# The use of care home environments to meet culture-specific needs of culturally and linguistically diverse residents with dementia: an integrative review using the ICF framework

## TL;DR

This review explores how care home environments can better meet the cultural needs of diverse residents with dementia, emphasizing communication, activities, and support.

## Contribution

The study integrates findings using the ICF framework to guide culturally responsive care home design for CALD residents with dementia.

## Key findings

- Bilingual staff and culturally relevant activities improve communication and reduce isolation for CALD residents.
- Environmental factors like ethnic food and culturally competent care enhance social participation and well-being.
- Collaboration with families and cultural communities supports meeting the social and cultural needs of residents.

## Abstract

Increasing global migration creates new challenges for multicultural societies in providing equitable care. Culturally and linguistically diverse (CALD) people who move into care homes find themselves in an environment where health professionals do not speak their language and the access to cultural activities is limited. This may increase loneliness and social isolation. When designing care home environments for CALD residents with dementia, culture is a key consideration. The aim of this integrative review is to highlight what elements of the care home environment are reported to meet culture-specific needs of CALD residents with dementia, and how.

A search strategy which included terms for care homes, forms of dementia and CALD people was developed, and a systematic search was carried out in six databases. Eligible articles were original peer-reviewed studies published between 2013 and 2024 and contained examples of how care home environments have been used to meet culture-specific needs of CALD residents. All screenings and extractions were carried out by two independent researchers.

The search resulted in 4311 records. After the screening process, 27 articles met the eligibility criteria. The review findings are categorized according to components of the WHO’s International classification of functioning, disability and health (ICF). Results linked to the ICF component Activities and participation stress the importance of communication in the resident’s preferred language, social and supportive relationships and culturally relevant activities, while the component Environmental factors highlights the significance of ethnic food and support from culturally competent care professionals and family members.

This integrative review underlines the complexity of using environments to meet culture-specific needs of CALD residents with dementia. The findings highlight the importance of bilingual staff, culturally relevant activities and inclusive environments in enhancing communication, building interpersonal relationships and reducing frustration among CALD residents. Collaborations between culturally competent staff, family members and members of cultural communities also facilitate meeting social and cultural needs of these residents. This review offers suggestions on how environments in care homes can be adapted for CALD residents and encourages further research to find practical solutions for equitable care.

A study protocol is registered on Prospero (CRD42023492906).

The online version contains supplementary material available at 10.1186/s12939-025-02748-0.