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CULTURAL DIVERSITY Aging, Health and Care Jennifer May Licardo Education Coordinator.

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Presentation on theme: "CULTURAL DIVERSITY Aging, Health and Care Jennifer May Licardo Education Coordinator."— Presentation transcript:

1 CULTURAL DIVERSITY Aging, Health and Care Jennifer May Licardo Education Coordinator

2 ● seniors  65 y/o make up 13.7% of Canada’s population senior population — in 2005 - 4.2 million — between the year 2005 to 2036 - 4.2 to 9.8 million; will account for about 25% of the total population - Statistics Canada AGING POPULATION

3 CULTURAL DIVERSITY in 2001 census - > 200 ethnic groups reported in 2006 census -  150 languages identified - Statistics Canada

4 CULTURE ● a health determinant - attitudes of the predominant culture influence the well being of other cultural groups: marginalization stigmatization loss or devaluation of language lack of access to culturally appropriate health care services - Public Health Agency of Canada

5 HEALTH ● ‘a state of complete physical, mental, and social well-being and not merely the absence of disease, or infirmity’ - World Health Organization ● healthy aging - ‘a lifelong process of optimizing opportunities for improving and preserving health and physical, social and mental wellness, independence, quality of life and enhancing successful life-course transitions’ - Health Canada

6 aging culture healthcare Cultural competency

7 CULTURAL COMPETENCY - “a set of behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross-cultural situations” - (Cross et al 1989)

8 -“in health care describes the ability of systems to care for patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural and linguistic needs” - (Betancourt et al 2002) -“is a process in which healthcare providers continually strive to work effectively within the cultural context of a patient” - (Brown & Rhymes, 2006) CULTURAL COMPETENCY

9 In our setting: Organizations and healthcare providers need to recognize and value cultural diversity among seniors.

10 CULTURAL COMPETENCY CHALLENGES Organizations: ● Policies - mission statements - staffing ● involve community, families, and person in meetings and assessments ● use of interpretation services and community health workers ● culturally and linguistically friendly physical environment (interior design, pictures, posters, art works)

11 ● Policies - mission statements e.g. Christianity – belief that Jesus Christ was the son of God and He came to earth as a man to restore the relationship between humans and God - staffing e.g. French speaking staff in a long-term care facility CULTURAL COMPETENCY CHALLENGES Organizations:

12 ● involve community, families, and person in meetings and assessments CULTURAL COMPETENCY CHALLENGES Organizations : CULTURAL COMPETENCY CHALLENGES Organizations :

13 ● use of interpretation services and community health workers e.g. Language Access Interpreter Services (204) 788-8585 free services Winnipeg Health Region CULTURAL COMPETENCY CHALLENGES Organizations: CULTURAL COMPETENCY CHALLENGES Organizations:

14 ● culturally and linguistically friendly physical environment (interior design, pictures, posters, art works, food and celebrations) CULTURAL COMPETENCY CHALLENGES Organizations: CULTURAL COMPETENCY CHALLENGES Organizations:

15 ● Judaism – Kosher symbols ●Southeast Asian refugees ●India – leather ●Hinduism – beef ●Islam – pork, Ramadan ●Buddhism - vegetarian CULTURAL BELIEFS/ISSUES

16 CULTURAL COMPETENCY CHALLENGES Healthcare providers: become familiar with core cultural issues of the groups with whom you work assess your own attitudes and values, knowledge and skills — recognize that people from other cultures may not share your own beliefs

17 Healthcare providers: con’t. enhance person-provider communication and trust — build skills that enhance communication promote mutual respect CULTURAL COMPETENCY CHALLENGES

18 ● become familiar with core cultural issues of the groups with whom you work CULTURAL COMPETENCY CHALLENGES Healthcare providers: CULTURAL COMPETENCY CHALLENGES Healthcare providers:

19 - CHINA  role of Confucianism - filial piety (“xiao”) - father - undisputed head of the family  role of Buddhism - emphasize “face” & dignity  role of Taoism - selflessness, cleanliness, emotional calm  illness as an imbalance of Yin & Yang CULTURAL BELIEFS/ISSUES

