By: Sara Velcani and Jeein Jang
Cultural competency is the practice of understanding, communicating, and effectively providing care to patients from diverse cultural backgrounds. This practice involves ensuring equity in care and understanding cultural diversity. Addressing the barriers that may prevent diverse populations from receiving the same care as other individuals is important to build trust and accessibility.
According to the U.S. Census Bureau, nearly 40% of Americans identify with a different cultural background. As the overall population continues to grow rapidly, the number of older individuals will also increase, leading to greater diversity within this age group. Consequently, cultural competence in geriatrics will be required by healthcare providers to deliver care that meets the cultural, linguistic, and social needs of older adults. We specifically focused on navigating language barriers, accommodating varied dietary patterns, and respecting traditional healing practices to address cultural competence in geriatrics.
Impact of Language Barriers on Healthcare Services:
Language barriers significantly hinder access to healthcare services for non-English speaking patients. Approximately 35% of such patients may misinterpret aftercare instructions, leading to adverse health outcomes. These barriers contribute to poorer health outcomes compared to patients who speak the local language. Language barriers exacerbate health disparities, particularly among racial minority groups. They lead to increased healthcare costs as patients are more likely to consume additional healthcare services due to misunderstandings and miscommunications. Moreover, these barriers reduce satisfaction for both patients and healthcare providers, as effective communication is a cornerstone of quality care.
Solutions:
Patient advocacy plays a crucial role in assisting non-English speaking patients in navigating the complexities of healthcare settings. These advocates can help patients understand their treatment options, interpret medical jargon, and ensure they receive the necessary care. By providing this support, patient advocates help bridge the communication gap and enhance the overall healthcare experience for non-English speaking patients.
To ensure that all patients, regardless of language proficiency, receive adequate care, federal law mandates that healthcare providers receiving federal funding must offer interpretation services at no cost. This requirement applies even if the healthcare organization does not receive reimbursement from the government for these services. Language access laws have been a crucial development to overcoming barriers. By 2019, all U.S. states had adopted such laws, with states like California having detailed provisions to tackle language barriers in healthcare.
With the increasing integration of technology in healthcare, creating bilingual online portals for medical records can significantly improve patient access to information. These portals should provide detailed treatment plans and health records in multiple languages, enabling patients to understand and engage with their healthcare more effectively. This approach not only empowers patients but also ensures that they are better informed and more likely to follow through.
Ultimately, addressing language barriers through patient advocacy, technological solutions, and supportive federal legislation is essential for promoting equitable care and cultural competency. By implementing these strategies, we can create better patient-provider relationships and bridge communication gaps.
Impact of Cultural Competency on Dietary Habits:
Cultural competency in healthcare includes understanding dietary patterns and nutritional practices, which vary significantly across cultures. This understanding is crucial for providing effective dietary advice, especially in geriatrics, where nutritional needs are critical for managing chronic conditions. Providers who align their recommendations with patients’ cultural preferences can improve adherence and health outcomes. Social determinants of health, such as socioeconomic status and food access, affect dietary habits and contribute to health disparities, especially among underserved groups who often lack access to nutritious foods. This competency is critical in oral healthcare, where diet significantly prevents and manages oral diseases. As well as in cardiovascular care, where a heart-healthy diet is as crucial as medication.
Cultural dietary practices vary significantly among racial and ethnic older populations, impacting oral health differently. 50% of the global older adult population suffers from untreated dental cavities, with diet being the main risk factor for this condition. Traditional Asian diets often include fermented foods and teas that are beneficial for oral health, while a Western diet rich in processed sugars could negatively affect these patients.
Solutions:
Healthcare providers should receive training in cultural competence to understand various cultural groups’ dietary habits and preferences. This training can help them provide personalized nutritional advice that respects and incorporates patients’ cultural practices. For example, dietitians can learn about traditional foods and preparation methods to offer realistic dietary modifications for older adults. Healthcare providers can utilize collaboration with cultural experts, such as community leaders and traditional healers, to develop and implement dietary interventions. These collaborations help ensure that nutritional advice is culturally sensitive and more likely to be accepted by patients. Nutrition counseling sessions should consider the patient’s cultural context, including beliefs about food and health, religious dietary restrictions, and traditional healing practices. Respecting these aspects can build trust and encourage better dietary adherence. Provider training, collaboration with cultural experts, and culturally sensitive nutrition counseling sessions are key strategies to enhance cultural competence in geriatrics, particularly in addressing dietary needs and preferences.
Integrating Traditional Healing Practices into Modern Medicine:
The sudden introduction of modern medicine to diverse older populations can be both shocking and uncomfortable. Integrating traditional healing practices into healthcare environments can significantly improve care effectiveness for these culturally diverse groups. Indigenous populations have long preferred traditional healing methods for their holistic approach, which often includes plant and animal-based medicines and spiritual techniques.
Western medicine can be viewed as experimental to many, including Hmong older Americans. The Hmong are classified as an ethnic group originally from the mountainous regions of China, Vietnam, Laos, and Thailand. According to Stanford Medicine’s ethnogeriatric program, the notion that Western medicine is experimental stems from the fear associated with the concept of “learn and practice.” The dependence on clinical trials and the practice of medical students learning on patients contribute to the apprehension surrounding Western medicine. Specifically, Hmong older Americans fear being more sick after treatment than prior. As a result, this highlights the need for autonomy and the incorporation of cultural competency to strengthen the trust between patients and providers.
Solutions:
According to an analysis of a Health and Retirement Study, nearly 88% of older Americans were reported to be using complementary and alternative medicine, otherwise known as CAM. As people age, they become more vulnerable to chronic health conditions. Many older adults and their caregivers are increasingly turning to CAM because it often provides gentler and safer methods for managing common health issues associated with aging. Integrating traditional and alternative medicines can lead to more effective healthcare solutions for older adults. By combining the strength of both modern and traditional approaches, providers can foster greater cultural sensitivity and cultivate trust.
Key Takeaways:
Training healthcare professionals in cultural competence is essential for creating an inclusive and welcoming environment. Such training, for example, should cover cultural practices related to language barriers, dietary habits, and traditional healing practices. which can vary significantly across different communities. By understanding cultural background, healthcare staff can provide more personalized and effective care, fostering better patient-provider relationships and improving treatment adherence.
About the Authors:
Sara Velcani is the 2024 summer policy and communications intern at the Eldercare Workforce Alliance. She is a senior at American University studying public health with a focus in health promotion and entrepreneurship. Her research focuses on nutrition education and developing programs that promote healthy eating and food equity.
Jeein Jang is the Gerontological Society of America (GSA)’s 2024 summer policy intern and a third-year doctoral student in the Department of Gerontology at the University of Massachusetts, Boston. Her research focuses on aging policies that promote equitable and healthy aging, particularly for underrepresented populations.
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