Academic journal article Care Management Journals

Frankly, None of Us Know What Dementia Is: Dementia Caregiving among Iranian Immigrants Living in Sweden

Academic journal article Care Management Journals

Frankly, None of Us Know What Dementia Is: Dementia Caregiving among Iranian Immigrants Living in Sweden

Article excerpt

In quite a short amount of time, Sweden has gone from being a relatively homogeneous society to a multicultural one, with a rapid expansion of immigrants having culturally and linguistically diverse (CALD) backgrounds growing old in Sweden. This is particularly interesting in relation to studying age-related dementia diseases. Research shows that not only do CALD persons with dementia diseases tend to mix languages, have difficulties with separation of languages, or revert to speaking only their native tongue as the disease progresses, but they also show tendencies to experience that they live in the cultural environment in which they were brought up, rather than in the current Swedish one. In this article, we explore findings in relation to one such CALD group in Sweden, Iranians. The article is empirically driven and based on data gathered in 2 separate settings with specific ethnocultural profiles, offering dementia care with Middle Eastern, Arab, and/or Persian profile. Observations were carried out in combination with semistructured in-depth interviews (n = 66). By using a combination of content and ethnographic analysis, 4 main findings related to ethnocultural dementia care were elucidated. These include (a) a wider recognition of people from different CALD backgrounds possibly having different perceptions of what dementia is, (b) a possibility that such ascribed meaning of dementia has a bearing on health maintenance and health-seeking behavior as well as the inclination to use formal services or not, (c) choosing to use formal service in the forms of ethnoculturally profiled dementia care facility seems to relate to being able to "live up to ideals of Iranian culture," and (d) "culture," however ambiguous and hotly debated a concept it is, appears to be a relevant aspect of people's lives, an aspect that is both acquired as well as ascribed to oneself and to others. As such, we argue that culture needs to be further addressed in relation to dementia care in multicultural societies because ascribing culture boxes people in as well as out. In addition, ethnocultural contextualization of dementia care needs to be understood in relation to this because it affects the care provided.

Keywords: dementia; caregiving; illness; disease; ethnoculturally profiled dementia care; culturally and linguistically diverse populations

As far as we know, people have migrated throughout the entire history of humankind. How migration has been constituted has of course differed and will continue to differ in the future. What we do know is that migration has increased in modern times and is projected to rise even more (Emami & Ekman, 1998). In a Swedish context, we can conclude historically that Sweden used to be a nation of emigrants rather than immigrants and it was not until after WWII that this changed, quite drastically. During a relatively short amount of time, from the 1960s to the 1970s and onwards, Sweden has gone from being a relatively ethnic and culturally homogeneous country (even if there of course have always existed age, class, status, and other regional subcultures) to being a multicultural and multiethnic society (Hannerz, 1983). It is estimated that today, nearly 20% of the Swedish population has a foreign background (foreign meaning being born abroad or born in Sweden of two foreign-born parents [Statistics Sweden, 2002, 2014]).

Because Sweden has gone from being a relatively homogeneous society to a multicultural one, the patterns of migration to Sweden have also changed throughout the years. Early migration (1950s-1970s) consisted primarily of labor force migrants (mostly from southern parts of Europe), whereas later migrants more often come from outside Europe and have been mostly refugees and/or asylum seekers. In general, the migration to Sweden has for the last 20-30 years consisted of those seeking asylum and reuniting families (Bäärnhielm, Ekblad, Ekberg, & Ginsburg, 2005; Pooremamali, 2012). …

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