20 - BUDDHISM  pain and suffering can provide valuable lessons in life - AFRICA  elders believed as representatives of ancestors & mediators between them and kin-group - ABORIGINAL  in many communities, age is not defined by chronology CULTURAL BELIEFS/ISSUES

21 ● assess your own attitudes and values, knowledge and skills CULTURAL COMPETENCY CHALLENGES Healthcare providers: CULTURAL COMPETENCY CHALLENGES Healthcare providers:

22 - SOUTHEAST ASIA  traditional remedies: ‒ herbal medicine ‒ therapeutic burning ‒ coin rubbing ‒ acupuncture ‒ cupping CULTURAL BELIEFS/ISSUES

23 - PAKISTAN  does not require much personal space - ABORIGINAL  women expected to be primary caregivers - BUDDHISM  strive for deep insight into true nature of life CULTURAL BELIEFS/ISSUES

24 - HINDUISM  belief that every soul is trapped in a cycle of birth and then death and then rebirth; aim is to be better than the life before  belief in “Karma” CULTURAL BELIEFS/ISSUES

25 - ISLAM  heart of faith for all Muslims is obedience to Allah’s will  upon death: prefer that body not be touched by non-Muslims  important to wash in running water (face, ears, forehead, feet, arms to the elbows) and rinse nose and mouth before prayer CULTURAL BELIEFS/ISSUES

26 ● enhance person-provider communication and trust CULTURAL COMPETENCY CHALLENGES Healthcare providers: CULTURAL COMPETENCY CHALLENGES Healthcare providers:

27 - INDONESIA  touching head of an elder is rude - JAPAN  direct eye contact may be intimidating or sexual - PAKISTAN  generally enjoy close interpersonal relationship  do not appreciate discussing about women in public CULTURAL BELIEFS/ISSUES

28 - INDIA  winking, whistling, pointing with fingers, touching someone’s ears or pointing your feet at someone considered rude  feet are considered unclean - if feet make contact, expect to apologize  use of first name is considered impolite  left hand considered unclean, use right hand for eating - ABORIGINAL  tend not to use direct physical or eye contact when speaking to another person CULTURAL BELIEFS/ISSUES

29 ● promote mutual respect CULTURAL COMPETENCY CHALLENGES Healthcare providers: CULTURAL COMPETENCY CHALLENGES Healthcare providers:

30 CULTURAL BELIEFS/ISSUES CHINA ● role of Confucianism - filial piety (“xiao”) - father is the undisputed head of the family ● role of Buddhism - emphasize “face” & dignity ● role of Taoism - selflessness, cleanliness, emotional calm ● illness as an imbalance of Yin & Yang

31 CULTURAL BELIEFS/ISSUES SOUTHEAST ASIA ● a number of SE Asians had traumatic refugee experience, sudden & involuntary cultural transplantation to a foreign culture, spent many years in refugee camps or held in political detainee prisons ● Buddhism - pain and suffering can provide valuable lessons in life

32 SOUTHEAST ASIA con’t. ● traditional remedies: - herbal medicine- therapeutic burning - coin rubbing- acupuncture - cupping ● Vietnamese - illness as function of the nervous system ● Indonesia - touching head of an elder is rude ● Japan - direct eye contact may be intimidating or sexual CULTURAL BELIEFS/ISSUES

33 AFRICA ● elders believed as representatives of ancestors & mediators between them and kin-group ● Nigeria - very rude not to shake hands when greeting someone

34 CULTURAL BELIEFS/ISSUES INDIA ● winking, whistling, pointing with fingers, touching someone’s ears or pointing your feet at someone considered rude ● feet are considered unclean - if feet make contact, expect to apologize ● wearing leather may cause offense ● use of first name is considered impolite ● left hand considered unclean, use right hand for eating

35 CULTURAL BELIEFS/ISSUES PAKISTAN ● does not require much personal space ● generally enjoy close interpersonal relationship ● do not appreciate discussing about women in public ● eat only with right hand

36 CULTURAL BELIEFS/ISSUES ABORIGINAL ● in many communities, age is not defined by chronology ● women expected to be primary caregivers ● tend not to use direct physical or eye contact when speaking to another person

37 RELIGIOUS BELIEFS BUDDHISM ● strive for deep insight into true nature of life ● do not worship gods or dieties ● many are vegetarians

