Cultural Safety in Dementia Care: Responding to the World’s Highest Rates Among First Nations People

By Jo Hughson, PhD (The University of Melbourne); Harold Douglas (The University of Melbourne); and Roslyn Malay (The University of Western Australia)

Dementia is one of the fastest growing health challenges worldwide, but for Aboriginal and Torres Strait Islander peoples the crisis is even more urgent. Rates of dementia in remote and rural First Nations communities are among the highest recorded globally, with onset occurring at a younger age than in the general Australian population. 

National projections suggest that by 2051, the number of Aboriginal and Torres Strait Islander peoples over 50 living with dementia will be 4.5 to 5.5 times higher than it is today.

Without targeted, culturally responsive interventions, this burden will continue to grow.

Why are dementia rates higher?

The causes lie in social and historical inequities. Colonisation, displacement from Country, and intergenerational trauma have left lasting impacts. Chronic conditions such as diabetes, cardiovascular disease and kidney disease are more common in First Nations communities, increasing dementia risk.

Access to care is also harder. Many people face delays in diagnosis due to limited culturally appropriate services, stigma, and fear of being moved away from Country. 

Cultural safety in practice

Addressing inequities requires more than clinical services, it calls for culturally safe, community-led models of care. 

The Best Practice Model of Care, includes:

• Community leadership with Elders and families 
• Integrating cultural knowledge in clinical care to ensure Indigenous values are respected. 
• Staff training in cultural competence for responsive, respectful practice.
• Holistic wellbeing that includes social, emotional and spiritual health.

A path forward

First Nations peoples are experiencing dementia earlier, more often and with fewer resources. Embedding cultural safety from diagnosis to long-term care can reduce stigma, improve access and strengthen wellbeing.