10 Mar Aging, Culture, and Communication: The Importance of Culturally Competent Senior Home Care in Philadelphia, Pennsylvania
The United States, along with Pennsylvania and Philadelphia, are experiencing the largest increase of the older adult population in their history.
The number of ethnically and culturally diverse groups is also growing, each with its own cultural traits. This can be seen across the country along with right here in greater Philadelphia region (including Bucks, Delaware, Chester, and Montgomery counties). Some racial groups present unique health or community challenges specific to that group.1
The increasing diversity of the nation brings opportunities and challenges for home health care providers and caregivers to create and deliver culturally competent at-home elder services.
What is cultural competency in healthcare and why is it important?
Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.
A culturally competent health and homecare system can help improve health outcomes and quality of care, and can contribute to the elimination of racial and ethnic health disparities.
Health Disparities and Cultural Challenges
Racial and ethnic minorities are disproportionately burdened by chronic illness
This includes higher morbidity and mortality from chronic diseases.2 The consequences can range from greater financial burden to higher activity limitations.
The population at risk for chronic conditions will become more diverse
Chronic conditions become more likely as one ages and the elder population is growing increasingly diverse. This creates challenges for health systems who need to consider language and cultural barriers to care along with meeting overall care needs.
Access to health care differs by race and ethnicity
Higher proportions of minorities compared to whites do not have a usual source of care and lack health insurance.3
Language and communication barriers are obstacles
Language and communication barriers can affect the amount and quality of health care received. For example, Spanish-speaking Latinos are less likely than Whites to visit a physician or mental health provider, or receive preventive care like mammograms or flu vaccines.4
Communication barriers may lead to dissatisfied patients, poor comprehension, adherence, and lower quality of care. Spanish-speaking Latinos are less satisfied with the care they receive and more likely to report overall problems with health care than English speakers.5
Low literacy affects access to health care
The elderly typically have lower levels of literacy, and have had less access to formal education than younger populations. Low literacy may affect patients’ ability to read and understand medical instructions. Those with low literacy skills use more health services, and the resulting costs are estimated to be $32 to $58 billion in additional health care expenditures.6
Patient dissatisfaction may stem from lack of cultural competency
Without culturally competent services, patients are at higher risk of having negative health consequences, receive poor quality care, or be dissatisfied with their care. African Americans and other ethnic minorities report less partnership with physicians, less participation in medical decisions, and lower levels of satisfaction with care.7
7 Ways to be More Culturally Competent and Sensitive in Home Care
A person should take stock of the culture, values, and biases she has and how they shape her view of others. Evaluating your prejudices and preconceptions is an essential first step toward cultural competency as a caregiver or home care agency.
One should resist the urge to make assumptions about cultures that they are not familiar with. This can lead to a breakdown in trust between the patient and provider and exacerbate the challenges we talk about here.
Often, patient knowledge is reduced to their medical history, list of medications, and symptoms. Healthcare can reach its full potential through education on the whole patient. This includes education on their daily lives, family, and culture while considering social determinants of health.
The best way to learn about others is to talk to them. Ask about their culture from a place of respect and curiosity. Don’t avoid others due to language or other barriers. The more you interact, the better you will become at it.
Overcome language barriers
Language barriers exacerbate all other challenges facing providers. Ensure access to translation services, but look at the patient and speak to them as if no language barrier exists. Consider body language, as beliefs about eye contact, physical distance, etc. can vary among cultures.
Understand different approaches to medicine
Western healthcare is just one approach compared to other medical philosophies practiced by people around the world. Maintain an open mind with patients and families who wish to consider alternatives to conventional medical treatment. Take the time to educate patients about practices of western medicine.
Listening is perhaps the most valuable tool for cultural competence. True cultural competence requires listening with an open mind and understanding the other person’s perspective. It’s important that patients feel heard and validated, particularly when they are in a vulnerable position.
Broader societal patterns that disadvantage older adults can make it difficult for them to enjoy a healthy old age. By practicing culturally sensitive at-home care to seniors and elders, home care agencies and caregivers can enhance transparency between the differences among us to reduce health disparities and improve care outcomes. Read more about Chosen Family Home Care’s commitment to cultural competence and sensitivity in care to reduce health disparities and increase patient satisfaction here.
1 2012 Population Estimates and 2012 National Projections. U.S. Census Bureau, 2012.
2 Diverse communities, common concerns. The Commonwealth Fund, 2002.
3 Key facts: Race, ethnicity, & medical care. Kaiser Family Foundation, 2002.
4 Disparities in health care by race, ethnicity and language among the insured. Medical Care, 2002.
5 Effect of Spanish interpretation method on patient satisfaction in an urban walk-in clinic. Journal of General Internal Medicine, 2002.
6 Impact of low health literacy skills on annual health care expenditures. Center for Health Care Strategies. 2003.
7 Cooper & Roter. 2003.