Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-29T01:29:51.173Z Has data issue: false hasContentIssue false

Chapter 58 - Cultural Competence

from Section IV - Principles of Care for the Elderly

Published online by Cambridge University Press:  30 June 2022

Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
Get access

Summary

The rapidly growing proportion of older Americans who are from very diverse ethnic and racial minorities will produce an ethnogeriatric imperative for geriatricians and other health-care providers. Many older adults from minority backgrounds experience disparities in the quality of their health care and disparities in their health status by their higher risk for diseases such as diabetes, heart failure, and dementia.

To provide effective ethnogeriatric care for this culturally diverse older patient population, health-care organizations need to become culturally competent by applying the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, including providing trained interpreters for providers to use in care with limited English proficient older adults. The geriatric providers themselves need to become culturally competent in their: (1) attitudes such as developing cultural humility and reducing their bias; (2) knowledge of cultural values and health risks of their older patients; and (3) skills in showing culturally appropriate respect, eliciting patients’ explanatory models of their illness, and working appropriately with interpreters.

Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 705 - 715
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Federal Interagency Forum on Aging-Related Statistics. Older Americans 2016: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office, August 2016.Google Scholar
Stevens, G. Age at immigration and second language proficiency among foreign-born adults. Language in Society. 1999; 28:555578.Google Scholar
National Healthcare Quality and Disparities Report Executive Summary. Rockville, MD: Agency for Healthcare Research and Quality, September 2019. AHRQ Publication No. 19–0070-EF.Google Scholar
2018 National Healthcare Quality and Disparities Report. Content last reviewed April 2020. Agency for Healthcare Research and Quality, Rockville, MD. www.ahrq.gov/research/findings/nhqrdr/nhqdr18/index.html.Google Scholar
Smedley, BD, Stith, AY, Nelson, AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: The National Academies Press, 2003.Google Scholar
Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services, 2020.Google Scholar
2018 Profile of Hispanic Americans Age 65 and Over was developed by the Administration for Community Living, U.S. Department of Health and Human Services; 2018 Profile of African Americans Age 65 and Over was developed by the Administration for Community Living, U.S. Department of Health and Human Services; 2018 Profile of Asian Americans Age 65 and Over was developed by the Administration for Community Living, U.S. Department of Health and Human Services; 2018 Profile of American Indians and Alaska Natives Age 65 and Over was developed by the Administration for Community Living, U.S. Department of Health and Human Services.Google Scholar
National Center for Health Statistics. Health, Table 5, United States, 2018. Hyattsville, MD, 2019.Google Scholar
Butterfield, S. Understanding heart failure in African Americans. ACP Internist, November/December 2019.Google Scholar
Sharma, A, Colvin-Adams, M, Yancy, CW. Heart failure in African Americans: Disparities can be overcome. Cleveland Clinic Journal of Medicine. 2014; 81(5):301311.Google Scholar
Mehta, KM, Yeo, GW. Systematic review of dementia prevalence and incidence in United States race/ethnic populations. Alzheimer’s and Dementia. 2017; 13;7283.Google Scholar
Yeo, G. How will the U.S. healthcare system meet the challenge of the ethnogeriatric imperative? Journal of the American Geriatrics Society. 2009 (Jul.); 57(7):12781285. PMID: 19558479.Google Scholar
Office of Minority Health USDoHHS. National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, 2013.Google Scholar
Cross, TL, Bazron, BJ, Dennis, KW, Isaacs, MR. Towards a Culturally Competent System of Care: A Monograph of Effective Services for Minority Children Who Are Severely Emotionally Disturbed. Washington, DC: CASSP Technical Assistance Center, Georgetown University Child Development Center, 1989.Google Scholar
Karliner, LS, Pérez-Stable, E, Gildingorin, G. The language divide: The importance of training in the use of interpreters for outpatient practice. Journal of General Internal Medicine. 2004; 19:175183.Google Scholar
