What are the implications for the BAME dementia community and how do we ensure service provision responds effectively?

Mohammed Ak Rauf, BAME Dementia Consultant

Dementia amongst Black Asian Minority Ethnic (BAME) communities is set to rise seven to eight-fold in the next three decades. However, not having a word for dementia in the five main South Asian languages creates a difficulty when you attempt to have conversations about a subject that has no identifiable term in those communities.  Given that migrant communities have settled in Britain throughout history, the diversity of the nation should not prevent us thinking outside our own ‘box’.

Prayers, chants, folk songs

During the last century the UK has had migrants initially arriving from former British colonies, and more recently from a transient global movement of people – asylum seekers, refugees, work permits and so forth due to global circumstances.  Whilst people may think of society as multicultural or diverse, there is a growing perspective of using the term ‘superdiversity’ recognising the very complicated nature of putting ‘people into boxes’. We all have an ethnicity (majority or minority), we all have our culture, likes and dislikes, foods, faiths, etc.

So, what does this mean in terms of dementia and music? Well, music exists in every culture; rhythm is present whether it is in words, instruments, prayers, chants, folk songs and songs which enable bygone era for many.  In terms of dementia, music allows individuals to reminisce about emotions, feelings, life events, touching on both positive and negative emotions.  Good choice of music will enable positive interactions with the person living with dementia – no different to any individual irrespective of background or identity.

Patriotism and history

BAME communities may be influenced by their own histories and experiences. Take for instance, South Asian communities in the UK, especially those who will have lived through the horrors of the ‘Partition of India’ or the separation of Bangladesh from Pakistan; they will no doubt have painful memories as well as the exuberance of having ‘freedom’ from the alleged prior difficulties.  Indian, Pakistan and Bangladesh are vehemently patriotic nations who have popular culture and music focused on patriotism.  However, the other side of the same coin is the music that reflects romance, love, a rich history of folk music, culture, faith inspired music, much of which is popularised through the cinema and film world; which transcends the geographical borders.

There have been great legends in terms of music which have crossed political, geographical boundaries given the commonalities within the diversity of the Indian sub-continent. Languages such as Urdu and Hindu have traversed issues of ethnicity (Punjabis, Sindhis, Gujaratis, Pashtuns, Bengalis, etc), geographical locations (the subcontinent is about 1000 miles across), faiths (Muslims, Sikhsm Hindus, Christians, Christians, Buddhists and Jains) and languages (Urdu, Punjabi, Hindi, Gujarati, Bangla and many more).  Singers such as Mohammed Rafi, Noor Jehan, Lata Mangeshkar, Asha Bhosle, Kishore Kumar are what are classed as legends across these nations, but more modern and diverse including western influenced music is also in existence.  Never the less, folk music is also embedded in cultural aspects of maintaining links to people’s heritage and a sense of identity.  Others still like the late Nusrat Fateh Ali Khan who brought sufi/classical style qawaali music into the realms of the western world, or Ravi Shankar and his sitaar.  So, music and rhythm are enjoyed by all, whether from films, classical, pop culture or instruments.

Migratory experiences

As an older person living in the UK, migratory experiences will be very important in helping people define who they are and also in terms of the transition from one ‘culture’ to another.  This will also bring with it nuances within experiences – the music of the 1960’s, 70’s will also be remindful of the era of national front and skinheads, of racist political slogans and a fear of prejudice from institutions.  But this should not prevent us from exploring what songs or music older people (in sheltered or residential homes), or people living with dementia may like.

There is also another aspect of music and rhythm enjoyed by South Asian cultures.  This is the relationship between music and worship (faith) in both Hinduism and in Sikhism – two of the three main religions of people of Indian, Pakistani and Bangladeshi heritage – the third faith being Islam.  Sikhism and Hinduism use music alongside devotional songs when chanting or reading from their scripture.  Islam on the other hand does not permit music in worship or reading scripture, but the beautiful recitations had a melody of their own within the styles of recitation – so not technically music but the rhythm within the recitation acts as a calming influence. Further still, some of the ‘naats’ (poetry praising the Prophet Mohammed PBUH), is often found to be accompanied by music which many people enjoy listening to.

So, we’re not all that different as communities, but personal preferences will enable enjoyment and reminiscence through general or faith-based music / rhythm.

Twitter – @BME_Dementia

BIOGRAPHY

Mohammed Akhlak Rauf is the Founder & Director of Meri Yaadain CiC, a community interest company, based in Bradford, UK.  Meri Yaadain aims to support Black Asian Minority Ethnic (BAME) people living with dementia in addition to carers looking after a relative or friend living with dementia. Meri Yaadain also work with service providers to embed cultural competency in practice.

Mohammed has over 20 years of experience working with BAME communities with regards to engagement, information, education and tackling inequalities.  He is also currently a PhD doctoral researcher studying how South Asian family carers cope with the transitions associated with looking after a relative living with dementia.  He was awarded an MBE from the Queen in recognition of his efforts for ‘services to people with dementia and their carers’.