Transcript PowerPoint

Cultural Competency in
Work with Individuals and
Families
Developed by DATA of Rhode Island
Through a special grant from the Rhode Island
Department of Human Services
September 2006
Learning Objectives
Participants will be able to:
 Describe definitions of diversity and
cultural competency
 Describe demographic trends for the
elderly US population
 Describe the knowledge and attitudes
necessary to provide cultural competent
services to family caregivers and
recipients
Overview
Demographic changes in the US
population over age 65 are making a
critical impact on both formal and informal
caregiving networks
The appreciation of diversity in the
caregiving experience although not new, is
taking center stage in the discussion on
cultural competency in the provision of
health, mental health and health and
human services for caregivers.
Definitions
DIVERSITY:

Refers to differences between groups with distinctive
characteristics and social identities based on culture,
ethnicity, gender age sexual orientation, religion ability,
and class
Cultural Competence:

Refers to the process by which individuals and
systems respond to people of all cultures, languages,
classes, races, ethnic backgrounds, religions and
other diversity factors in manner that affirms and
values the worth of individuals, families and
communities and protects and preserves the dignity of
each.
What does it mean to be culturally
competence
“…having the capacity to function
effectively as an individual or an
organization within the context of the
cultural beliefs, practices and needs
presented by persons and their
communities that you serve.”
Source: The National Standards for Culturally and Linguistically Appropriate Services in
Health Care, adapted from Cross, Basron, Dennis & Issacs, 1989
Why is cultural competence
important
• Everyone has a right to care that meets their needs
• We are serving an increasingly diverse population
• Health and human service system are not always
responsive
• Health inequalities are experienced by many groups
• Cultural competence improves service outcomes
• It’s the law
Institute On Medicine REPORT:
UNEQUAL TREATMENT
“Racial and ethnic minorities tend to receive a
lower quality of healthcare than non-minorities,
even when access-related factor as such as
patient’ insurance status and income are
controlled. The sources of these disparities
are complex, are rooted in historic and
contemporary inequities, and involve many
participants at many levels . . .”
Conditions or factors that are
important or relevant for you to
know?
A disproportionately high percentage of
minority adults have severe disabilities
This is particularly true of African American
and Hispanic women
A wide range of internal and external
cultural factors can influence a persons
behavior
HIV/AIDS DEATH RATE
AGE> 13, RATES PER 100,000
POPULATION
115.3
120
100
80
55.8
60
40
20
0
16.2
WHITE
14.1
BLACK
HISPANIC
AI/AN
7.5
ASIAN/PI
CANCER DEATH RATE
DEATHS PER 100,000 POPULATION
180
167.8
160
140
125.2
120
100
77.8
84.9
76.3
80
60
40
20
WHITE
0
BLACK
HISPANIC
AI/AN
ASIAN/PI
W
H
CARDIOVASCULAR DISEASE DEATH
RATE
DEATHS PER 100,000 POPULATION
191.5
200
180
160
140
131
120
100.8
88.6
100
71.7
80
60
40
20
WHITE
BLACK
HISPANIC
AI/AN
ASIAN/PI
0
W
H
DIABETES-RELATED DEATH
RATE
DEATHS PER 100,000 POPULATION
30
28.8
27.8
25
18.8
20
15
11.6
8.8
10
5
WHITE
0
BLACK
HISPANIC
AI/AN
ASIAN/PI
Cultural Competency
 Two Approaches:


Fact Centered approach emphasizes the
importance of acquiring knowledge about the
target group in order to increase one’s
understanding
Attitude Centered approach has at its core belief
an openness to embrace diversity, and
recognizes one’s own beliefs, attitudes and
behaviors that may parallel or conflict with those
of the client’s.
Cultural Factors That influence
Individuals and Groups
Internal Factors
Cultural/Racial Identity
Socioeconomic Status/Class
Nationality
Language
Family Constellation
Social History
Health Beliefs & Practices
Perception of Disability
Age & Life Cycle Issues
Spatial & Regional Patterns
Gender & Sexuality (sex roles)
Sexual Orientation
Religion & Spiritual Views
Political Orientation &
Affiliation
Developed by National Center for Cultural Competence, 2002
External Factors
Institutional Biases
Community Economics
Intergroup Relations
Natural Networks of Support
Community History
Political Climate
Workforce Diversity
Community Demographics
Modified from James Mason, Ph.D.,
NCCC Senior Consultant
Ways to Facilitate Communication
Across Cultural Boundaries
1.
2.
3.
4.
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10.
Recognize differences
Build Your Self-Awareness
Describe, Identify, carefully Interpret
Don’t assume your interpretation is correct
Verbalize your own non-verbal signs
Share your experience honestly
Acknowledge any discomfort, hesitation, or concern
Practice politically correct communication
Give your time and attention when communicating
Don’t evaluate or judge
CULTURAL COMPETENT
COMMUNICATION SKILL
LEARN Model
Listening to the patient’s perspective
Explaining and sharing one’s own perspective
Acknowledging differences & similarities
between these two perspectives
Recommending a treatment plan
Negotiating a mutually agreed-on treatment plan
Berlin EA, Fowkes, WC Jr. West J Med 1983; 139(6):934-8
Practical ways to enhance cultural
competence
Understandable and Respectful Care of persons
served
Employ Diverse Staff and Leadership
Ongoing Education and Training for all staff
Language Assistance Services
Right to Receive Language Assistance Services
Competence of language Assistance
Patient- Related materials in other languages
Written program Plans that incorporate cultural issues
Patient/Consumer Data/demographic and satisfaction
Community Partnerships
Conflict /Grievance Processes
DEMOGRAPHICS
 35 million persons in the US over age 65 12% of the
population, baby boomers are projected to push that
up to 34%.
 Racial and ethnic minorities represent 16.4% of that
population, progressing to 25.4% by 2030.
 3.4 million of the elderly are below the poverty level,
another 2.2 million are classified as near poor
(125% of the poverty level)
 8.9% of elderly whites are poor, compared to 22.3 %
of elderly African Americans and 18.8% of elderly
Latinos.
 The highest poverty rates were among older Latina
women who lived alone or with non relatives
Questions
Wrap up