Hospitalization experience of ethno-racial older adults with dementia and caregivers: scoping review

Dementia and hospitalization are complex, interwoven experiences, particularly for older adults from ethno-racial communities. Systemic racism, stigma, health care provider bias, and the lack of culturally and linguistically appropriate care impede access to equitable care while admitted to the hospital. This scoping review aims to describe the existing literature on the hospitalization experiences of ethno-racial older adults (age ≥ 60 years) with dementia and their caregivers and identify challenges in receiving care in hospitals.

A scoping review was conducted using JBI and Arksey and O'Malley's 5-stage scoping review framework. Systematic searches were conducted across six databases, including PubMed, Scopus, Medline, PsycINFO, CINAHL, and Google Scholar. No restrictions based on publication year or geographical location. Data extracted using a structured data charting table.

Eleven studies were included in the review from an initial search of 3,395. Experiences and challenges in the journey of hospitalization pertained to (1) pre-hospitalization factors, (2) hospitalization and dementia care, (3) discharge and readmission, (4) challenges related to culturally tailored care practices, and (5) challenges encountered by caregivers.

The review findings illustrate a persistent gap in providing culturally focused dementia care and addressing the needs of ethno-racial older adults and their caregivers during hospitalization, from admission to discharge and the transition back to home. Future studies are needed to explore how ethno-racial older adults living with dementia and their caregivers navigate the hospitalization journey and discharge process and to find ways to improve hospital care practices and policies.