How to Accommodate Cultural Differences When Caring for Aging Adults

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Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

The duties of a caregiver can be intense and exhausting. Adapting to a client’s personal preferences is hard enough, but cultural differences can add a whole new layer of understanding and acceptance.

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Cultural diversity is the norm in the U.S., and the chances of taking care of an older adult who is from a different culture are high. The Brookings Institution reports that “nearly four of 10 Americans identify with a race or ethnic group other than white.”

Moreover, caregivers themselves come from a variety of cultural backgrounds. In 2017, approximately 23 percent of all home care workers were Hispanic or Latino, and 28 percent were Black or African American. 

As a result, there are now several different cultures working together to provide sensitive and compassionate care to aging adults. Accommodating cultural differences when caring for aging adults can be an ideal way to form trusting relationships. 

How Does Culture Influence Our Ideas on Aging and Long-Term Care?

Cultural differences have a tremendous influence on ideas of aging and long-term care. The American Geriatrics Society states that “Minority individuals over age 65 have higher rates of disease and disability when compared with Caucasian men and women, for example.

Furthermore, of the 36 percent of Americans who report limited health literacy (the ability to obtain, process, and understand basic health information), most are older, less educated, and not white. And as AGS researchers note, mistrust of medicine and medical research remains a persistent barrier to high-quality multicultural care.”

We have seen the impact of cultural distrust of the medical system among Black, Hispanic, and Native Americans specifically. A distrust of medicine from culturally diverse groups comes from years of healthcare disparities and lack of proper support and access to medical care. But other general cultural attitudes come from a very different view of taking care of aging loved ones.

Other cultures revere their elders

Western culture focuses on youth in the media, employment, and the allocation of resources. Ageism is a hot topic of discussion as age discrimination in the United States remains a persistent problem, as some find that the national attitude toward aging can be demeaning and disrespectful. Families who have financial resources look to senior living institutions to take care of their loved ones. 

Some other cultures revere their elders and consider it their time-honored tradition to care for an aging adult and respect their wisdom and history. In some cultures, elders are the head of the family.

Other cultures take care of their elders

In the United States, it is not unusual for families to live at a great distance from one another, which can make caregiving difficult. Other cultures consider it their duty to take an elder into their home and care for them until the end of life. Placing someone in assisted living or nursing homes is not considered appropriate. 

Many families in the U.S. do take elders into their homes due to financial constraints and a sense of duty. But, many find senior living a viable option since caregiving duties can be stressful, and the lack of supportive resources makes caring for someone in the home difficult. 

Other Cultures have a different view on death and dying

Of course there are so many different views of death and dying based on spiritual beliefs, family customs, and other factors. Different cultures may have very different ideas of death and dying that may be different than the traditional Christian Judeo approach. Rituals and the act of grieving can be very different among various cultures.

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How Families Can Discuss Cultural Differences With a Caregiver

Bringing a caregiver into a culturally diverse home can take some work and sensitivity to make it successful. You may want to start off being honest, transparent, and open about what these differences are and how to handle them. Expecting a caregiver to “get it” without some discussion puts the caregiver at a disadvantage and isn’t fair to anyone.

Discuss non-English speaking issues

It is not unusual for an older person from another culture to be non-English speaking or have a limited understanding of the English language. If the client is Spanish speaking, you can ask an agency for a Spanish-speaking caregiver.

Otherwise, there has to be a way to communicate. One way to address this challenge is to develop a plan of care in the client’s native language so they understand caregiver duties. Revisit this often and check in with your loved one to make sure that you address any problems or concerns. 

Discuss personal space preferences

Some caregivers are naturally effervescent, and that can be great for some clients.

Clients from some other cultures may prefer a more distanced relationship without a lot of chatter or assumed familiarity. Discuss these preferences with the caregiver so that they know how to adjust their attitude and style to the client’s needs.

Discuss issues of intimacy and boundaries

Clients from other cultures may be very uncomfortable with some of the intimate tasks that caregivers need to perform. Personal caregiving can involve helping someone toilet, bathe, and dress. There are ways to approach someone that honors their dignity and demonstrates respect.

