. The model and accompanying pathway also have the potential to be rolled out nationally for use by health professionals across a variety of health services.

Goeman D ，King J ，Koch S 《BMJ Open》

A longitudinal study of the health and wellbeing of culturally and linguistically diverse caregivers of people with psychosis in Australia.

Despite Australia being an ethnically diverse country, there are limited longitudinal studies of the health and wellbeing of culturally and linguistically diverse (CALD) carers of people with psychosis. An Australian population-based survey found that 22.7% of carers of people with mental disorders were born overseas. This study aimed to explore the demographic profile, social connectedness, psychological health, quality of life, grief and caregiving consequences of CALD carers of people with psychosis over 12 months. This longitudinal study utilised a prevalence survey design and recruited 52 CALD carers who were born in 24 countries outside Australia. A series of validated instruments were administered to assess carer health and wellbeing. Descriptive and inferential analysis of the results suggested that CALD carers experienced social isolation (34.7%), psychological distress (28.9%), moderate grief and caregiving consequences and poorer quality of life than the general population. Younger CALD carers and spouse carers experienced greater negative caregiving consequences than other kinship or friend carers. There were no significant changes in these outcomes over the 12-month period of the study. Ethnic-sensitive interventions are needed to better support CALD carers experiencing negative caregiving consequences, especially younger carers or spouses, within the current level of service provision.

Poon WC ，Joubert L ，Harvey C 《-》