Background:As populations age and diversify, the need for culturally responsive dementia care in residential settings is urgent.Minority ethnic (ME) residents often face barriers to equitable care, and a ‘one-size-fits-all’ approach risks overlooking whatmatters most for their wellbeing. This review investigates how culturally tailored interventions improve wellbeing for MEresidents with dementia.

Methods:A realist synthesis was conducted to explainhow,why, andunder what conditionsinterventions work. The protocolwas registered with PROSPERO (CRD42024581293). Six databases were searched for studies published between 2013 and2024. Using the Integrated Model of Place as a framework, data were analysed to develop Context-Mechanism-Outcomeconfigurations (CMOCs). Findings were validated with stakeholders from 10 care homes.

Results:Seven studies were included. Analysis revealed that effective interventions are those aligned across three contextual domains/environments: the physical(culturally familiar sensory cues), thesocial(native-language communication, sharedactivities), and theorganisational(supportive leadership, staff training, structured routines). When aligned, these contextstrigger mechanisms of familiarity, emotional memory, trust, and identity affirmation. This leads to outcomes of reduced agitation,improved mood, enhanced communication, and stronger family-staff relationships. On the other hand, interventions lacking thisintegration, such as those without language support, failed to engage residents and families.

Conclusion:Wellbeing for ME residents is not achieved by interventions alone but through care environments that areholistically culturally responsive. Culturally attuned physical, social, and organisational contexts must be synergistically alignedto activate essential wellbeing mechanisms. This synthesis provides a practical framework for designing and implementinginclusive dementia care.