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Chapter 58 - Cultural Competence
- from Section IV - Principles of Care for the Elderly
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- By Gwen Yeo
- Edited by Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Samuel C. Durso, The Johns Hopkins University, Maryland, Christine Arenson, Thomas Jefferson University, Philadelphia, Rebecca Elon, The Johns Hopkins University School of Medicine, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel
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- Book:
- Reichel's Care of the Elderly
- Published online:
- 30 June 2022
- Print publication:
- 21 July 2022, pp 705-715
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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.
Chapter 55 - Cultural competence and health literacy
- from Section IV - Principles of care for the elderly
- Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
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- Book:
- Reichel's Care of the Elderly
- Published online:
- 05 June 2016
- Print publication:
- 23 June 2016, pp 735-748
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Summary
Person-centered geriatric care requires attention to the diversity of older patients. The looming ethnogeriatric imperative, when 40% of geriatric patients will be from a minority population, will require health care organizations and providers to meet elders’ unique cultural needs. These include meeting the Culturally and Linguistically Appropriate Standards (CLAS), especially providing language access for elders with limited English proficiency; developing cultural humility and confronting unconscious bias; knowing major health beliefs, special health risks, and the cohort experiences of elders of different populations; and using culturally appropriate assessment techniques, including eliciting elders’ explanatory models of their conditions. Older adults are also more likely to have low health literacy or to experience challenges obtaining, processing, or comprehending health information. As low health literacy has been linked to poor health outcomes, geriatric providers must develop skills to ensure they understand their patients and that their patients understand them
53 - Ethnogeriatrics
- Edited by Christine Arenson, Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Kenneth Brummel-Smith, Florida State University, James G. O'Brien, University of Louisville, Kentucky, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel, Georgetown University, Washington DC
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- Book:
- Reichel's Care of the Elderly
- Published online:
- 19 May 2010
- Print publication:
- 09 February 2009, pp 552-559
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Summary
ETHNIC, RACIAL, AND CULTURAL ASPECTS OF HEALTH CARE FOR OLDER ADULTS
Introduction and Demographics
Because effective geriatric care is heavily influenced by cultural beliefs and practices of elders and their family members and the differential health risks of specific populations, any comprehensive discussion of geriatrics needs to include the recognition of the growing ethnic and racial diversity of America's older population. One measure of the growing diversity is the projection that elders from populations described as ethnic and racial minorities will grow from 18% to 39% of all older Americans by mid-century.
Table 53.1 summarizes the projected increases in ethnic and racial minorities of older adults aged 65 years and older by race and Hispanic origin. These projections, however, drastically understate the cultural diversity that geriatric providers will increasingly face because within each of these categories there is great heterogeneity, for example, the rapidly increasing population of Asian American elders include immigrants from more than 30 countries with very different cultures, and the non-Hispanic white category includes elders from the diverse Middle Eastern and eastern European countries as well as those from western European ancestry. Then within each of the ethnic and racial populations, there are vast differences in acculturation levels to the mainstream society, English language proficiency, educational and occupational backgrounds, income, religion, and family structure; all of which effect their interactions and expectations with health care providers.
So, how can geriatric team members attempt to work effectively in the face of such growing diversity? Part of the solution is knowing as much as possible about the background of the elders and their families the providers are likely to see, which may be challenging in very diverse regions.