As a family member, make those preferences known and suggest some ideas on how to perform these intimate tasks while observing personal boundaries.

Discuss holidays and customs

Different cultures and religions have their own unique customs and celebrations. If your client is of a particular religious or cultural background, make sure to know what those are so you can accommodate any preparations required by such beliefs.

Don’t assume that your client has similar family traditions or celebrates traditional Western holidays like Christmas and New Year’s. 

Discuss integrating other family caregivers

As many cultures pride themselves on taking care of their elders, they may continue to do so even with professional caregivers helping. It can get confusing coordinating several caregivers and their duties, so discuss delineating tasks so that no one is offended.

The client may prefer for a family member to perform certain tasks, so discuss those in advance.

Discuss death and dying

Sometimes caregivers are called upon to assist someone who is near death.  Educating the caregiver about cultural and spiritual belief systems will help them be more sensitive to the client’s journey.

How Caregivers Can Discuss Cultural Differences With Their Clients or Client’s Family

As a caregiver, it can be frightening and overwhelming working with a client and family from a very different culture. You want to seem competent and confident, but accept that you may have a lot to learn.

Ask, don’t assume

It is almost always better to ask if you aren’t sure than to assume you know the answer. Making a mistake about how someone likes to be treated or touched based on cultural differences can set back the relationship and erode trust.

Ask the client how they want to be addressed

Sometimes, first and last names may be in a different order than you might expect, and many older adults from other cultures expect to be addressed formally because it shows respect. Just ask how they want to be addressed and follow it.

Ask where your client is from

It is better to ask where your client is from than to guess. When you find out the country or culture of origin, this can be a great starting point for a great conversation. The more you learn about another person’s culture, the better job you will do.

Ask about dietary preferences

In some cultures, certain foods are forbidden. A client may want the food of their native country that might be very foreign to you. Ask about their dietary preferences and learn to shop and cook in a new way!

More Tips for Accommodating Cultural Differences When Caregiving

Caregiving is hard enough even without cultural differences. Be patient with yourself and follow some handy caregiver tips to create a lasting and positive relationship with your client and their family. Tread lightly and be open to learning. 

You will make mistakes

You will likely make some culturally insensitive mistakes, and that is OK. Just apologize and accept that you are doing your best. No one is perfect, and you can’t anticipate everything that might come up.

You can’t be too respectful

You can only be disrespectful, so better to err on the side of showing too much respect. Follow your client’s lead when it comes to familiarity.

In many other cultures, concern and high regard for an aging adult are ingrained in society. 

Use humor carefully

Humor exists across cultures but is perceived very differently. Typical western humor may not work well or may fall flat with other people who may not understand the joke. It is better to be careful so as not to say something offensive to your client.

Never use swear words and minimize slang

Swearing, even inadvertently, or using slang may be offensive and confusing to someone from a different culture. Clear communication is the key to understanding, so use concise language. If you think you have made a mistake, just apologize and move on.

Cultural Differences When Caring for Aging Adults

Different cultures can be exciting and stimulating. All of us tend to get lost in our bubble of customs and culture. As a caregiver for an aging adult, train yourself to be open and accepting of the amazing diversity around us.


Sources:
  1. “Share of Home Care Workers in the U.S. by Ethnicity 2017.” Statista, September 2019, statista.com/statistics/720230/home-care-workers-united-states-by-ethnicity/
  2. “Guidance From American Geriatrics Society on Diversity Proves “Seeing” Older Patients is About More Than Seeing Age.” American Geriatrics Society, 4 February 2016, americangeriatrics.org/media-center/news/guidance-ags-diversity-proves-seeing-older-patients-about-more-seeing-age
  3. “Black Vaccine Hesitancy Rooted in Mistrust, Doubts.” WebMD, 2 February 2021, webmd.com/vaccines/covid-19-vaccine/news/20210202/black-vaccine-hesitancy-rooted-in-mistrust-doubts
  4. Kita, Joe. “Age Discrimination Still Thrives in America.” AARP, 30 December 2019. aarp.org/work/working-at-50-plus/info-2019/age-discrimination-in-america.html
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