Chapter 8: Working with Diverse Older Patients
"Cultural differences, not divides."
"Accurate and effective communication between patients and clinicians is the most essential component of the health care encounter. Lacking effective communication strategies, patients and clinicians can be frustrated and misunderstood.“
- U.S. Office of Minority Health
Appreciating the richness of cultural and ethnic backgrounds among older patients can help to promote good health care. Good communication skills enable you to listen closely to what your patients are saying, regardless of their cultural background. Understanding how different cultures view health care helps you to tailor questions and treatment plans to the patient’s needs. Although you cannot become expert in the norms and traditions of every culture, being sensitive to general differences can strengthen your relationship with your patients.
The use of alternative medicines, herbal treatments, and folk remedies is common in many cultures. Be sure to ask your patient if he or she takes vitamins, herbal treatments, dietary supplements, or other alternative or complementary medicines. By being respectful of native healers on whom your patient may also rely, you help to build a trusting relationship.
Older immigrants or non-native English speakers may need a medical interpreter. Federal regulations require physicians and health care providers to create a plan for serving their non-English speaking patients. Guidance for accommodating people with limited English proficiency is available.
For more information on accomodating people with limited English proficiency, contact:
Federal Interagency Working Group on Limited English Proficiency www.lep.gov |
Medical interpreters are more reliable translators than are family members or friends, who may be unable to interpret medical terminology or may inadvertently misinterpret information. Although a patient may choose to have a family member translate, he or she should be offered access to a professional interpreter. Whenever possible, offer patients appropriate translations of written material or refer them to bilingual resources.
When working with patients from other countries, be sure to ask which language they prefer to speak and whether or not they read and write English (and, if not, which language they do read). If translations are not available, ask the medical interpreter to translate medical documents.
Each culture has its own rules about body language and interpretations of hand gestures. Some cultures point with the entire hand, because pointing with a finger is extremely rude behavior. For some cultures, direct eye contact is considered disrespectful. Until you are sure about a patient’s background, you might opt for a conservative approach. And, if you aren’t certain about a patient’s preferences, ask.
For more information on working with patients with diverse cultural backgrounds, contact:
U.S. Office of Minority Health P.O. Box 37337 Washington, DC 20013-7337 Phone: 1-800-444-6472 www.omhrc.gov This Federal government agency works to improve the health of racial and ethnic populations through the development of effective health policies and programs that help to eliminate disparities in health.
National Institutes of Health (NIH) www.salud.nih.gov The NIH has a wealth of patient education materials – a wide variety of which are available in Spanish. Visit the website for a complete list of Spanish language resources.
The National Council on Interpreting in Health Care 1217 Sunset Avenue Santa Rosa, CA 95407 Fax: 707-541-0437 www.ncihc.org Contact the Council for more information about medical interpreters or to locate local resources.
The Providers Guide to Quality and Culture Management Sciences for Health 165 Allandale Road Boston, MA 02130 Phone: 617-524-7799 http://erc.msh.org This Guide offers materials for health care providers who work with diverse populations, including information about common beliefs and practices. |
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