Flores, G, Abreu, M, Barone, CP, Bachur, R, Lin, H. Errors of medical interpretation and their potential clinical consequences: A comparison of professional versus ad hoc versus no interpreters. Annals of Emergency Medicine. 2012; 60(5):545553.Google Scholar
Lindholm, M HJ, Ferguson, WJ, Reed, G. Professional language interpretation and inpatient length of stay and readmission rates. Journal of General Internal Medicine. 2012; 27(10):12941299.CrossRefGoogle ScholarPubMed
Fadiman, A. The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures. New York: Farrar, Straus, & Giroux, 1997.Google Scholar
Betancourt, JR. Becoming a physician: Cultural competence – Marginal or mainstream movement? New England Journal of Medicine. 2004; 351(10):953955.Google Scholar
Weissman, JS, Betancourt, J, Campbell, EG, Park, ER, Kim, M, Clarridge, B, et al. Resident physicians’ preparedness to provide cross-cultural care. JAMA: The Journal of the American Medical Association. 2005 (Sep. 7);294(9):10581067. PMID: 16145026.Google Scholar
Tervalon, M, Murray-Garcia, J. Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved. 1998 (May); 9(2):117125.Google Scholar
Shulman, KA BJ, Harless, W. The effect of race and sex on physicians’ recommendation for cardiac catheterization. New England Journal of Medicine. 1999; 340(8):618626.Google Scholar
Chapman, E, Kaatz, A, Carnes, M. Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities. Journal of General Internal Medicine. 2013; 28(11):15041511.CrossRefGoogle ScholarPubMed
Green, AR, Carney, DR, Pallin, DJ, Ngo, LH, Raymond, KL, Iezzoni, LI, et al. Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. J Gen Intern Med. 2007 (Sep.); 22(9):12311238. PMID: 17594129.Google Scholar
Oliver, MN, Wells, KM, Joy-Gaba, JA, Hawkins, CB, Nosek, BA. Do physicians’ implicit views of African Americans affect clinical decision making? Journal of American Board of Family Medicine. 2014; 27(2):177188.Google Scholar
BlairIV, Steiner Fairclough, JF Hanratty, DL R, et al. Clinicians’ implicit ethnic/racial bias and perceptions of care among Black and Latino patients. Annals of Family Medicine. 2013; 11(1):4352.Google Scholar
Adler, R, Kamel, H, eds. Doorway Thoughts: Cross-Cultural Health Care for Older Adults, Volume 1. From the Ethnogeriatrics Committee of the American Geriatrics Society. Sudbury, MA: Jones & Bartlett, 2004.Google Scholar
Adler, R, Brangman, S, Pan, C, Yeo, G, eds. Doorway Thoughts: Cross-Cultural Health Care for Older Adults, Volume 2. From the Ethnogeriatrics Committee of the American Geriatrics Society. Sudbury, MA: Jones & Bartlett, 2006.Google Scholar
Grudzen, M, Brangman, S, Pan, C, Yeo, G, eds. Doorway Thoughts: Cross-Cultural Health Care for Older Adults, Volume 3. From the Ethnogeriatrics Committee of the American Geriatrics Society. Sudbury, MA: Jones & Bartlett, 2009.Google Scholar
Lavizzo-Mourey, R, MacKenzie, E. Cultural competence: An essential hybrid for delivering high quality care in the 1990s and beyond. Transactions of the American Clinical and Climatological Association. 1995; 105:226237.Google Scholar
Kleinman, A. Culture and depression. New England Journal of Medicine. 2008; 351(10):351353.Google Scholar
Lee, SE, Diwan, S, Yeo, G. Causal attributions of dementia among Korean American immigrants. Journal of Gerontological Social Work. 2010; 53(8):743749. doi: 10.1080/01634372.2010.515290.CrossRefGoogle ScholarPubMed
Yeo, G, Hikoyeda, N, McBride, M, Chin, S-Y, Edmonds, M, Hendrix, L. Cohort analysis as a tool in ethnogeriatrics: Historical profiles of elders from eight ethnic populations in the United States. Stanford, CA: Stanford Geriatric Education Center, 1998.Google Scholar
Kleinman, A, Eisenberg, L, Good, B. Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine. 1978; 88(2):251258.Google Scholar
Berlin, E, Fowkes, WA. A teaching framework for cross-cultural health care. Western Journal of Medicine. 1983; 139:934938.Google Scholar
Yeo, G, Gallagher-Thompson, D, eds. Ethnicity and the Dementias, 3rd edition. New York: Routledge, 2019.Google Scholar
The Montreal Cognitive Assessment (05/23/2014). www.mocatest.org/default.asp. Accessed on 06/04/2020.Google Scholar
Mui, AC, Kang, SY, Chen, LM, Domanski, MD. Reliability of the Geriatric Depression Scale for use among elderly Asian immigrants in the USA. International Psychogeriatrics/IPA. 2003 (Sep.); 15(3):253271. PMID: 14756161.Google Scholar
Cross-Cultural Health Care Program. Communicating effectively through an interpreter: An instructional video for health care providers – Barriers to communication. Seattle, WA. https://xculture.org/about-our-publications.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×