Special Aspects of Dementia for Hispanics

• If age and educational status are controlled, ethnicity does not appear to be associated with dementia

  • the original studies indicated lower rates of dementia in Hispanic populations but later study results are inconclusive.
  • some experts recommend using a MMSE threshold of 18 in elderly Hispanics (instead of 23) to determine cognitive impairment
  • about half of dementia in Hispanics is attributed to Alzheimer's disease

   

• Family members may be ashamed of the symptoms and seek to protect the patient by hiding or minimizing symptoms

  • cognitive decline and other symptoms are likely to be perceived as normal aging, particularly early in the process
  • symptoms may be regarded as the result of previous evil deeds by the individual or family members, or attributed to the evil eye inflicted by an enemy (el mal de ojo), or to mental illness (nervios)
  • They may also persistently seek a medical explanation/cure and find the diagnosis particularly difficult to accept

   

• Multiple members of the extended family and trusted others are likely to be involved in decisions and the provision of health care

  • if dementia is regarded as punishment for sin, family members may feel obliged to accept caring for the patients as penitence
  • both person spiritual beliefs and church communities are important influences on health care decisions and resources
  • external agencies may be regarded as inappropriate, not-attuned to cultural needs, or as potentially hostile, especially if family members or others are undocumented
  • patients are likely to be cared for within the family and not admitted to long-term care institutions
  • patients and families may use complementary and alternative medicine (CAM) preparations and/or healers in place of or in addition to conventional medicine.
  • the care plan has to allow for the respected role of the elderly in the family and community, especially if the patient is the matriarch
  • care options may be limited by poverty, legal immigration status, transport problems, language and cultural factors, educational status and social factors
  • medical comorbidities, especially diabetes may have to be incorporated into the medial plan
  • reliable data on medications for dementia are limited in elderly Hispanic patients

   

Minority: Elderly Minorities | Minority Groups | Significance | ETHNICS | Factors | Beyond the Words...
Hispanic: Health Care for Elders | Health Problems | Managing Health Problems | Aspects of Dementia
African-American: Health Care for Elders | Managing Health Problems | Aspects of Dementia