Dementia and Aging: Types of Health Delivery, Impacts of Poverty, and Discrimination in Healthcare

This article discusses the types of health delivery for dementia/aging, the impacts of poverty on those with dementia/aging, and the discrimination faced in healthcare. It explores the prevalence of dementia in Australia, the types of healthcare services available, the effects of poverty on mental health, and the importance of cultural safety and person-centered care. The article also highlights the experiences of discrimination faced by Indigenous Australians and the need for healthcare providers to adhere to codes of ethics and conduct.

Running head: HEALTHCARE ASSESSMENT TASK 2 1
PROFESSIONAL PRACTICE AND CULTURAL SAFETY
Student Name
Institution Affiliation
Facilitator
Course
Date

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DEMENTIA/AGING
Introduction
Dementia is a health condition where the affected people lose cognitive functioning like
memory, thinking and the ability to reason properly (Alzheimer's Association, 2014). These
people can also be affected in terms of behavioral abilities such that they can’t perform their
daily activities as expected of them. Some of the functions which are reduced include language
skills, qualitative problem solving, focus, paying attention, visual perception and personal
management among other personal activities.
In Australia, dementia is termed as the second leading cause of death. Dementia causes
approximately 17 percent of deaths annually. 5.8% of the total deaths are men and 11.3% are
women (Thomson et al, 2014). Australia Institute of Health and Welfare statistically suggests
that above 400,000 people are living with this condition of dementia. The number of people
joining this condition on a daily basis has increased from 250 to 318 and this suggests that by
2028 more than 500,000 people will be having dementia. Among the 55% of these people are
women. In the aged health care facilities, 50% of the people are living with dementia (Moyle,
Murfield, Griffiths, &Venturato, 2012).
Chances are that this condition is more prevalent among the aged than young people. It is
evident that every 10 people above 85 years of age three are affected and among every 10 people
above 65 years of age 1 person is affected (Gurgel et al, 2014). Between the range of 45 years to
65 years only 1 person among 100 is affected. Below the age of 45, it is said that about 1 person
in a population of 1000 is affected. Dementia is more prevalent among people of lower social
class than that of the higher social class (Lund et al, 2010). In Australia, the most marginalized
groups like Indigenous people are at a higher risk as compared to other groups. Kimberly

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Indigenous people are five times at a higher risk as compared to all other locations. North
Queensland, dementia prevalence is at 20% higher for the indigenous people.
Types of health delivery for dementia/aging
Primary care and community service
In this kind of a setting, the aged or people living with this non-specific disease are taken
care through home healthcare support, home services by professional nurses and community
nurses in accordance to their codes of ethics and codes of conduct (Robinson et al, 2013). The
primary healthcare providers include pharmacists, practitioner and community nurses,
professional nurses, Aboriginal health providers, allied health providers, dentists, and other
specialists.
A couple of assumptions are made which underpin this kind of healthcare services (May,
2013). The healthcare providers assume that the users might behave unpredictably or childish but
they still have adult feelings and hence they should be treated like grown-ups. Better health care
is needed for them because this condition worsens unconditionally and the aged might become
more insecure over time. It is also assumed that despite the loss of ability to conduct many
activities, these people still have the remaining skills and the health care providers are needed to
focus more on them to keep their dignity and care. It is assumed that they have memory issues
and they shouldn’t be forced to remember anything. It is assumed that their condition would
deteriorate with time and thus, they become more opposing and reliant on the care offered by the
providers. Providers are also assumed that they know how important they are to the dementia
patients and hence their conduct, demeanor and abilities determine the personal health condition
of the aging people.

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Types of health care delivery in dementia/aging and their underpinning principles
There are different types of healthcare delivery services for the aged in Australia
basically residential healthcare program and community-based (home) care program (McGorry,
Bates, & Birchwood, 2013). They are always supported by some principles so that they can
ensure cultural safety and person-centered care is achieved at its best. Culturally safe practice is
intended in the improvement of life and the wellbeing of the Australians who have different
beliefs and cultural practices from the others through different ways. It is done through the
emphasis on positive wellbeing and lifeways for better results. Insurance that there is recognition
of those practices and beliefs and the way they vary in all aspects including, financial status,
gender, employment status, religious inclinations, disability and by generation.
The aim of the culturally safe practice is an improvement on the way the health services
are administered by ensuring they shelter the providers culturally (Luquis, 2013). Through that,
they recognize the importance of a special relationship between the people and the experts
involved in service use and delivery respectively. The providers work hand in hand with others
after accepting to perform a safe service after undergoing an examination institutionally and
personally of the power of the relationships. Encouraging the clients of the services. Individuals
ought to have the option to express degrees of wellbeing based on safety or risks. For instance, a
genuine intervention is needed for the people who feel unsafe of the services offered to ensure
they benefit fully. Preparation of the healthcare providers to appreciate the diversity in a certain
social fact and the effects on any individual who is different from them. Sociology should be
applied to support the actions of all the service provision.
The application of cultural safety is broad. It recognizes the employment, social
interactions, wellbeing, and educational disparities within different communities. This principle

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also addresses the impact and course relationship of political, social and history of educational,
employment, housing and gender experiences on the people who use psychological issues. Social
insurance practice is about adequate relation and relation to individuals who have different needs
and qualities such that the others who use the service are safe.
Impacts of poverty on those with dementia/aging
According to the World Bank Organization, poverty is encompassed by the deprivation
of the basic needs such as food, access to clean water, shelter, healthcare and less or lack of
resources (Allen, Balfour, Bell, & Marmot, 2014). It depends on what setting poverty manifests
itself because of is many faces and diversity. In the case of the people living with dementia or the
aged, poverty is termed as the greatest risk factor. The situation worsens because of the effect it
has on the mental health of the aged and people living with dementia.
People from low social class living with this condition are highly disadvantaged. The
prevalence of dementia among the poor is multiple folds higher than that of the people from a
better or higher social class (Prince et al, 2015). Poverty leads to malnourishment this is because
they can't afford to buy food all the needed supplements to ensure a balanced diet. In comparison
with the people living with dementia in higher social classes, the life expectancy for the poor is
shorter and the gap gets wider and wider as they age.
Risk of other mental illnesses is stated to appear because it’s said that in life expectancies
have been prolonged. Depression and more psychological problems are expected to increase in
the next 25 years amongst the people living with dementia and hence posing a threat of many
premature deaths through suicides or similar cases.

