The City of Bradford Metropolitan District Council became aware that South Asian people were not getting the support they needed to help them cope with dementia. Part of the problem was that there is no concept of dementia in Pakistani and other Asian cultures. But there is a concept of memory loss, so the team called the project ‘Meri Yaadain', which means ‘my memories'.
Key learnings for other councils
- Start small and build up the service slowly.
- Work in lots of ways – with individuals, their families and the system – and target different audiences separately.
- In some languages the spoken word is more powerful than a leaflet – use events and local radio to reach the South Asian community.
- Use every bit of the network you can– religious, cultural and ethnic organisations.
- Bilingual staff are essential.
Background to the council
Bradford Council covers a very mixed area, both rural and urban, with a population of nearly half a million. About a fifth of the population is of Asian descent.
Who was involved?
Meri Yaadain was set up in January 2006 and led by Bradford's Council's Adult and Community Services in partnership with:
- Bradford and District Age Concern
- Bradford and District Alzheimer's Society
- Bradford and Airedale Teaching Primary Care Trust (TPCT).
The steering group included partners and the council's Asian health and social care officer, and was chaired by the council's service coordination and communications manager.
Meri Yaadain was funded by the Treasury and the Cabinet Office's ‘Invest to Save' budget.
The problems and how we tackled them
One of Bradford's social workers says that before 2006 he constantly came across "people stuck in back bedrooms". Many elderly people with memory problems were isolated either within their families or within the system.
The system often failed individuals and families because of problems with language or GPs not knowing what to do when approached. Many families had given up trying to get help.
Meri Yaadain provides multi-lingual outreach workers. They support those with dementia, their families and carers when dealing with health and social services professionals. The team also runs events to support health and social services professionals.
Understanding about dementia is generally poor but in South Asian cultures there is no concept of dementia. This made it difficult to find sufferers.
Meri Yaadain runs mostly bilingual events with lots of pictures and discussions about what dementia is and what can be done about it. The team uses religious, cultural, and ethnic organisations and Radio Ramadan to raise awareness of dementia and Meri Yaadain's support services.
Communication is mostly face-to-face and verbal, not written, but Meri Yaadain has a website and has published some leaflets to support their work. Leaflets have been produced in Urdu, Punjabi, Bangla, Hindi and Gujarati.
Meri Yaadain also offers:
- home visits to ensure that individuals are getting the right homecare and that this meets cultural and language needs
- a monthly support group for carers and sufferers where participants can share information, take part in activities, relax and get a bite to eat
- telephone advice for those who need to talk or find out about something, which can often help speed up referrals to appropriate agencies.
Overcoming fear and shame
Some families and individuals do not want to talk outreach worker because they are scared and ashamed.
It is important to be open and accessible. Many people may want to talk about getting an extra bedroom or sorting out benefits rather than dementia. You have to be willing to discuss anything and everything until you have built up a relationship with your service user.
Bilingual staff are essential. Meri Yaadain has a small number of highly skilled outreach staff who understand dementia, the culture and the languages used. They make individual contact either with professionals, families or individuals.
Outcomes and impact
Meri Yaadain celebrated its fifth anniversary in January 2011.
Its coverage has spread from the centre of Bradford to Keighley, encompassing two large Asian areas and several languages and communities.
Over 160 families are currently using the service. One user said:
"I have been coming [to Meri Yaadain support groups] for two years. It is very good and I feel very refreshed."
Rani Shukla, of the Alzheimers Society, says of those using the service:
"When I saw these people to start with they would hardly speak about their dementia or memory problems. They are now opening up more and speaking more about their memory problems."
Meri Yaadain has won two awards:
- the Mental Health Award, the Department of Health and Social Care Awards 2006
- the Reducing Inequalities Award, Care Service Improvement Partnership 2006.
What could have been done better
It took a lot of time to get health and social service professionals to understand that Meri Yaadain had value. Some may have felt threatened.
Bradford is considering using the Meri Yaadain model to work with older people suffering from depression and delirium.
Further information and contacts
Adult and Community Services
City of Bradford Metropolitan District Council
Bradford BD1 5RE
Nick Farrar, Service Coordination and Communications Manager
Akhlak Rauf, Asian Health and Social Care Officer
Telephone: 01274 437996