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To explore barriers in access to dementia care in Turkish, Pakistani and Arabic speaking minority ethnic groups in Denmark. Semi-structured qualitative individual- and group interviews with minority ethnic family carers, primary care dementia coordinators, staff in elderly daycare, and multicultural link workers. Hermeneutic phenomenology was used as theoretical framework. A total of 21 individual- and 6 group interviews were conducted, including a total of 35 participants. On the service user side, barriers in access to dementia care were related to lacking language proficiency and strong cultural norms, including familial responsibility for the care of older family members and stigma associated with mental illness and dementia. On the care provider side, the available formal services were rarely tailored to the specific needs of minority ethnic service users and were often considered inadequate or unacceptable. Care practices and perceived consequences of dementia in minority ethnic communities were heavily influenced by cultural factors leading to a number of persisting barriers to accessing dementia care services. There is a simultaneous need to raise awareness about dementia and the existence of dementia care services in minority ethnic groups, to reduce stigma, and to develop culturally appropriate dementia care options. [ABSTRACT FROM AUTHOR]

Objective: Loneliness has a negative impact on physical health, and rheumatoid arthritis symptoms can lead to social isolation. However, there is a lack of research exploring patients' perspectives on self‐perceived loneliness in everyday life with rheumatoid arthritis. The purpose of this study was to gain insight into the meaning and importance of self‐perceived loneliness among adult patients diagnosed with rheumatoid arthritis. Methods: This study was designed as a qualitative, exploratory interview study using a narrative framework. Semi‐structured interviews were conducted with Danish adults with rheumatoid arthritis. All interviews were recorded, transcribed verbatim, and analyzed within a narrative thematic framework. Results: Ten women and seven men were interviewed, aged between 18 and 73 years and a disease duration between 6 months and 40 years. Three themes were identified during the analysis: (1) explanations of loneliness in everyday life with rheumatoid arthritis, (2) disclosing or disguising loneliness, and (3) feelings of loneliness in social life. Conclusion: The findings from this study show that loneliness can be burdensome when living with RA. Narratives of loneliness can be hard for patients to disclose, so health care practitioners should take responsibility for legitimizing this subject. A narrative approach in consultations may be helpful to support patients and to encourage a dialogue about loneliness in everyday life with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

OBJECTIVES To summarize available tools that can assist clinicians in identifying and reducing or stopping (deprescribing) potentially inappropriate medications and that specifically consider frailty or limited life expectancy. DESIGN Systematic review and narrative synthesis. SETTING We searched MEDLINE (via Ovid SP), EMBASE (via Ovid SP), and CINAHL from inception to December 2017, along with grey literature. We included articles that described a tool to guide deprescribing of medications. PARTICIPANTS Frail older persons and older persons with limited life expectancy. MEASUREMENTS Narrative description of tools. RESULTS: We identified 15 tools and organized them into three main categories: tools (n = 2) that described a model or framework for approaching deprescribing, tools (n = 9) that outlined a deprescribing approach for the entire medication list, and tools (n = 4) that provided medication‐specific advice. The complexity of the tools ranged from simple lists to detailed, step‐wise protocols. The development methodology varied widely, and the methods used to synthesize the tools were generally not well described. Most tools were based on expert opinion. Only four of the 15 tools have been tested in clinical practice (in very low‐quality studies). CONCLUSION: Tools exist to help clinicians deprescribe in frail older persons and those with limited life expectancy. These tools may assist clinicians at various stages in the deprescribing process. However, it remains to be investigated whether use of such tools in practice is likely to improve clinical outcomes or reduce inappropriate medication use. J Am Geriatr Soc 67:172–180, 2019. [ABSTRACT FROM AUTHOR]

Purpose: Older non-Western migrants in Europe are a vulnerable population, due to old age and multiple disadvantages related to language barriers and different understandings of care, health, and disease. Our aim was to gain a better understanding and insight into the care needs of families with refugee background Method: The study was designed as a qualitative exploration using semistructured individual interviews and family group interviews. Results: The results illustrate how vulnerability can “transmit” from one family member to another. Discrepancies between the older person’s expectations and needs and society’s expectations trap family members in ethical and moral dilemmas. This divides and stresses the family and results in difficult decision making, increased stress, and vulnerability. Conclusion and Implication: Migration and displacement can lead to ambivalent feelings among younger relatives regarding their role in caring for older relatives. Health professionals need to address and acknowledge this to be able to provide culturally congruent health care. [ABSTRACT FROM AUTHOR]