Cultural perceptions of medication management during hospital‐to‐home transitions of older Latino adults living with dementia

Abstract

AbstractBackgroundIn a country with a growing Latin American and Spanish‐speaking population, the health care system is tasked with providing care across changing landscapes of culture and language. Specifically, the hospital‐to‐home transition is a high‐risk period for medication errors and adverse events for older adults with Alzheimer’s Disease and Related Dementias (ADRD), and the older Latino population is widely understudied. Family caregiver perspectives are especially important in Latino populations. The field of human factors engineering, which studies the interactions among people and systems, can be useful to understand complex phenomena. Our objective was to elicit and categorize family caregivers’ cultural perceptions of ADRD and views on medication use during the hospital‐to‐home transition of Latino older adults with ADRD.MethodQualitative study using semi‐structured interviews and participant solicited diaries with family caregivers of older Latino adults with ADRD after hospital discharge. We used the human factors engineering‐informed Systems Ambiguity Framework to guide data analysis. At least two researchers independently coded each transcript using a content analysis approach. We identified recurring cultural perceptions of medication use and resource accessibility. We used Atlas.ti software to facilitate data analysis.ResultWe interviewed 11 caregivers of older Latino adults with moderate‐to‐severe ADRD. We elicited caregivers’ cultural perceptions of medication management, medication purpose, and available resources. Recurring themes expressed by caregivers indicate 1) Concern about over‐medication, 2) Resignation over limited medication effectiveness for treating ADRD, 3) Scarcity of culturally specific and appropriately translated resources, and 4) Wariness to trust providers and medical institutions based on negative experience. Multiple caregivers experienced initially incorrect diagnoses or contradictory information from multiple providers, contributing to a sense of resignation regarding treatment options and a lack of trust in providers and institutional resources.ConclusionWe identified four cultural perceptions of medication use and resource accessibility. The elicited themes point to a need for culturally tailored care instructions for family caregivers, appropriate language services across the care continuum, and a concerted outreach effort to form trusted relationships among Latino communities and health care providers.