Post on 15-Jan-2017
transcript
Cultural Aspects of Geriatric Care: The Latino
ExperiencePresented by
Gregory A. TalaveraChief of Research
San Ysidro Health Center, Inc
12-4-16
Learning Objectives
• Define issues related to cultural competency in the care of Latinos– Individual level– Systems/Structural/Organizational
• Introduce a Cultural Framework for change• Devise strategies to enhance skills toward the
provision of care in a culturally competent manner
Perspectives
Cultural Destructiveness
Cultural Incapability
Cultural Blindness
Cultural Pre-Competence
Cultural Competence
Cultural Proficiency
Source: NAHH (2007)
Towards Cultural Proficiency for Health Care Organizations
Holding culture in high esteem
Acceptance of and respect for differences
Movement towards reaching out to other cultures
Predominant system… Philosophy of being unbiased
No capacity to help clients from other cultures
Destructive to other cultures
Health Provider Perspective
• Linguistic & Cultural Competency– Individual level– Systems level
Definitions and Concepts
What is Culture?
• How we conceptualize health & illness stems from culturally-derived (culture-bound) health beliefs
• These may be known or unknown to the individual and/or provider
What is Culture?
• System of meaning and symbols that: – frames the way people locate themselves within
the world, – perceives the world, and– finds meaning within the world
• General socio-economic, cultural and environmental level of ecological model.
Culture: 5 Basic Criteria• Common pattern of communication, sound
system, or language unique to the group• Similarities in dietary preferences and
preparation methods• Common pattern of dress• Predictable relationship and socialization pattern
patterns among members of the culture• Common set of shared values, beliefs and
practices• Slonim, 1991 (in Huff and Kline)
Comparison of Common Values
May, 1992
Values and FamilyUnited Way, 1991
MainstreamLatino, other
Cultural Factors
that Affect
Latino Care
Cultural beliefs and
use of complementa
ry and alternative medicine
Traditional gender roles
Level of acculturation (adoption
of mainstream
culture)
Role of religiosity/ spirituality in health
Family-centeredne
ssand decision- making
The Magic
• What we see as science, Native Americans see as magic; what we see as magic, Native Americans see as science.
• Hammerschlag, 1988
notes
Cultures on Parade
Culture on Continuum
Traditional
Health Beliefs
Western
Health beliefs
Acculturation: the European model
Primary culture Secondary culture
(Assimilation)
(Mexican) (American)
Two Dimensional Acculturation
Low American
High American
Low Non-dominant High Non-dominant
III
III IV
Acculturation along Border
Primaryculture
mainstream“American”
Blended/BorderCulture
Border Health Culture• Blended pattern of communication, language
unique to the area (terms and concepts)• Blended dietary preferences, purchasing
patterns and preparation methods• Medication access on both sides• Health seeking behavior: self-limited illness
and self-medication• Culture-bound beliefs and practices related to
alternative remedies• Adapted form Slonim, 1991 (in Huff and Kline)
Ethnocentrism:
• The tendency to view one's own cultural group as the center of everything
• the standard against which all others are judged
• It assumes that one's own cultural patterns are the correct and best ways of acting
Clinically-relevantCulture-bound beliefs
• Examples (later we will discuss approaches)– Susto, Hot and cold theory of illness– Use of complementary & alternative medicine
• Tea for diabetes• Nopales for diabetes
– Concepts of illness prevention– Illness has symptoms
Your Goal: Competence
• Having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs behaviors, and needs presented by consumers and their communities.
• Embracing these differences
Cultural Destructiveness
Cultural Incapability
Cultural Blindness
Cultural Pre-Competence
Cultural Competence
Cultural Proficiency
Source: NAHH (2007)
Towards Cultural Proficiency for Health Care Organizations
Holding culture in high esteem
Acceptance of and respect for differences
Movement towards reaching out to other cultures
Predominant system… Philosophy of being unbiased
No capacity to help clients from other cultures
Destructive to other cultures
Summary
• Where are you on the ethnocentric & cultural competency continuum?
• How does knowledge of the culture improve your communication skills and service to seniors?
• What are you doing to create system change in your environment?