Cultural Competence in Ethnogeriatric Care

A Continuum

Based on degree of effectiveness of skills and service delivery in caring for older adults from diverse ethnic backgrounds.

1. System or Institutional-Level Components
   1. Implementation of Standards of Culturally and Linguistically Appropriate Services (CLAS Standards) developed by Office of Minority Health.
   2. Adequate interpreter services and availability of translated forms
   3. Diversity of policy making board and staff
   4. 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
   5. Training of staff for intercultural interactions
   6. Multicultural expertise in ethics committees
   7. Institutional multicultural task force to identify needs and recommend innovations
2. Individual Provider Level
   1. Awareness of one’s personal biases and their impact on practice
   2. 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
   3. 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
3. Ethnic-Specific vs. Multi-Ethnic Models of Health Care