It is believed that the incidence of dementia is underreported in African Americans, partly because of delays in seeking medical care. There is a critical need to explore factors that impede the diagnosis and treatment of dementia in this population. As part of a larger ethnographic study, in-depth interviews were conducted with 15 African American family caregivers living in 2 counties of the Arkansas Delta. This article focuses on (1) primary concerns related to the elder's condition and (2) access and use of health services. Findings are discussed within context of historical and sociopolitical factors of the geographic region.
Linda A. Gerdner, PhD, RN, is Consulting Assistant Professor, Stanford Geriatric Education Center, Center for Education in Family and Community Medicine, Stanford University School of Medicine. At the time of this study, she was a postdoctoral fellow at the Department of Veterans Affairs, Little Rock, Arkansas.
Helen C. Simpson, a lifelong resident of the Arkansas Delta, spent her early childhood during the Jim Crow era. She is dedicated to the care of elder's with dementia.
Address correspondence to: Linda A. Gerdner, PhD, RN, Stanford Geriatric Education Center, Center for Education in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA 94305 (Igerdner@gmail.com).
*Cotton County and River County are pseudonyms for the actual names of the research sites.
† Chronic confusion is defined as “an irreversible, long-standing and/or progressive deterioration of intellect and personality characterized by decreased ability to interpret environmental stimuli, decreased capacity for intellectual thought processes and manifested by disturbances of memory, orientation, and behavior.” 10(p119)
This study was funded by the University of Arkansas for Medical Sciences, Donald W. Reynolds Department of Geriatrics, Center on Aging, The Dementia Center of Arkansas.