Table 3 Barriers and facilitators

Lack of carer/patient understanding of the causes and symptoms of dementia

Improving knowledge of dementia

Lack of Knowledge, familiarity and awareness of services and how to navigate the system

Professionals lack of specialist knowledge and lack of cultural and linguistic ability to achieve diagnosis

Improving training for professionals in identifying and screening for dementia

Limitations of available services and lack of cultural awareness

Broadening and adapting servicesContinuity of care

Preconceived ideas of treatability /normalisation

Anxiety/trust issues about ‘outside’ support and its cultural appropriateness

Tackling the issue of ‘outsiders’

Issues around trust and racism, both historic and current

Societal stigma of mental illness and denial or concealment as a defence against the reactions of others

Addressing societal stigma/denial/concealment

Cultural issues impacting on perceptions of Western medicine and the acceptability of services

The impact of cultural/familial expectations and community perceptions on care decisions

Health care provider exclusion and dismissal of carer concerns/Negative carer experiences of help seeking

Negative emotions associated with response from own community