Culturally Appropriate Geriatric Care: Fund of Knowledge

Traditional Health Beliefs

Hmong elders understand health as a harmonious balance of forces in the natural world, the supernatural world, and between the two worlds (Cha 2000; Culhane-Pera & Xiong, 2003). Similarly, illness is an imbalance of these forces. To understand the concepts of health and illness in the Hmong culture, providers must understand the interlocking connections between the spiritual world and the physical world.   The natural and the spiritual worlds affect and reinforce each other, so illnesses may have both biological and spiritual causes, although during the course of an illness the perceived etiologies may change. Natural causes include imbalances of metaphysical forces (similar to the Chinese concept of yin/yang), change in weather, bad food, heredity, aging, and germs.   Hmong ideas of germs (called kab in White Hmong, kaab in Green Hmong and phav nyaj in Laotian, a common term used by Hmong elders) are closely aligned with Western concepts.   Hmong elders are beginning to understand chronic illnesses such as diabetes, hypertension, and coronary disease that result from changes in lifestyle. Illnesses believed to be derived from natural causes are often treated with Western Medicine and traditional techniques ranging from massage, acupuncture, and dermabrasion, to the application or ingestion of a variety of herbal preparations or other organic substances (Bliatout, 1991). People often use these techniques and remedies in conjunction with shamanic healing ceremonies, for illnesses that also have supernatural etiologies.