Gerontology, Simon Fraser University, Vancouver, Canada.
Clinical Quality & Patient Safety, Fraser Health, Surrey, Canada.
Ethn Health. 2022 Jan;27(1):83-99. doi: 10.1080/13557858.2019.1655529. Epub 2019 Aug 16.
This paper explores the role of immigrant-serving agencies in facilitating access to dementia services and supports provided by dementia service agencies (particularly the health authority and local chapters of the Alzheimer Society) through their propensity to develop trusting relationships between staff and clients. Our research is a qualitative case study of Punjabi and Korean speakers living in the Lower Mainland of BC, Canada. Data are drawn from interviews with 15 dyads of persons with dementia and their family caregivers (10 Punjabi, 5 Korean), six focus groups (one focus group with each of 8-10 older men, older women, and mixed gender working age adults in each community). We also interviewed 20 managerial and frontline staff of dementia service agencies, i.e. the health authority and the local Alzheimer Society ( = 11) and two immigrant-serving agencies ( = 9), each dedicated to either Punjabi or Korean-speaking clients. We adopted the Candidacy framework for understanding access to dementia services and supports and the concept of trust as guiding precepts in this study. Families of persons with dementia are pivotal to identification of a problem requiring professional help, navigation to appropriate services and acceptance of services offered. However, trust in family members should not be taken for granted, since family dynamics are complex. Alternative sources of trusted support are therefore needed. Immigrant-serving agencies are more often instrumental in establishing trusted relationships between their staff and clients, but they often lack detailed knowledge about heath conditions, their treatment and management, and they lack power to implement statutory care. Partnerships between mainstream mental health/dementia services and the community sector have proven successful in increasing the accessibility of specialized resources, while maximizing their combined trustworthiness, accessibility and effectiveness. Such partnerships should become fundamental components of health service strategy and provision for vulnerable and underserved immigrant older adults.
本文探讨了移民服务机构在促进移民获得痴呆症服务和支持方面的作用，这些服务和支持由痴呆症服务机构（特别是卫生当局和阿尔茨海默病协会的地方分会）提供，其通过员工与客户之间建立信任关系的倾向来实现这一目标。我们的研究是对居住在加拿大卑诗省低陆平原的旁遮普语和韩语使用者的定性案例研究。数据来自对 15 对痴呆症患者及其家庭照顾者（10 名旁遮普语，5 名韩语）的访谈、6 个焦点小组（每个社区一个由 8-10 名老年男性、老年女性和混合性别成年工作者组成的焦点小组）。我们还采访了 20 名痴呆症服务机构的管理和一线工作人员，即卫生当局和当地阿尔茨海默病协会（ = 11）和 2 个移民服务机构（ = 9），每个机构都专门为讲旁遮普语或韩语的客户服务。在这项研究中，我们采用了候选资格框架来理解获得痴呆症服务和支持的途径，以及信任的概念作为指导原则。痴呆症患者的家庭对于确定需要专业帮助的问题、找到合适的服务以及接受提供的服务至关重要。然而，不应理所当然地认为家庭成员值得信任，因为家庭动态是复杂的。因此，需要替代的可信赖的支持来源。移民服务机构通常更有助于在其员工和客户之间建立信任关系，但他们往往缺乏关于健康状况、治疗和管理的详细知识，而且缺乏实施法定护理的权力。主流心理健康/痴呆症服务和社区部门之间的伙伴关系已被证明可以成功提高专门资源的可及性，同时最大限度地提高其综合可信度、可及性和有效性。这种伙伴关系应该成为弱势和服务不足的移民老年人群体的卫生服务战略和提供的基本组成部分。
