This guidebook is designed for use by providers of services to
racially and ethnically diverse older populations. There is growing
interest in learning how effective, culturally appropriate services
can be provided by professionals who have mastered culturally
sensitive attitudes, skills, and behaviors. We hope you will find
this document a helpful introduction. However, it is only an introduction
and not intended to substitute for more rigorous and on-going
study. We hope that you will find each chapter both enlightening
and useful. For readers who have taken more formal courses to
acquire cultural competence, this guidebook might serve as a review--a
tool to engage you further and to enable you to evaluate current
programs with a critical eye towards your staff achieving cultural
In designing service programs, we cannot assume that methods
designed for majority group older persons will automatically apply
to minority elders. This poses a challenge and opportunity for
all of us to design culturally appropriate interventions that
are responsive to the needs of minority communities and to offer
support that withstands the changing needs of diverse populations
Racial and ethnic minorities face many barriers in receiving
adequate care. These include difficulties with language and communication,
feelings of isolation, encounters with service providers lacking
knowledge of the client's culture and challenges related to the
socio-economic status of the client. Often, service providers
have a responsibility to provide a voice for clients who cannot
speak for, or represent, themselves.
The guidebook is divided into six chapters and five appendices.
Each of the first three chapters takes a particular perspective
or point of view critical to understanding cultural competence.
For example, in Chapter Two we explore the meaning of cultural
competence. Part A provides a definition of culture and discusses
the intervening factors that determine the impact of culture.
Part B provides a definition of cultural competence, Part C outlines
the barriers to accessing services experienced by minority elders,
and Part D gives an overview of research accomplished in this
Chapter Three examines the importance of cultural competence,
and is divided into three sections. Part A introduces the reader
to the importance of providing services and programs that exemplify
cultural competence. Part B evaluates demographic information
pertaining to various racial and ethnic minorities, and Part C
discusses the demographic information with relation to disparities
among racial and ethnic minorities.
The focus of Chapter Four is to demonstrate the way in which
agencies can conceptualize culturally competent practice within
their organizations, set goals, and move on to the development
and implementation of interventions by culturally competent professionals.
Part A is a basic introduction to the principles of cultural competence.
Part B explains the five elements essential in developing culturally
In Chapter Five, the reader is given illustrative examples to
gain a better understanding of individual and broad cultural differences
between racial and ethnic groups and the process of acculturation.
Part A presents profiles of people with regard to age, education,
gender and geographic location. Part B provides profiles of programs,
and Part C concludes the chapter with a discussion of the implications.
Appendix One summarizes the national laws relevant to cultural
competency. Appendix Two provides a brief overview of executive
orders related to the concerns of minority groups. Appendix Three
describes the Healthy People 2010 effort to improve the health
status of racial and ethnic minority populations.
No guidebook would be complete without accompanying handouts,
and these are provided in Appendix Four. The handouts are
intended as aids for providers during presentations in training
workers to implement culturally appropriate programs within their
agencies and can also be used as overhead slides.
Appendix Five concludes the guidebook with references for readers
who would like to receive more in-depth information on culturally
competent practice and how professionals can be culturally competent
in their provision of services and programs for an increasingly
diverse aging population.