Transcultural Perspectives in the Care of Older Adults

Chapter 8: Transcultural Perspectives in the Care of Older Adults

Copyright © 2016 Wolters Kluwer Health | Lippincott Williams & Wilkins

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Transcultural Perspectives in the Nursing Care of Older Adults #1

Longer life spans and the aging baby boomer generation will lead to a large population of older adults aged 65 years old and older who will seek health services.

Delivering culturally appropriate care to clients is set by how available and affordable national, state, and local health care resources are for older adults.

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Transcultural Perspectives in the Nursing Care of Older Adults #2

There are three areas of influences for older adults that guide their help-seeking behaviors:

Societal and economic factors; affordability and accessibility

Cultural values, practices, patterns of caregiving, and available community resources

Family, individual lifestyles, health, and coping behaviors

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The Older Adult in Contemporary Society: Factors Affecting Health Care

Societal level

Demographics: ethnicity and income level, low literacy

Socioeconomic status: fixed income, increased health-related expenses, delayed retirement

Theories of aging: explain patterns of behavior

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Question #1

Is the following statement true or false?

The health status of non-Hispanic Whites is typically better than other minority ethnicities.

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Answer to Question #1

True

Rationale: At all ages, the health status of Hispanics, Asian Americans, African Americans, Native Americans/Alaska Natives, and Native Hawaiians/Other Pacific Islanders has long lagged behind that of non-Hispanic Whites.

Also, approximately 40% of Hispanics and African Americans have no private savings for their retirement and will look to government-funded assistance.

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The Older Adult in the Community: Cultural Influences #1

Cultural level

Differences in culture and ethnicity shape health and illness behaviors and actions.

Specifically:

Physical functioning: mobility/exercise

Social and emotional well-being: acculturation, family/peer support

Quality of life: satisfaction and happiness

Beliefs and practices: remedies, traditional healers, self-care

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The Older Adult in the Community: Cultural Influences #2

Cultural level (cont.)

Culture change: relocating, migrating

Caregiving: willingness of family to offer support, responsibility to care for elders

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Question #2

Is the following statement true or false?

It is generally not recommended for older adults to utilize self-help strategies to maintain their health.

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Answer to Question #2

False

Rationale: Older adults who use self-help strategies to maintain their health generally report better psychological well-being and physical functioning than older adults who do not use these approaches.

Nurses who are aware of cultural variations can appreciate that older individuals will have different value orientations underlying their decisions to adopt health behaviors.

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The Older Adult in the Community: Cultural Influences #3

Cultural level (cont.)

Dimensions of Social Support:

Affective support: respect/love

Affirmational support: endorsement for one’s behavior/perceptions

Tangible support: aid or physical assistance

Complicated by separation from family members, loss of spouse/partner, declining physical abilities

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The Older Adult: Caring for Individual Clients #1

Older adults continue to meet developmental tasks:

Satisfaction of basic needs, such as safety, security, and dignity

Fulfillment of integrity and self-actualization

Maintaining self-esteem and choices about where he/she will live

Engaging in meaningful activity

May embrace increased religion/spirituality

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The Older Adult: Caring for Individual Clients #2

Continuum of care

Older adults generally require three types of care:

Intensive personal health services

Health maintenance and restorative care

Coordinated services

Nurses assess that values of independence and self-reliance may be very strong for some older clients; they may refuse any assistance; the nurse should evaluate clients’ behaviors relative to underlying values.

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The Older Adult: Caring for Individual Clients #3

Community-based services for older adults

In home care

Skilled nursing facility, assisted living

Community resources: home-delivered meals

Local or church-affiliated volunteer visitors

Day programs in communities and adult day care

Volunteering within the community and the educational system

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Question #3

Which criterion is among those used to determine the appropriate level of residential placement for an older adult who is reluctant to live alone?

Community support

Age and Gender

Financial resources

Risk for injury

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Answer to Question #3

D. Risk for injury

Rationale: Criteria that the nurse often considers to recommend the level of care or residential placement that would be most appropriate for an older client include mental orientation, physical mobility restrictions, degree of assistance needed to complete activities of daily living, frequency of incontinence, and level of risk for accident or injury if living independently.

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