Cultural Competence
A Continuum
Based on degree of effectiveness of skills and service delivery in caring for older adults from diverse ethnic backgrounds.
- System or Institutional-Level Components
- Implementation of Standards of Culturally and Linguistically Appropriate Services (CLAS Standards) developed by Office of Minority Health.
- Adequate interpreter services and availability of translated forms
- Diversity of policy making board and staff
- Use of cultural guides or cultural brokers: bicultural members of elder’s ethnic community to help providers understand cultural issues in the health care interaction and help elders understand and navigate the health care
- Training of staff for intercultural interactions
- Multicultural expertise in ethics committees
- Institutional multicultural task force to identify needs and recommend innovations
- Individual Provider Level
- Awareness of one’s personal biases and their impact on practice
- Knowledge Base
- Risk factors for disease by ethnic population among older adults
- Major systems of culturally based health values, beliefs, and behaviors
- Variations in response to treatment by ethnic population
- Skills
- Ethnically appropriate methods of showing respect
- Assessment of older adults’ position on the acculturation continuum
- Methods of eliciting and acknowledging older adults’ health beliefs or explanatory models
- Culturally appropriate assessment techniques
- Working with families from diverse ethnic backgrounds effectively
- Recognition of culturally related values and needs in terminal care, including spiritual care
- Ethnic-Specific vs. Multi-Ethnic Models of Health Care