Rapid literature review: Inequalities in dementia

Published: 12 December 2023 Page last updated: 12 December 2023

This research looks at why some people with dementia get better care than others, and the barriers to them getting good care.

We commissioned RSM UK Consulting LLP to carry out this research, write the summary below, and the full report.

Purpose of this research

We did this research to learn about why some people with dementia get better care than others, and the barriers to them getting good care. This report explains what we currently know about what works. CQC want to use this report to make sure they can help more people with dementia.

Background and introduction

RSM UK Consulting LLP (RSM), with Professor Claudia Cooper at Queen Mary University of London and the University of Birmingham Library Services, were asked by Care Quality Commission (CQC) in March 2023 to look at information about inequalities in dementia care. RSM looked at this issue in care homes, and we paid special attention to groups of people who might need extra help because of the law (the Equality Act 2010); which makes sure people aren’t disadvantaged because they are different equality groups or living in poorer areas can make things even harder.

Findings from the review

When someone has dementia and is from a different equality group, like having a different skin colour or being attracted to someone of the same sex, the people taking care of them need to be aware. Sometimes, people with dementia might have had bad experiences with doctors and nurses, which can make them scared and not want to talk to care staff. They might have had hard times in their life, and those hard times can come back because of their memory problems. As they forget things, they might get confused about who they are or who they love, or they might forget the language they know best. They might also act differently because of their culture or how they learned to deal with problems. So, it’s important for the people taking care of them to understand why they act the way they do and what they need.

The research found that taking care of people with dementia for those from different equality groups isn’t the same for each person. Staff should talk to them and their families, as this helps staff understand what the person really needs. Making a plan that’s just for that person is important because it helps protect their rights and who they are.

Taking care of people with dementia depends on seven features from the research. We also looked at how CQC could help make this kind of care better for more people. You can see this in figure 1.

Talking to people who have gone through similar things in their life

We couldn’t find much information about how people with dementia from different backgrounds are involved in care. It has been shown care homes that talk to the people from different backgrounds in their care homes, tend to do a better job. Staff who help them can learn what’s most important to each person and make choices that help them.

This research tells us that having good leaders and training for the people who take care of others is really important. It helps create a care home where the people who live there, their families, and the staff can talk openly and feel safe. It takes time and money to build trust and make sure everyone is treated with respect.

Things we could still learn about

This research tells us that we don’t know everything yet about people with dementia from different equality groups in care homes and we have more things to learn. CQC can lead the way in doing more research, or encouraging others to do research, and telling others what they find.

Here are three areas that more can be learnt about:

  • CQC can help make research happen in the care homes where adults get care. They can do this in different ways, by doing the research themselves, asking others to do it, or telling everyone why research is important. They can also collect stories about places that do a good job and share those stories with others.
  • CQC can do their own research to learn even more about how to make things better for people with dementia who live in care homes.
  • CQC can help with more research to learn about the things we don't know yet in this area. For example, we could do more research about how to take risks in a safe way, or about how people from different equality groups make decisions about whether or not they choose to live in a care home.


We couldn't find a lot of information about what good care for people with dementia looks like, especially for those who are from different equality groups or live in poorer places. But from what we did find, we know that taking care of each person in the way they want to be cared for is important. Making sure the people who help them are confident and well-trained, care homes being made suitable for everyone, good leaders, a diverse team, enough money for care homes, and being part of the community are all really important to creating good care.

Read the full report