Culturally Appropriate Geriatric Care: Fund of Knowledge

Common Cultural Beliefs

To care for older adults from Asian Indian backgrounds effectively, it is important for providers to be familiar with their traditional health beliefs and historical experiences that may have influenced their attitudes toward health care. Use of complementary or alternative medicine is quite common in Indian subcontinent; however, some systems are not indigenous to the country, as some were introduced into the subcontinent by foreign invasion and foreign trade.

caution iconHealth care providers should be aware of some of the following customs and beliefs, as it would help them provide culturally appropriate care with the caveat that there is tremendous diversity in the Asian Indian Hindu population in the U.S.

Older Hindus who immigrated to the United States late in life may still be wedded to traditional Indian healing sciences of Ayurveda and Siddha. It is also important to educate patients about any potential drug-herb interactions if the patient is concurrently using Western medications as well. Clinicians should use a gentle and non-judgmental manner to ask about these healing systems and then document use of herbs or complementary and alternative medications

1. Ayurveda

the three doshas

Ayurveda is an ancient and sophisticated healing art that originated in the Indian subcontinent. It is a comprehensive and holistic healing art thought to have been derived from the Atharveda, one of the oldest Hindu scriptures. It dates back to 1000 BC and includes both herbal remedies as well as surgical techniques (salya-chikitsa) aimed at preserving life (ayus) and promoting wellbeing. (Ayurveda is made up of two Sanskrit words, Ayu meaning “life” and veda meaning the “knowledge of ”). Practitioners used mercury- and sulfur-based medications and herbs to treat ailments and emetic herbs to maintain body homeostasis or balance of the tridosha (three humoral systems):

  • pitha (fire)
  • vatha (wind)
  • kapha (water)

Each Dosha represents certain bodily activity. The ratio of the doshas varies in each individual. When any of the doshas becomes accumulated, Ayurveda will suggest specific lifestyle and nutritional guidelines to assist the individual in reducing the dosha that has become excessive.

2. Unani or Yunani Medicine

Unani Medicine or Yunani Medicine means “Greek” is a form of traditional medicine widely practiced in the Indian subcontinent. Unani science of medicine originates from ancient Greece; it was further adapted by the Arabs and is a popular form of complementary and alternative medicine practiced in India. Unani postulates that the human body is made of four humors:

  1. blood (Dam)
  2. phlegm (Balgham)
  3. yellow bile (Safra’)
  4. black bile (Sauda’)

Each person is thought to have a unique and innate mixture of these substances which then determines both her/his temperament and health.

  • A “predominance of blood” is thought to give the person a sanguine temperament.
  • A “predominance of phlegm” is thought to make a person phlegmatic.
  • A “predominance of yellow bile” is thought to make the person bilious (or choleric) and
  • A “predominance of black bile” is thought to make the person melancholic.

When these humors are in perfect balance, the person is healthy. Any imbalance of the four humors is thought to result in ill-health. Thus the thrust of unani treatment is aimed at restoring the natural balance, especially by dietary modifications.

Additionally, healers also use measures that induce:

  • ripening (Munzij)
  • purging (Mushil)
  • cupping (Mahajim)
  • sweating (Taareeq)
  • diuresis (Idrare Baul)
  • herbal bath therapy (Hammam)
  • massage therapy (Dalak)
  • purging (Qai)
  • exercise (Riyazat)

3. Siddha Medicine

Siddha Medicine is another form of Indian native healing system which uses calcined metals and mineral powders to heal illnesses.