Truswell D (2023) Peace of Mind. Journal of Dementia Care 31(5)30.
Cheryl Jackson, who runs Peace of Mind Home Care Solutions, tells David Truswell how her agency provides culturally competent domiciliary care to the African-Caribbean Community Peace of Mind Homecare Solutions is a small domiciliary care agency based in north-west London, supporting people in the community. The service rehabilitates people back into the community after a stay in hospital. Approximately one third of the people supported at any given time are from an African-Caribbean background which on average includes six or seven service users living with dementia. Many African-Caribbean people do not access dementia services for various reasons. Dementia is still considered a taboo subject, with many families hiding the illness and not seeking support from local services. Many African-Caribbean people who do not have children to support them tend to get lost outside the system. Once people have been given the diagnosis they are often left to cope alone, until an incident occurs or they are in crisis, which usually results in an admission to hospital via Accident and Emergency. A lot of the people we now see developing dementia are from the Windrush generation. One of the things Peace of Mind has found is that the same values and core strengths that got people through moving to the UK and helped them to survive once they were here, are hindering them now, such as wanting to be independent and self-reliant, telling themselves, “I can do this on my own.” People from the Caribbean are very proud and will say, “We are OK. We don’t need help.” But in all the cases we see it’s clear they do need support and they are struggling, but find it really difficult to ask for help. One of the ways we make a difference is by recognising the importance of culture. When we go to see a family, 70% of the issues that would normally arise disappear because we are coming from the same cultural perspective. For example, the majority of the households we visit with older Caribbean people will expect the workers to wear shoe covers in the house. They expect it to be automatically understood that there is one cloth for cleaning the upper body and a separate cloth for personal hygiene for the lower body. They expect the worker to know about creaming the skin. Each family will have its own idiosyncrasies in what they consider to be appropriate behaviour. An important part of our staff training is on-site, in people’s homes. When we employ a non-Caribbean member of staff they are accompanied by a Caribbean staff member as part of their induction to show them how to behave and what they are expected to do when they enter a Caribbean home. Hands-on coaching and shadowing with experienced Caribbean staff from the start has proven invaluable to make our service successful for Caribbean families. All new staff have online training as well, to provide extra support in understanding people’s idiosyncrasies, but much of this cannot be taught online. People learn better when they encounter real people. Providing a domiciliary service involves catering for each community, all of which will have their own ways of doing things. Having staff from the same cultural background not only helps deliver culturally inclusive care but, through feedback and onsite coaching, also supports the rest of the organisation to understand what is important to people. More information on Peace of Mind Homecare Solutions can be found at https://www.peaceofmindhcs.co.uk
David Truswell is a writer and researcher on the impact of dementia on Black, Asian and minority ethnic communities