Black, Minority Ethnic and Refugee Communities and Dementia Reflections from Implementing The National Dementia Strategy in London David Truswell Senior Project Manager

Croydon 22% Sutton & Merton 14% Kingston 12% Richmond & Twickenham 11% Wandsworth -2% Waltham Forest 4% Barking & Dagenham -7% Redbridge 17% Havering 24% Tower Hamlets -2% City & Hackney -6% Newham -1% Lambeth -1% Lewisham 0% Greenwich 12% Bromley 21% Bexley 28% Southwark -1% Enfield 18% Camden 18% Islington 0% Haringey 10% Barnet 20% Healthcare for London Dementia Increase Projections Hounslow 8% Harrow 22% Hillingdon 18% Ealing 8% Brent 24% Hammersmith & Fulham 14% Westminster 32% K & C 54% KEY >10% >1% but <10% No change or decrease The scale of changing dementia care needs across London

Percentage increases in the number of people from black and minority groups with dementia by PCT, 2001 to 2021 Taken from Healthcare for London Dementia Service Guide Appendix1: Needs Assessment (2009)

Financial impact PCTNumber of people from BME groups with late onset dementia in 2001 Estimated number of people from BME groups with late onset dementia in 2021 Total IncreaseAddtional Annual cost at £48,306 per annum ($) Total Annual Cost by 2021 at £48,306 per annum ($) Barking & Dagenham $12,559,560$14,588,412 City & Hackney $11,206,992$27,147,972 Islington $4,975,518$12,173,112 Lambeth $11,545,134$30,481,086 Lewisham $16,762,182$28,114,092 Newham $24,732,672$41,011,794 Southwark $15,216,390$26,906,442 Tower Hamlets $11,206,992$24,056,388 Wandsworth $8,791,692$21,641,088 Central London (Overall Dementia Rate Declining) $116,997,132$226,120,386 London Total $448,279,680$813,762,876 UK Average cost of residential care in 2011/12 is $48,306 per annum

Why is this a particular concern for black, minority ethnic and refugee (BMER) communities? 1.In London, home to 45% of the total UK black and minority ethnic population, the numbers of those aged 65 and over in the BMER population are expected to triple between 1991 and Within these broad trends there is projected to be a substantial increase of older people in some BMER populations, notably the Indian and African-Caribbean populations, reflecting historic migration patterns into the capital 3.Lack of awareness as well as social and cultural factors militate against help seeking behaviours in BMER populations, especially for mental health problems 4.There is an expectation of discrimination and/or lack of cultural competence from mental health services by BMER populations 5.There are known predisposing health factors e.g. South Asian and African Caribbean groups are at increased risk of developing vascular dementia - the second most common form of the dementia - due to enhanced levels of diabetes and hypertension 6.Professionals’ assumptions about lifestyle and care giving cultural norms of BMER communities may inhibit help-giving behaviour 7.Use of appropriately standardised diagnostic tools in assessments needs to be considered

Stigma Factors affecting service access Information Access to Services & Support Community Engagement

What would organisations working with dementia in BMER communities like to see? Raise awareness that will advise and inform relevant regional and national bodies Develop an expert reference group for BMER issues and dementia services for London Ensure expertise of BMER communities is recognised and valued Improve clarity on accountability structures for commissioners Improve the role and financial stability of 4 th sector organisations (4 th Sector = small BMER grassroots groups that struggle to secure funding) Larger 3 rd sector organisations need to work more closely with the 4 th sector Improve promotion of the work of providers who demonstrate good practice

System wide benefits of improving focus on BMER groups Use of Community Services A & E access Use of In-patient Services Rate of access to Residential Care Carer Use of Health Services

Ethnic-and-Refugee-Communities/ This Facebook Page is to provide a networking and information sharing forum for organisations working to support people from Black, Minority and Refugee communities living with dementia and their carers.

Dementia & Minority Ethnic Communities and Dementia Awareness Project  Working across 6 London Boroughs – Westminster, Harrow, Hillingdon, Barnet, Brent, Enfield, Islington  In partnership with major 3 rd Sector organisations – Dementia UK and Alzheimer's Society  Establishing contacts with local community organisations – Culture Dementia UK and Chinese National Healthy Living Centre  Developing locally sourced information material and exploring multi- media platforms  Deliberately eclectic

Contact Details David Truswell Senior Project Manager, CNWL Mobile: or via Linked-In