38 RELIGIOUS BELIEFS CHRISTIANITY ● believe that Jesus Christ was the son of God and He came to earth as a man to restore the relationship between humans and God ● Catholics - usually would want “Sacrament of the Sick” (last rites) to be given when dying or upon death

39 RELIGIOUS BELIEFS HINDUISM ● religion is a matter of practice rather than beliefs ● belief that every soul is trapped in a cycle of birth and then death and then rebirth; aim is to better than the life before ● beef is prohibited - cow regarded as sacred ● belief in “Karma”

40 RELIGIOUS BELIEFS ISLAM ● heart of faith for all Muslims is obedience to Allah’s will ● pork and alcohol are prohibited ● major fast:“Ramadan” - complete abstinence from sunrise to sunset for one month; light meals only after sundown ● upon death: prefer that body not be touched by non-Muslims ● important to wash in running water (face, ears, forehead, feet, arms to the elbows) and rinse nose and mouth before prayer

41 RELIGIOUS BELIEFS JUDAISM ● belief that there is a single God who not only created the universe, but with whom every Jew can have an individual and personal relationship ● conservative Jews “keep Kosher” (no mixing of meat and dairy products) ● do not eat pork or shellfish

42 CULTURAL COMPETENCY CONSIDERATIONS ● avoid generalizations or stereotypes ● maintain a non-judgmental attitude ● practice person-centered care

43 CULTURALLY COMPETENT HEALTHCARE PROVIDER WARMTH - acceptance, liking, commitment, and unconditional regard EMPATHY - ability to perceive and communicate, accurately and with sensitivity, the feelings of an individual and the meaning of those feelings GENUINENESS - openness, spontaneity, and congruence

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45 REFERENCES: Statistics Canada. 2007. Detailed Mother Tongue (186), Knowledge of Official Languages (5), Age Groups (17A) and Sex (3) for the Population of Canada, Provinces, Territories, Census Metropolitan Areas and Census Agglomerations, 2001 and 2006 Censuses - 20% Sample Data (table). Topic-based tabulation. 2006 Census of Population. Statistics Canada catalogue no. 97- 555-XCB2006015. Ottawa. Released December 04, 2007. http://www12.statcan.ca/english/census06/data/topics/Print.cfm?PID=89201&GID=837928&D1 =0&D2=0&D3=0&D4=0&D5=0&D6=0 (accessed February 20, 2008). http://www12.statcan.ca/english/census06/data/topics/Print.cfm?PID=89201&GID=837928&D1 =0&D2=0&D3=0&D4=0&D5=0&D6=0 Statistics Canada. 2007. Manitoba (table). 2006 Community Profiles. 2006 Census. Statistics Canada Catalogue no. 92-591-XWE. Ottawa. Released March 13, 2007. http://www12.statcan.ca/english/census06/data/profiles/community/Index.cfm?Lang=E http://www12.statcan.ca/english/census06/data/profiles/community/Index.cfm?Lang=E (accessed February 22, 2008). Public Health Agency of Canada. Population Health. What Determines Health? Key Determinants. www.phac-aspc.gc.ca/ph-sp/phdd/determinants.html#culture Statistics Canada. 2007. “A Portrait of Seniors in Canada” Catalogue no. 89-519-XIE. www.statcan.ca/english/freepub/89-519-XIE/2006001/findings.htm

46 Public Health Agency of Canada(PHAC). “Healthy Aging in Canada: A New Vision, A Vital Investment.” Division of Aging and Seniors. www.phac-aspc.gc.ca/seniors-aines/pubs/haging-newvision/pdf/vision_rpt_e.pdf National Advisory Council on Aging (2005). “Seniors on the Margins: Seniors from Ethnocultural Minorities.” Minister of Public Works and Government Services Canada. Achieving Cultural Competence: A Guidebook for Providers of Services to Older Americans and their Families. January 2001 Manitoba’s Office of Rural and Northern Health. Multicultural Reference Guide: Etiquette & Religion. October 2006. Brown, D. and Rhymes, J. 2006. Cultural Competence for Primary health Care in Nova Scotia: A DVD and Discussion Guide Wieland, D. et al. 1994. Cultural Diversity and Geriatric Care. Kratiuk-Wall, S. et al. 1997. Cultural Diversity and Dementia.REFERENCES:


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