Alzheimer\'s: Healthcare Access in Saudia

ALZHEIMER'S: HEALTHCARE ACCESS IN SAUDIA ARABIA

Alzheimer's

The research questions this study is aiming to address are the following: (1) what are the barriers for the use of an Alzheimer Disease (AD) community day care center in Saudi Arabia and (2) what community service factors are associated with quality of life?

Alzheimer's disease (AD), together with other forms of dementia, represents a major challenge for health care systems with aging populations. In particular, the debilitating effects of the disease can sometimes have a negative influence on the ability of patients and their caregivers to gain access to needed services.

To help reveal what barriers to healthcare access would be overcome if Alzheimer's community services were to be implemented in Saudi Arabia, the experiences of AD patients in a Baltimore, Maryland clinic will be assessed using survey instruments. The primary focus of the research will be on what healthcare service factors are associated with quality of life measures among ethnic minorities. This focus is based on the observation that Alzheimer's services tend to be underutilized by minorities because elder care is assumed to be the responsibility of the family. This phenomenon has been observed among Asian-Americans caring for elders suffering from dementia (Chow, Ross, Fox, Cummings, and Lin, 2000).

Arabic cultural norms and expectations would be predicted to have a similar insulating effect between families caring for elders with dementia and care providers. Cultural norms in Arabic culture tend to emphasize family responsibility for providing care and a respect for elders. Given these norms, Arabic families would be expected to be more engaged in providing care for elders compared to other ethnic minorities. Such cultural traditions tend to deemphasize the need to maintain social independence for AD patients, which is a focus of community AD services.

Research Design

The research was conducted in 40-day care centers located in Baltimore County. A total of 510 newly admitted Alzheimer patients agreed to participate in the study and filled out the questionnaire during their first visit to the day care center. A follow-up survey was conducted two months later using the same instrument.

Study participants also completed an instrument designed to identify barriers preventing community services from being utilized, from the perspective of patients and caregivers. The instrument also assessed whether access to community services impacted the patient's quality of life.

The research design was based on the Trans-Theoretical Model (TTM), which assumes that individuals will differ significantly in how motivated and ready they are to change their health-related behaviors (Prochaska, and Diclement, 1983). This research design has been used by a number of researchers to investigate the association between barriers to healthcare services and quality of life measures (e.g., Skevington, Day, Chisholm, and Trueman, 2005). The hypothesis proposed here is that TTM is a valid research model for understanding the barriers that are preventing minority AD patients and their caregivers from accessing community AD services, as well as understanding the impact these barriers have on the psychological and social status of patients.