Dementia Care

Vol 5 No 6 December 2016/January 2017

Australian Journal of Dementia Care

ritualistically ingrained habits and

patterns of their past life history, but these

rituals can be seen as very ‘foreign’ and

‘odd’ behaviours for outsiders or those

who are not culturally competent. This

stigma is exaggerated if the person is

living with dementia and reverts to

communicating in their first language,

which is not familiar to those caring for

them, and is unable to explain their wishes

to maintain the practices of their youth

(such as religion and dining). As a result,

these cultural considerations are often

neglected by staff.

Creating a home for CALD residents

If an aged care facility has a dominant

culture and information about the

minority ethnic population is ignored or

not known and catered for, it can lead to

isolation, stigma, depression and

decreased health among residents in the

minority group (Valle 1989). Our board

and management have focused on

ensuring that the dominant Italian culture

and design of our care homes doesn’t lead

to social isolation for residents from other

cultures.

Daily activity programs provide

meaningful lifestyle options for residents

of all cultures, religion or shared life

experiences (eg refugees or war veterans).

The village cultural coordinator

establishes what each individual wants, in

collaboration with the resident and/or

relatives and by observing how they react

to different leisure and lifestyle activities.

We emphasise to all care staff,

contractors, architects and builders

working with the organisation the need for

culturally sensitive design and care

practices. The Italian phrase ‘sono io’

means ‘this is me’ and is a philosophy of

cultural practice that’s being rolled out

across all Scalabrini Villages and to all

staff. It is also included in all our lifestyle

programs and briefs for environmental

design, including the newDrummoyne

facility. Our CEO, Chris Rigby, and

Director of People, Learning and Culture,

Elaine Griffin, conduct workshops for staff

in every village to show that we are

committed, from the board down, to the

‘Sono Io/This is Me’ philosophy.

Keeping culture in mind

Cultural heritage assessment is an

important part of the admission process in

all our care villages. A23-question

assessment form is used to create a

personal profile of each resident and

ensure their cultural needs are captured

and included in daily practice. We look at

each person as an individual and know

their history, including where they

worked, where they lived, their spiritual

needs, what they like to do, how they best

like to relax etc.

We employ multilingual staff; set up

each person’s room in a style that is

culturally familiar to them; ensure lifestyle

activities suit their needs; give each staff

member a list of behaviours or actions we

expect them to display in every interaction

with residents; distribute dementia-

friendly language guides; and have trained

ambassadors in each village to promote

adoption of the ‘Sono Io’ approach.

This philosophy of meaningful cultural

competence helps prolong memory and

facilitate reminiscence, increases staff

awareness of the history of the person and

increases cultural pride for residents of all

nationalities (Cohen &Moore 1999).

Creating culturally appropriate

living environments

People living with dementia need an

environment they can relate to. The built

environment should enrich life and

provide opportunities for personal

growth. Aculturally familiar home-like

environment is generally the most

comforting and positive environment for a

person living with dementia.

People with dementia from non-English

speaking backgrounds often feel agitated

and restless in care homes that are not

culturally-specific because their

surroundings look and feel unfamiliar

compared to their own culturally-friendly

home.

It is often the practice for designers to

propose highly abstract and decorative

cultural references in aged care facilities,

but in my experience these have little

value for people living with dementia who

are unable to either recognise or appreciate

such abstract meanings in the art work or

design.

Accommodating cultural heritage in

residential aged care settings requires

sensitive spatial organisation. The physical

environment should support culturally-

based lifestyles and rituals. One of the

ways we do this is by providing kitchens

and living rooms where families can join

residents, volunteers and staff to cook and

gather together – just as they would in the

family home. For example, we now have

residents, who previously spent most of

their time sitting in front of a television,

involved in pasta making.

Another point to remember when

designing and decorating care

environments for CALD residents is don’t

assume that all people from a certain

culture like the same icons or observe the

same religion. For example an Italian

person may not feel that a picture of the

Colosseum has any relevance for them,

just as anAustralian may not be bothered

looking at photos of kangaroos.

We ensure that language, cultural

competence and relevant environments for

people with dementia are front of mind

when refurbishing our existing buildings

and designing new ones. Our signage

illustrates this. Signage assists residents

with wayfinding and navigation, thus

lessening anxiety and frustration.

However, these signs (eg ‘kitchen’, ‘dining

With the support of Scalabrini Village staff, this resident regularly attends the nearby

Australian Baha'i Temple in Sydney

Signage assists wayfinding, but must be in

words and pictures that are familiar to, and

in the language of, the care home residents

– not just in English.