Transcript Asian Indian Culture

Cultural Diversity
ELDER Project
Fairfield University School of Nursing
Asian Indian Culture
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Objectives: Upon completion of this session, the
participants will be able to ….
 Discuss the role of religion, traditional health care beliefs,
social values, and family structure of Asian Indian culture
and the impact these factors have on health care.
 Identify specific culturally sensitive practices that can be
incorporated into your work with Asian Indian patients and
Asian Indian American patients.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Introduction:
 The Asian Indian culture is a complex and diverse ancient
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culture.
Indian Americans, known more commonly as Asian
Indians, makeup the largest subgroup of South Asians
consisting of people from India, Pakistan, Bangladesh,
Nepal, and Sri Lanka.
They may refer to themselves as East Indians or IndoAmericans.
Their immigrant communities share some common
cultural, social and linguistic characteristics and are often
grouped together.
Some immigrants from the Caribbean, East Africa and Fiji
also identify themselves
as South Asian.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Introduction:
 While the majority of this discussion will focus on those
people from India, the surrounding nations have a mixture
of cultures that include a mixture of religious beliefs.
 The discussion will center on Hinduism with some
reference to Buddhism, where appropriate.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
India
Muslim 13.4%
Pakistan
Muslim 95%
Hindu 80.5%
Christian 2.3%
Hindu 5%
Sikh 1.9%
Bangladesh
Muslim 89.5%
Hindu 9.6%
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Sri Lanka
Muslim 7.6%
Hindu 7.1%
Nepal
Christian 6.2%
Muslim 4.2%
Sikh 0%
Hindu 80.6%
Buddhist 69.1%
Christian 0%
Sikh 0%
Buddhist 10.7%
Kirant 3.6%
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Communication:
 The major language is Hindi; however English is commonly
used in many areas of life.
 Most Asian Indians are bilingual or multilingual.
 Eighteen languages are recognized in India.
 Use of formal titles is expected (Mr. and Mrs.) until told
otherwise.
 Addressing people older than you by their first name alone is
disrespectful.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Communication:
 Embracing members of the opposite sex is unacceptable;
however it is acceptable with members of the same sex.
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Public displays of affection are not encouraged.
 Direct eye contact is limited.
 Traditional Indian greeting is “namaste” which is uttered
while joining palms together as if in prayer under the chin
slightly nodding the head and looking down.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Family and Social Structure:
 Several generations will live in the same household sharing
a common budget.
 Older Asian Indians may be financially dependent on their
children.
 Grandparents play a role in raising children and are highly
respected and form a link to Asian Indian culture and
heritage.
 Respect is important and old age signifies wisdom.
 Strong family bonds exist with a close knit family structure.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Family and Social Structure:
 Asian Indians practice patriarchal extended families.
 The head of the house is the senior male, who also makes all
the decisions.
 In the US, the American Asian Indian tends to be more a
nuclear family.
 Joint families are temporary; once they are self-sufficient they
move out.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Personal Hygiene:
 Modesty is highly valued.
 Showers are more the norm as tub baths are seen as
unsanitary.
 The focus on bathing is being clean rather than on
eliminating body odors.
 Using deodorants is not a common practice.
 Odors are not seen as potentially offensive.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
View of Illness:
 Health is related to connectedness of the body, mind and
spirit.
 Mental illness is concealed and often presented as somatic
complaints.
 The elderly focus spiritually in preparing the soul for life
after death.
 Pain and suffering are viewed as due to bad karma from a
past life or past actions.
 Illness may be seen as something to be accepted and endured
rather than fixes or cured.
 Consequently Asian Indians may be stoic in their expression
of pain.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
View of Illness:
 The Asian Indian respects authority of the healthcare
provider and feels their own role is passive.
 They will not ask a lot of questions as this is viewed as
impolite.
 They would rather ignore suggestions if they do not agree,
which may result in missed appointments or excuses for not
following the plan of care.
 Offering a variety of treatment choices can make the
physician seem incompetent as it is expected that the
physician be confident.
 Family and friends may want to provide personal care when
in the hospital.Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Folk Medicine:
 Tend to use home remedies such as massage, ritual bathing
and herbal medicine before seeking a physician.
 Physicians are only sought for serious illnesses.
 The Asian Indian is less open to homecare or long term
care for elders.
 When caring for the ill, they will utilize behaviors such as:
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ritual chanting by priests
tying a thread around the sick person’s wrist
writing protective verse and wearing it in a metal cylinder
around the neck or wrist
promising temple god gifts if they recover
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Folk Medicine:
 Ayurvedic medicine is the traditional Indian system of
medicine. (ī'yər-vā'də, -vēc‘)
 Translated it means the meaning of the knowledge of life.
 Relates to the complete human being, body, mind, senses and
soul.
 Focuses on attaining balance between the physical, mental
and spiritual.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Folk Medicine:
 Ayurvedic Medicine
 The belief is that every individual is made up of three doshas
(fire, wind and water) that represent certain bodily activities.
 Ayurveda uses specific lifestyle and nutrient guidelines to
help decrease the dosha that has become excessive.
 Mercury and sulfur based medications and herbs are used to
treat ailments and emetic herbs to maintain body
homeostasis or balance.
 Surgical techniques are also used and are aimed at preserving
life and promoting well-being.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Folk Medicine:
 Unani (or Yunani) Medicine:
 Can be traced back to Hippocrates
 Based on the ancient Greek theory of four basic elements (air,
earth, fire and water) and four bodily humors which
determine one’s temperament and health - blood, phlegm,
yellow bile and black bile.
 When a person is in perfect balance - a person is healthy.
 Treatment is aimed at restoring natural balance by dietary
modifications.
 The use of ripening, purging, cupping, sweating, diuresis,
herbal bath therapy,
massage and exercise
is common as well.
Supported by DHHS/HRSA/BHPR/Division
of
Nursing Grant #D62HP06858
Asian Indian Culture
Folk Medicine:
 Siddha Medicine:
 One of the oldest systems of medicine in India.
 Has close similarity to Ayurveda, with specialization in
Iatrochemistry (seeking chemical solutions to disease and
medical aliments).
 According to this system, the human body is the replica of the
universe and so are the food and drugs irrespective of their
origin.
 Uses calcined metals and mineral powders to heal illness.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Note:
 Though categorized under Folk Medicine, Ayurveda,
Unani and Siddha Medicines are practiced medical
systems supported and promoted by the government
in India.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Dietary Habits:
 Dietary staples include rice, grains and breads.
 Many are vegetarians or vegans.
 Have diets rich in carbohydrates, poor in protein and
deficiencies in calcium.
 If they do eat meat, it usually is not beef (Asian Hindus).
 The cow is recognized as a life giving role:
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producing dairy products
pulling plows
fertilizing fields
 Gelatin based products are avoided because the processed
collagen comes
from cows or pigs.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Dietary Habits:
 Asian Muslims do not eat pork and consume halal foods
which are religiously accepted.
 Lactose intolerance is very common in the older person.
 Fasting is common; believe it improves the welfare of the
family.
 Chew betel leaves because they act as anti-flatulent and
anti-inflammatory.
 Often chewed with tobacco, which can lead to oral cancer.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Dietary Habits:
 Use a lot of spices:
 Curcumin is an active ingredient in turmeric, a key ingredient
in Indian curry that has anti-inflammatory and antioxidative
properties.
 Thought to be a protective factor in the aging brain and
dementia.
 Eating and drinking from another person’s plate or glass or
using dishes that have been used by someone else is not
acceptable.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Time Orientation:
 Believe things will happen when they have to happen.
 Bulk of Indian population live in villages or in the
country and time is measured by seasons instead of
dates and watches.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Religious Beliefs:
 Religion is central to the way of life.
 80% Hindus:
 Believe everyone goes through a series of births or
reincarnations that eventually lead to spiritual salvation.
 With each new birth, one moves towards enlightenment.
 Believe in a cast system.
 Other religions include:
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Muslim,
Christianity,
Jainism (nonviolence towards all living creatures)
Buddhism
Sikhism (intended to bring the best of Hinduism and Islam
together)
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Religious Beliefs:
 Hindu religion has aspects that affect health care decisions:
 “Karma” involves the actions of past life that affects
circumstances in which one is born and lives in this life.
 Often believe illness is caused by Karma and that every action
leaves an imprint on one’s soul and spirit.
 Believe good actions produce good results and bad actions
produce bad results.
 Karma greatly influences the patient’s world view of health,
death and dying and model of illness.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Religious Beliefs:
 Hindu religious paraphernalia include:
 Mangalsutra - a 9 sacred necklace which is worn by a married
woman.
 Women also may wear a bindi or tilak (dot on forehead).
 Other symbols of marriage are bangles and toe rings.
 Men wear a sacred thread around the torso.
 Both sexes may be reluctant to remove these items.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Asian Indian Culture
Religious Beliefs:
 Buddhism adheres to non-violence and advocates giving up
worldly desire to attain nirvana (salvation).
 Believe in four truths:
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Life leads to suffering,
Suffering is caused by desire,
Suffering ends when you give up desire and attain enlightenment,
Reaching this state is achieved by the eight fold path.
 Sikh men do not cut their hair and wear a bracelet and a
truban.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Reference

