Written by Mutsai Hove Bird, Admiral Nurse on our Dementia Helpline.
I feel humbled to have been asked to write about Black History Month and how it links in with issues of the experience of dementia in Black communities. On the back of the disproportionate impact of the Covid-19 pandemic on Black communities and the recent Black Lives Matter movement, I have pondered about the poignancy of writing about Black History Month this year.
Importance of Black History Month
I therefore take this opportunity to introduce and emphasise the continued importance and relevance of Black History Month as a means of reflecting upon and celebrating the history, culture, achievements, and contributions of Black people to this country. In the UK, it has been celebrated in October since 1987. It is usually a month of varied activities like debates, lectures, plays, concerts, culinary events, parades, and storytelling all around the country. These events enable people of different backgrounds to share and celebrate different accounts and insights into shared history and experience from a Black perspective.
Mutsai at last year’s Admiral Nurse forum
Black role models like Mary Seacole
As a Black Admiral Nurse working on Dementia UK’s Admiral Nurse Dementia Helpline, I often get asked where my accent is from. I mention Zimbabwe and we most likely end up talking about its chequered history from colonial Rhodesia to present. The path to a nursing carer for myself and others has been paved by the celebrated achievements of role models like Crimean War nurse Mary Seacole and more recently Dame Professor Elizabeth Nneka Anionwu who challenged the norm of the day to make an immense contribution to nursing. It is sad to note that it has taken over a hundred years for Mary Seacole’s journey from Jamaica to her contribution in the Crimean War to be recognised – even though she served at the same time as, and in a similar role to, Florence Nightingale.
I am often reminded that there are a lot of Black people working in health and social care. They are mostly from communities who have migrated to this country for socioeconomic reasons, including post-war African-Caribbean migrants. With migrations comes aging in a new world, the presentation of certain medical conditions then being tested and experienced in a different cultural context.
The experiences of dementia in the Black community
As well as various perceptions of what dementia is, there are many challenges to be encountered in relation to dementia amongst the various Black communities. While the biggest risk factor for dementia is age, the high prevalence of cardiovascular disease, hypertension and diabetes in African-Caribbean people puts them at greater risk of developing vascular dementia. Dementia may be a new experience for some people, especially if families that migrated to the UK were of working age and did not bring older relatives. In some countries of origin, dementia is viewed more as a normal part of ageing, or it can be viewed as a punishment by God or possession by spirits. This in turn makes it an ‘unpreventable’ condition and contributes to a poor understanding of dementia and how to manage it.
People living with dementia from African/African-Caribbean communities also tend to seek help later in the development of dementia. This means that they may not benefit from early diagnosis support, and often access services when the dementia is quite advanced or when there is a crisis. Barriers to diagnosis include stigma of a diagnosis, worries about being treated fairly and lack of culturally tailored services after a diagnosis.
For first-generation migrants to the UK the experience of migration, and of coping with the lifetime impact of discrimination, reinforces a cultural expectation of resilience that makes individuals reluctant to seek help for health and social care problems. Most recently the Windrush generation’s experiences of racial discrimination by immigration authorities has further reinforced a perception of being discriminated against by other services, including health and social care.
Dementia UK is committed to the delivery of person-centred, culturally tailored care to meet the dementia support needs of families and people from Black communities. Over the years, Admiral Nurses have positively contributed to working with Black, Asian and Minority Ethnic communities (BAME). We still have a lot more to learn about the full impact of dementia on Black communities and how best to offer appropriate support.
As such, Dementia UK is best placed to work in partnership with other organisations to continue exploring the experiences of Black communities, and how our services and others can support their needs.. Recognising Black History Month also offers the organisation, supporters and the families we support, an opportunity to share and celebrate the insights, experiences and cultural diversity of Black communities.
Here is to future Black History Months of shared learning and celebration.
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