Cultural competence in elderly care: Why is it important?


We all live and work in a multicultural society with diverse backgrounds, cultures and ethnicities, which we need to understand to allow us to socialize and live together respectfully. This is especially important for healthcare and nursing professionals, who may occasionally experience knowledge or understanding gaps when caring for people of a different culture or background from their own.

In elderly care, cultural competence is becoming increasingly important. Given the conditions and frailty that can arise with age, older people rely more on their caregivers than most. This makes showing respect, empathy and understanding a must. However, elderly populations are more ethnically diverse than ever before. It is not simply enough, or even respectful, to assume all older people demand the same standards of care and support. This makes it extremely important for nurses to understand how to practice cultural competence and empathy when caring for older people.

In this article, we explore what cultural competency means in practice, why it’s growing so crucial in elderly care and the positive strategies gerontologists and geriatric nurses can use to help support older citizens from diverse backgrounds.

What is cultural competence?

Cultural competence is a term frequently used in nursing and healthcare that refers to how caregivers communicate with people from different cultures and backgrounds. Communication barriers can arise when there is a problem in understanding a patient’s language or dialect. However, the broader term of cultural competence focuses more on a nurse’s understanding of a patient’s cultural needs.

For instance, a nurse from a Christian background might need to care for someone of a Jewish or Muslim upbringing. Healthcare remains the same, but differences in beliefs and lifestyle might prevent some people from receiving specific treatments or might conflict with what a caregiver otherwise expects.

It’s up to the caregiver to show respect, understanding and empathy for all their patients. This applies regardless of culture, ethnicity, and religion. A culturally competent caregiver should take the time to learn more about the different cultures and people they are likely to treat in their clinics.

Beyond this, cultural competence revolves around the idea that a caregiver should be kind and flexible, and that a patient, already likely to be feeling some form of discomfort, should not be expected to bend to the needs of the carer or organization. A culturally competent nurse or caregiver puts prejudices and preconceptions aside. As part of their standard code of ethics, a competent nurse must be willing to listen to the patient’s needs regardless of the reasons why.

Nurses are encouraged to practice new skills with the utmost respect and kindness when learning to become an Adult Gerontology Nurse Practitioner at a reputable institution such as Wilkes University. Combining on-site clinical placements with 100% online coursework, the Online Master of Science in Nursing (MSN) – Adult-Gerontology Primary Care Nurse Practitioner program at Wilkes University provides students with the technical skills and knowledge to care for the unique needs of adults of all ages while helping them understand how to provide adequate care with a gentle approach.

The importance of cultural competence in elderly care

Elderly care requires a particularly sensitive and understanding touch. Older people can feel scared by the conditions they develop and often need caregivers with a kind disposition and a confident attitude to help them get through treatments.

When cultural barriers emerge, nurses need to demonstrate extra care. This is especially important if there is a language barrier, as they might be unable to communicate kindness and support verbally. In these cases, there are techniques that nurses can use to help older people from diverse backgrounds feel more at ease, which we will discuss further later.

Older adults depend on nurses for a variety of care needs, ranging from mental health to physical relief. To prevent distress and to help support mental health and comfort, nurses should demonstrate cultural competency and a willingness to work outside of their own cultural comfort zones.

Cultural competency in elderly care ensures that all people receive the same standards of care and kindness. Individual nurses’ respect and competency can help support broader healthcare systems and provide a positive example to others on the same team.

Of course, cultural competence takes many different forms. It might not be physically possible to learn about and retain knowledge regarding all cultures and backgrounds around the world, but nurses can at least start to make a difference by learning from their patients, each other and by starting to broaden their horizons.

Demonstrating cultural competence when working with elderly people

The best ways to demonstrate cultural competence when working with older adults will vary from case to case. You should never assume that culturally competent care for one person will serve the next in quite the same way!

If you are considering a role in nursing older people or are curious to know more about how caregivers can be more culturally sensitive at work, here are a few techniques that have proven to be supportive and kind over decades of practice:

Ask about preferences

The best thing a nurse can do to show cultural competence and sensitivity when treating older people is to ask questions! Nurses studying gerontology will learn that showing confidence and taking the verbal lead is incredibly important when supporting older people. After all, many will rely on their caregivers to bring them back to health or support them through illness.

When it comes to cultural competence, provided your questions are sensitive and open-ended, there are no reasons why you should keep them to yourself.

Asking someone about their preferences during their treatment shows that you genuinely care about how they react to medicine and healthcare. It’s good practice to ask questions regarding patient opinions, and to ask for permission to carry out certain checks.