About the Systems. Retrieved on March 10th, 2010 from http://indianmedicine.nic.in/index.asp?lang=1.

Asian Indian Culture:Influences and Implications for Health Care. Retrieved March 10th, 2010 from
http://www.molinahealthcare.com/medicaid/providers/common/pdf/asian%20indian%20culture
%20%20influences%20and%20implications%20for%20health%20care_material%20and%20test.pdf?E=t
rue.
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Health and Healthcare of Asian Indian American. Retrieved December 18, 2010 from
http://www.stanford.edu/group/ethnoger/asianindian.html.

The World Factbook: South Asia: India. Retrieved March 25th, 2010 from
https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html.

Periyakoil, V.J. and Dara, S. (2010). Health and Healthcare of Asian Indian American Older Adults. Retrieved
February 5, 2011 from http://stanford,edu/ethnomed/asian_indian.

Working with People with Disabilities: An Indian Perspective. Retrieved December 12, 2010 from http://
cirrie.buffalo.edu/cultural/monographs/India.php.
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858
Power Point Presentation
Created by:
Joyce Cunneen, MSN, RN
Fairfield University School of Nursing
ELDER Project Education Coordinator
Monica Starr, BSN, RN
Fairfield University School of Nursing
ELDER Project Program Coordinator
Supported by DHHS/HRSA/BHPR/Division of
Nursing Grant #D62HP06858