The memory issues are common among the aging population. Many of those who experience problems with memory and thinking address the health and social care services for help. However, it is observed that often patients fail to receive the timely diagnosis for different reasons. The recent research has proved that the cultural and demographic backgrounds affect the diagnostic procedures to a large extent (Whaley, 2011). It takes a different amount of time to diagnose dementia in patients of distinct ethnic groups, social and financial status. The lack of understanding of the cultural aspects in diagnosis affects the efficiency of the healthcare response. It is thus important to comprehend how the different factors affect the diagnosis seeking processes.
Client’s Demographic Background
The client who addressed for assistance in seeking diagnosis and obtaining the information related to the dementia issues is the African American person, Horace Milton. Mr. Milton is 54, and he currently lives in New York, NY. He moved to the USA from Namibia, Africa, when he was 22 years old. He lived in New York ever since, got married at 26, and has two children. Although he lives in America for thirty-two years, he couldn’t reach the complete assimilation into the local culture. Mr. Milton honors the traditions and customs of his homeland, and he belongs to the Evangelical Lutheran Church.
Mr. Milton has only eleven years of education; he doesn’t have a degree and specialization in any field of knowledge. Throughout life, he worked as a janitor, driver, and shop assistant. Nowadays, he is a carpenter, and he enjoys his work although it doesn’t bring a large profit. For a long time, he saved money for his children’s education. Therefore, he couldn’t afford the health insurance and tries not to attend health care settings frequently.
Mr. Milton and his wife rent a small apartment in Brooklyn. He works nine hours a day and has one or two days off a week. He is interested in woodwork and enjoys attending dance evenings in the local cafe with his wife. Writing small stories remains his biggest interest for a long time, but the progressing memory problems cause disturbance for the creative process. The memory issues emerged nearly a year ago and had induced the difficulties in thinking, mental focusing, and writing.
Recommendations and Interventions
In the majority of cases, the causes of dementia are unknown. The causes seem to depend on multiple factors with implications of “age, genetic susceptibility, environmental factors, diet, and general health” (Harrison-Dening, 2013, p. 131). The disease may have various manifestations. Lack of attention, problems with writing, and comprehension that the client has recently experienced may be considered as the first symptoms of dementia. It is recommended to pass the Mini-Mental State Examination to detect the degree of the damage to health and find which of the brain areas is affected most (Folstein, Folstein, & McHugh, 1975).
Overall, the dementia diagnosis is a long-lasting process, and it involves some tests and assessments. It is especially difficult to detect dementia at the early stage of development. Mr. Milton needs to attend the memory assessment services and visit neurologist and psychiatrist for testing and evaluations.
The attendance of the cognitive training classes and taking medicine are recommended for the patients with memory issues (Memory loss, 2004). The drugs Dopenezil is used in dementia treatment for several decades. The medicine is recognized as one of the most efficient. It helps “to slow the process of decline and reduce neuropsychiatric symptoms and functional impairment in some people with dementia,” and the patients thus need to commence taking it early (Harrison-Dening, 2013, p. 134). The psychosocial interventions are also essential because they are meant to improve the quality of a person’s life and performance as well as reduce the threats of the following disability.
The combination of the pharmaceutical and non-pharmaceutical interventions together with the constant observation by health and social care services’ representatives will help Mr. Milton to reduce the negative impacts of memory and cognition issues on his life and functioning and prevent the rapid evolvement of the disease.
Strengths
Since for the majority of people with dementia the efficient social functioning and communication abilities are limited, any kind of assistance in everyday life performance is of significant help. In Mr. Milton’s case, the family support is the main strength that contributes to the healthcare plan fulfillment. “Dementia affects the whole family, and people close to the person with dementia find themselves providing increasing amounts of care and support as the disease progresses” (Harrison-Dening, 2013, p. 133). The raise of awareness regarding the dementia issue and care planning among the family members must take place along with the processes of the disease investigation.
Barriers
The researchers observe that dementia is “imposing huge societal economic burdens, both through direct (medical and social care) and indirect (unpaid caregiving by families and friends) costs” (Wimo et al., 2013, p.2). Therefore, low-income and the absence of the health insurance coverage can be considered a significant barrier in testing, conditions’ assessments, and the further treatment procedures conduction. The lack of resources for coverage of expenses can prolong the diagnosis. Low incomes and inability to cover costs can slow down or postpone the treatment. Therefore, Mr. Milton needs to find the sources of financial support from his family and community members, social services, and government.
Cultural Recommendations
It is proved by researchers that the duration and the results of the diagnosis-seeking efforts depend on the ethnic, cultural, and racial factors. According to Schrauf and Iris (2011), “African Americans and Hispanics experience longer delays in dementia diagnosis than do whites” (p. 743). Mr. Milton may likely experience this kind of challenges while following the healthcare plan. The main causes for the exceeded diagnosis seeking duration are considered to be “normalization of symptoms and physician under-diagnosis” (Schrauf & Iris, 2001, p. 759). And these factors appear in the low-income families more frequently, especially when a patient needs caregiving support from the members of his family.
It is also proved by another research that African Americans often mistrust the psychiatric testing results because of the abuse of the clinical information in the past (Whaley, 2012). It creates hindrances for the diagnosis and treatment effectiveness as well. Mr. Milton was recommended to approach his testing indications with a greater responsibility and was informed about the necessity of the repeated assessment procedures. The client accepted the given information calmly and agreed to follow the plan.
Conclusion
The consideration of the client’s demographic background helps to make the appropriate recommendations. The client-oriented approach increases the efficiency of the diagnosis. By addressing the cultural and social aspects of the patients’ life, the social workers can avoid and prevent the risks of the failure in providing the healthcare services required for the person’s health sustainability and well-being.
References
Folstein, M., Folstein, S., & McHugh, P. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Psychiatric Research, 12(3), 189-198.
Harrison-Dening, K. (2013). Dementia: diagnosis and early interventions. British Journal of Neuroscience Nursing, 9(3), 131-137.
Memory loss; researches to take on memory issues in older adults. (2004, May 29). Obesity, Fitness & Wellness Week. Web.
Schrauf, R., & Iris, M. (2011). Very long pathways to diagnosis among African Americans and Hispanics with memory and behavioral problems associated with dementia. Dementia, 11(6), 743-763.
Whaley, A. (2012). Psychiatric and demographic predictors of memory deficits in African Americans with schizophrenia: The moderating role of cultural mistrust. Psychiatric Quarterly, 83(2), 113-126.
Wimo, A., Jonsson, L., Bond, J., Prince, M., & Winblad, B. (2013). The worldwide economic impact of dementia 2010. Alzheimer’s & Dementia, 9, 1-11.