Importantly, many of these older adults are more diverse than ever before. By 2050, for example, “minority” older adults will account for nearly 40% of the 80 million Americans aged 65 and older.
To increase our sensitivity to health disparities, culture, and health literacy, experts in ethnogeriatrics—the study of how ethnicity and culture impact the health and well-being of older people—at the American Geriatrics Society (AGS) recently published a position statement. The document, published in the Journal of the American Geriatrics Society, describes strategies for achieving high-quality multicultural geriatric care. It serves as a blueprint for providing culturally effective, respectful care that meets the unique needs of our richly diverse older adult patient population.
While health inequities are already well-documented among older people, they are even more pronounced for multi-cultural older Americans. Minority individuals older than age 65 have higher rates of disease and disability when compared with Caucasian men and women of the same age. Additionally, of the 36% of Americans who report limited health literacy, most are older, less educated, and not white.
Sadly, many minority individuals also tend to mistrust health personnel and systems. They also lack trust in medical research. These factors can undermine the therapeutic bond and exacerbate barriers to high-quality multicultural care.
Seeing More Than Age
As outlined in the AGS position statement, delivering culturally effective care means exploring and being responsive to the unique care needs of each patient during every clinical encounter. Putting processes or systems in place to ensure that patients are asked about their ethnicity, their preferred language, their level of education, and their familiarity with helpful resources like interpreter services, for example, can go a long way toward incorporating the identity of older patients into their care.
Healthcare professionals need to become skilled in communicating effectively with people from different backgrounds, particularly since our own personal values and beliefs might inadvertently impede care without a healthy dose of self-awareness. As a tool for recognizing our own unique differences, the AGS position statement notes that all patients are common in their desire for care that is high-quality, person-centered, and supportive of the values and expectations that inform who we are.
The AGS statement has identified several key components of high-quality multicultural care. These include the following:
- Culturally Sensitive Indicators of Care: It’s important to track information about a person’s ethnicity, preferred language, and education (to the extent they are willing to share) so that care can be tailored to specific needs, improve health outcomes, and curb inefficiencies.
- Communication Skills & Linguistic Competency: Healthcare professionals need to be mindful of how to communicate in ways that address language and individual cultures, values, beliefs, and biases. Health systems also need tools to work with people who may not be native English-speakers or who may have difficulties with health literacy.
- Self-Awareness: Healthcare professionals need to be aware of their own cultural backgrounds and how they might impact care and communication.
- Research & Education: Healthcare providers must be educated to care for diverse individuals, and more must be done to study how culture and ethnicity impact care.
VJ Periyakoil, MD, has indicated to Physician’s Weekly that she has worked as a consultant for the American Board of Internal Medicine and has received grants/research aid from the NIH.
Readings & Resources (click to view)
American Geriatrics Society Ethnogeriatrics Committee. Achieving high-quality multicultural care. J Am Geriatr Soc. 2016 Jan 25 [Epub ahead of print]. Available at: http://onlinelibrary.wiley.com/doi/10.1111/jgs.13924/abstract.
For more information from Geriatrics Care Online (which is powered by the American Geriatrics S), go to www.GeriatricsCareOnline.org.
For more information from the Health in Aging Foundation, go to www.HealthinAging.org.
For more on the Stanford University Ethnogeriatrics Curriculum, go to http://geriatrics.stanford.edu.