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Literature shows that people with a migration background (PwM) with dementia are an especially vulnerable group. Data on the number of PwM with dementia in Germany is scarce meaning the healthcare system faces a challenge of an unknown magnitude. They are mostly not part of the healthcare landscape and lack knowledge about dementia and healthcare services. Healthcare professionals and services do not seem to be culturally sensitive enough and not adequately equipped to take care of PwM with dementia. Therefore, this work focuses on a) estimating the number of PwM with dementia broken down by country of origin and federal state; b) exploring the caregiving experience, barriers of healthcare utilisation and measures to increase utilisation; and c) determining the scope of culturally sensitive information and healthcare services as well as projects on dementia and migration in Germany. A combination of quantitative and qualitative research methods as well as a scoping review are applied to examine the research focus.
Calculations show that an estimated 96,500 PwM have dementia, presumably mostly originating from Poland, Italy, Turkey, Romania, and the Russian Federation. The majority of affected PwM live in North Rhine-Westphalia, Baden-Württemberg, and Bavaria. Family members experience similar challenges and consequences as non-migrants in the care of a person with dementia. PwM lack sufficient knowledge of dementia and information regarding the available healthcare services. These are only two of the reasons why the healthcare system is not utilised. To increase utilisation, services should be culturally sensitive and information easily accessible. In addition, easier navigation and the expansion of existing healthcare structures is needed. The scoping review identified 48 culturally sensitive healthcare and information services and projects for PwM with dementia. The majority are located in North Rhine-Westphalia, Baden-Württemberg, Bavaria, and Hesse, which mirrors the distribution of PwM with dementia in Germany. For the most part, these services offer counselling in different languages. These results confirm that PwM (with dementia) and healthcare professionals need in-depth education on this topic. There should be a focus on the design of information and healthcare services that are tailored in a culturally sensitive way. This dissertation further indicates that culturally sensitive healthcare services, personalised for individual situations on site, should be expanded and also facilitated by not only healthcare professionals and service providers but also by law- and decision-makers. Furthermore, there is a need for cooperation between researchers, healthcare professionals, service providers, healthcare systems, law-makers, and other stakeholders in the field on a national and an international level.
The Common Tern (Sterna hirundo) is one of Germany’s farthest migrating bird species. Ringing studies have shown the use of the East Atlantic flyway, and according to their main wintering areas at the western and southern African coasts, German and European Common Tern populations have been divided into two allohiemic groups. However, first ring recoveries of German Common Terns in Israel indicated that some of the birds breeding in eastern Germany cross central Europe and migrate along the eastern African coast. To investigate the migratory behavior of Common Terns from East Germany, we fitted 40 Common Terns breeding in a colony at the German Baltic coast with light-level geolocators. Twenty-four loggers with analyzable datasets could be retrieved, revealing two different migratory strategies within one population. Seventeen individuals (70.83%) used the eastern Atlantic flyway and spent the winter at the western African coast, the Gulf of Guinea and the southern African coast, while the other individuals (n = 7; 29.17%) crossed central Europe, migrated along the eastern African coast and overwintered in the Mozambique Channel and South African coast. We, therefore, suggest to add a third allohiemic group to complement the picture of European Common Tern migration. Moreover, our results provide new knowledge and open new questions, which can be used for future studies regarding the evolution of different migratory strategies and its consequences in relation to climate change.