Positive Mental Health Outcomes in Individuals with Dementia: The Essential Role of Cultural Competence.

Over five million people in the United States are diagnosed with some form of dementia, and many more with cognitive impairment remain undiagnosed. In addition, most individuals with dementia experience one or more neuropsychiatric symptoms such as depression, anxiety, irritability, agitation, hallucinations, or delusions at some point during disease progression. The vast majority of individuals with dementia, including those with symptoms of serious mental illness, are cared for in home and community based settings by unpaid caregivers, often family members, who struggle with the daily challenges of providing care and services to someone with dementia. This article will briefly review selected aspects of the need for community care for individuals with dementia and cultural aspects related to dementia and mental health. A detailed case study will illustrate some of the challenges related to the mental health of individuals with dementia living in the community. We specifically discuss culturally competent care, using the example of a Nepalese refugee family caring for a family member with dementia and depression, as a critical aspect of the care plan. Finally, we provide implications for practice for organizations wishing to engage families in a comprehensive system of home-based dementia care.