Today, there are about 58 million Americans over the age of 65, according to the latest data from the U.S. Census Bureau. By 2060, that number is estimated to more than double to nearly 100 million. While this population is undoubtedly large, it’s also more racially and ethnically diverse than previous generations, according to the Population Reference Bureau.
As the number of culturally diverse elders increases, it’s important that senior caregivers recognize and respect cultural differences in their elderly charges. That’s why we’ve asked experts and caregivers to share what it means to provide multicultural care and how you can infuse cultural diversity into your work.
What is multicultural care — and why is it important?
According to the Joint Commission (an organization that accredits U.S. healthcare institutions), it’s a caregiver’s responsibility to acknowledge a patient’s “cultural, religious or spiritual beliefs and practices that influence care.” So, how do you do that?
Acknowledge their world view
Recognizing a patient’s world view, and incorporating that into how you care for him or her, is prudent professional practice. Awareness of a senior’s world view doesn’t necessarily mean understanding everything about where a person comes from — it means understanding that their background, upbringing or culture may impact how you approach your work.
Be culturally sensitive and aware
Being proactive about the cultural components of your care is the best way to address your charge’s needs and to ensure you can provide for them. Communication is the first step in providing individualized, thoughtful care, says Amber Behn, customer care manager of BrightStar Care Stroudsburg & Allentown. “Initiating a dialogue is key to being able to proactively address the needs of multicultural clients and their caregivers,” she says.
“Don’t be afraid to ask questions respectfully. Most people enjoy educating others on their culture.”
—Dr. Barb Norvell, podiatrist specializing in geriatric care
Ask questions
Dr. Barb Norvell, a podiatrist specializing in geriatric care and CEO of Podiatric Physicians of Georgia, agrees. Sometimes the best and easiest way to understand another culture, she says, is to simply ask the person you’re caring for. “Don’t be afraid to ask questions respectfully,” she adds. “Most people enjoy educating others on their culture.”
Key considerations for supportive and respectful multicultural care
Here are just a few things to be mindful of when caring for seniors who may have different attitudes, practices or beliefs than your own.
1. Communication
Address any concerns about communication early with your patient and their family, and check in to ensure everything is going smoothly from time to time. Ask questions like:
- Is a handshake or a hug welcomed in your senior charge’s culture?
- Should they be addressed in a certain way?
- Are there any gestures or topics of conversation that should be avoided?
- Are there certain family members who can speak for your patient?
“When I worked with a Russian family, I would check in with the daughter who hired me once every couple of weeks,” says Jenny Baker, a senior care provider from Thornton, Colorado. “I’d make sure that her father was comfortable with me, and that I was respecting his preferences in our interactions. It was awkward at first to match his communication style, which was very blunt, but eventually it made it easier for me to care for him.”
When Baker learned that native Russian speakers sometimes prefer shorter, more to the point conversation, it helped her work through her own communication styles with her charge.
2. Touch and body language
Not all people have the same approach to touch and body language. Consider how your habits might be viewed by someone from another culture. For example, “eye contact may be viewed as threatening in some cultures, while in others, it is a sign of respect,” says Susan Scatchell, business development director of Gentle Home Services in Deerfield, Illinois. As a result, Scatchell says, “Personal hygiene care needs must be delivered in a manner that is respectful to the person and their beliefs.”
For example, caring for a Muslim charge may require helping them carry out “ablutions,” which involves washing the hands, face, ears, nose, mouth and feet under running water. Because this is a holy act, only they or someone of their faith can perform this ritual. In Hindi cultures, a female caregiver may not be able touch hands with a male charge, as that goes against tradition.
Not sure how to address this? Talk to your patient and their family about what constitutes respectful hygiene practices, personal space, eye contact or physical touch when necessary.
3. Food and diet
Food is a large part of one’s culture, so it’s important that a caregiver knows their elder patients’ food and eating customs. “Certain cultures may have different practices, such as the foods they eat, how it is prepared, as well as how the food may sit on their table or plate,” says Norvell.
This is critical for a care provider to know, as food prep and serving meals is a common part of this work. Ask your charges or their families questions like:
- Are there particular foods that should be avoided?
- Should mealtimes be scheduled for certain times of day?
- Are there any holidays in which special foods are required or fasting takes place?
- How is food prepared and served, and are you expected to prepare and serve in a specified way?
4. Medical care and spirituality
Beliefs about medical care and spirituality can have a strong influence on your elder patient’s approach to life. For example, says Norvell, other cultures may have different times of the day that they pray, and during those times, “It would be inappropriate for them to be disturbed,” even for doctors appointments or other care needs.
“Different cultures utilize alternative medicine, coping strategies or have different spiritual needs.”
—Susan Scatchell, business development director of Gentle Home Services
In my own experience as a senior care provider, I worked with someone who was a Jehovah — the name for someone of the Jehovah’s Witness faith. Her faith guided her opinion on medical and end-of-life care, which differed from my own. After speaking with the family at length about their mother and wife’s wishes, I was able to understand what she needed and provide it with loving care. I knew, for example, that she did not want to take the medications prescribed to her, and that she wished to end all treatment in a medical facility. She wanted to have in-home, non-medical care until the very end.
This was very hard for me, but as Scatchell explains, “Different cultures utilize alternative medicine, coping strategies or have different spiritual needs.”
Remember: As a care provider, it’s not your job to provide care in only one way; it’s your job to provide care that aligns with what your charge wants.
The bottom line
As a caregiver, it’s your job to respect cultural differences and not let your own beliefs or background get in the way of providing the best care possible. “Often, people do not realize how the beliefs they hold and assumptions they might make can impact the care they provide,” says Rabbi Sara Paasche-Orlow, director of spiritual care at Hebrew SeniorLife.
Take a moment to take stock of what you believe and what practices you engage in that may feel different to people from other places or backgrounds. Also know that you may not always understand everything about the seniors you care for, and that’s OK. Treat everyone as an individual, a unique person who has their own set of values and beliefs. Ask questions and absorb the information you’re given. That’s part of delivering high-quality care, and care should be prioritized above all else.
As caregivers for others, “It’s not our place or right to judge but to deliver care in the manner appropriate and expected,” says Scatchell.