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Females from poor backgrounds living with this condition are said to be in higher risks as
compared to males. This is brought about by the role the community, families, and health
providers and the health care facilities. The negative roles played poverty in these facilities
include; community neglect, stigmatization, and discrimination in healthcare homes, family
neglect, homelessness, abuse, and physical assault. For the whole population living with
dementia lead a very hard life because of many issues; poor dieting, lack of basic care, lack of
healthcare, social isolation, and many other mental issues.
Lack of shelter because of poverty is another extreme negative impact on people living
with dementia. In Australia cases of homelessness has been reported for the aged and the people
living with dementia. The biggest reason being, the aged cannot work or get employment like
young people. They can’t also afford to rent any homes because they don’t get any income or
any funding. The impacts of poverty in people living with this health condition is far much
negative that the governmental and non-governmental organizations should show concern and
try to improve it.
Cultural safety and person-centered care
Consumer experiences against discrimination
In Australia, discrimination in all the healthcare facilities is termed as an unlawful act
whether it is direct or indirect (Harpur, 2010). There are certainly given reasons why a healthcare
provider can discriminate against someone. Most cases it is because of; racism, gender,
disability, health condition, pregnancy, or ageism among others. Equity Law 2010, is an act of
law which acts against any form of discrimination so they can be arraigned in a court of law. It is
evident from different sources that discrimination is rampant amongst most healthcare facilities

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in Australia. Different consumers have had different experiences of discrimination in different
forms like; racism and ageism.
Racism; the Indigenous Australians face a lot of race discrimination in these health care
services because of their cultural beliefs and practices (Sue, Sue, Neville, & Smith, 2019). It
includes the use of stereotypes when describing them, racists names, and use unpleasant teasers.
This has brought about very negative impacts on the health of those who receive these health
care services. Increased cases of depression and self-stigma have been reported. This has led to
poor health among dementia patients who rely on these services.
Ageism; this is whereby dementia patients face separation or the stereotypical separation
due to their ages (Gove, Downs, Vernooij-Dassen, & Small, 2016). Most of the dementia
patients are proved to be above the age of 65. Ageisms occurs differently in levels; personal and
institutional. Study shows that, on a personal level, patients are reported that the health care
providers show bad moods and intentionally show attitudes against the aged instead of being
professional. It is also evident that, institutionally, the care reimbursement methods, clinical trials
participation, and training of the aged on the common skills is discriminative.
Application of the codes and standards
Discrimination cases in Australia against people living with dementia as studied and
discussed is evident (Holt-Lunstad, Smith, & Layton, 2010). It is said to have impacted
negatively the consumers such that; poor education in the health care centers, lack of enough
exposure, and premature deaths due to anxiety has been reported. Nurses are always guided by
well-laid codes of ethics, codes of conduct and other consumer-provider guidelines.
From the different cases reported, the analysis does not fit with the aspects of nurses.
Discrimination is a disengagement which has not been addressed and this goes against the code

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of conduct of the nurses. The code of conduct of the nurses suggests in “principle 4.1 (h): nurses
must actively address indifference, omission, disengagement/ lack of care and disrespect to
people that may reflect under-involvement including escalating the issue to ensure the safety of
the person if necessary”.
Discrimination against Indigenous dementia patients in Australia, their cultural safety,
and person-centered care is much worse (Frampton, Charmel, &Guastello, 2013). This is
because, in accordance with ethics, the care delivery should perceive singularity and uniqueness,
an ensure that it respects the privileges of the patient for it t be termed safe. Their cultural rights
should be observed and respected. In reference to the code of conduct of the nurses, “principle 3
of the code provides the overarching standard that nurses are expected to adopt in their practice:
‘Nurses’ should engage with people as individuals in a culturally safe and respectful way, foster
open, honest and compassionate professional relationships, and adhere to their obligations about
privacy and confidentially.”
According to the code of conduct and the ethics of nurses, “Principle 2.1: Nurses should
apply person-centered and evidence-based decision making for the delivery of safe and quality
care.” This is broken when ageism is displayed in any of the health care facilities because
“partnership with the consumers is the main objective in order to ensure the wellbeing of the
dementia patients no matter their age.”
Conclusion
Dementia is termed the second leading cause of death amongst the aged hence posing a
threat. Health care delivery should be reviewed to ensure that this issue is controlled and it
doesn’t turn out as predicted by the statistics. Women are said to be the most affected by

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dementia hence a course action should be taken to ensure that this gap between the males and the
females is closed.
The most disadvantaged groups due to different issues like poverty-stricken areas should
be put under government health protection to ensure that they don’t face many challenges such
as homelessness and discrimination. Actions should be taken against all the people who
discriminate against others as it is clear in the laws. Cultural safety and person-centered care
should be delivered as it is in line in the code of conduct of the nurses to ensure quality services
and care for these patients.

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