In practice, it’s recommended you review a patient’s file and cultural background before starting care provision and asking questions. This is not only easier on the nurse, but also helps them to prepare for the more sensitive delivery of treatment over time.

The adage “if you do not ask, you might never know” can apply here, though again, language barriers might restrict what you can and can’t enquire about.

Discuss their family life

Building a rapport with patients is extremely important for patient-caregiver relationships to thrive. It’s true that some people might be more resistant to small talk than others, which is why it’s important to discuss matters with sensitivity and at a slow pace — you really do need to judge each case as they arise.

Many older people may feel comfortable talking about what they’ve experienced and the family they’ve raised. If appropriate and applicable, asking universal questions about people’s families can offer a gentle introduction to open communication.

Of course, there are other topics you could touch upon, and the subject of family won’t apply to all patients. However, it is a leading topic that many nurses use to build culturally sensitive care upon. It’s also a great way to ask more about someone’s culture, but one should always take gentle steps to avoid insulting anyone.

Show curiosity

Showing curiosity in your patients shows you care. Most people are thrilled to talk about their lives and experiences regardless of age and culture. Showing genuine interest in someone is likely to make them feel more connected to you.

Of course, there is a fine line between being curious and becoming intrusive. It’s important to respect patient privacy, and nurses will learn how to work within these boundaries. Part of being culturally competent is understanding when to proceed with discussing sensitive topics, and when to stop.

Showing curiosity in a different culture also shows that you’re willing to broaden your horizons. Some patients of a certain age might find this approach touching and will happily share their life stories with you.

It’s important not to apply anything you’ve learned about someone’s culture into a conversation unless it comes from the patient themselves. Let patients lead the conversation should it turn that way. Learning about different cultures should help nurses to build an understanding of how to adjust care needs as a priority rather than demonstrating what they’ve learned to patients.

Welcome the use of interpreters

In multicultural settings, interpreters commonly support people of different ethnic backgrounds when they receive medical care. Sometimes, these interpreters may be in the employ of a hospital or facility, or they may even be members of a patient’s family.

Regardless, it’s always a good idea to talk with an interpreter about what you want to say. This is likely to be more beneficial if you are working with an elderly person’s family, as they will be able to give you more background on their needs and wants, their personality and what you can and can’t do or say.

An absolute must when communicating with elderly people of diverse backgrounds is to speak directly with them. Speaking to a family member or interpreter directly and expecting them to relay your message and eye contact isn’t recommended. Instead, nurses should keep that interpersonal link strong, and speak with their patients, while letting interpreters translate mid-flow.

Body language accounts for a lot. For instance, gerontology nurses can tell when patients are open to conversation depending on how they smile. It’s wise to use interpreters as support though to ensure you’re following the most appropriate path.

Do your research

Research is vital when it comes to understanding different cultures. You can pick up much of what a patient wants from a few conversations, but this might not always be possible due to language barriers or certain conditions.

Caregivers are encouraged to broaden their minds and horizons. This might mean taking the time to read into how people from different backgrounds and belief systems react to certain treatments. When working with older people, it’s also a good idea to consider the time in which they grew up and worked as the world they grew up in has likely changed a lot over the years.

In this case, make sure to learn more about diversity worldwide on a broad scale. If you’re training to be a nurse, it’s good practice to build knowledge that you can use to back up your technique.

However, don’t make assumptions about individual patients! If they have family available that you can talk to, discuss their needs carefully with them and ask questions. Nurses don’t have to discuss their research and it’s not always a recommended course of action, but working with patient families can help add context to any details they might have gleaned through their studies.

You can’t boil down a person’s culture or practices into a generic statement or book. Nurses must balance their willingness to learn and adapt with interpersonal techniques to deliver the best possible care.

Flexibility is key

As mentioned above, being culturally competent is all about ensuring that as a nurse you are ready to be flexible and open-minded when treating people from various backgrounds and of different age groups.

Older people from diverse cultures might not necessarily understand what you expect from them, whether they speak a common language or not. As a result, the best thing any nurse can do is lead with a kind, flexible attitude, and to ensure patients know that they lead the way when it comes to deciding what can and can’t happen during treatment.

This last statement can be a little loaded at times as there may be occasions when medical intervention is necessary, but otherwise, giving older patients control will help them feel more relaxed and more open to communicating.

Cultural competence is an asset in all forms of nursing, not just in gerontology, so all caregivers should follow a strong code of ethics and demonstrate that everyone deserves the same standards of care and kindness. No one likes being in hospital, and it’s up to hard-working nurses to help our older populace feel more at ease.

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