Working with Hispanic Elderly. America was once envisioned as “the melting pot”. U.S.A. Health Care. “In a complicated health care system where there are rulers …, the needs of vulnerable populations suffer” (55). Christina Aguierre-Molina Health Issues in the Latino Community.
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America was once envisioned as “themelting pot”
“In a complicated health care system where there are rulers …, the needs of vulnerable populations suffer” (55).
Health Issues in the Latino Community
Immigration from Mexico to the United States rulers …, the needs of vulnerable populations suffer” (55).
In 2000, Latino population in the U.S. was 66.1% Mexican (Aguierre-Molina 4).
“Mexican Americans have been more persistent than any other ethnic group in maintaining their language and culture” (172).
Multicultural Clients: A Professional Handbook for Health Care Providers and Social Workers
Lack of understanding of U.S. health care system
Lack of transportation to facilities
Exorbitant health care costs
Lack of health insurance
Limited knowledge of English language
Health Insurance rulers …, the needs of vulnerable populations suffer” (55).
Many Latinos lack health insurance because of the language barrier, but
MOST lack health insurance because: they work in low-paying, less stable, often hazardous jobs that do not offer employee benefits.
“Latinos are the most likely to be uninsured” (Aguierre-Molina 50).
The Language Barrier rulers …, the needs of vulnerable populations suffer” (55).
Spanish-speaking community is: one of the largest minority groups in the U.S.
However, there are few Spanish-speaking deliverers of health care.
“One way to sensitize young students to the severity of the language barrier is to have them present a health problem to a person who does not speak or understand a word of English. It’s often difficult and embarrassing.”
Cultural Diversity in Health and Illness
“I can’t understand what the doctor and nurses are saying! They speak a foreign language!”
A hospital can be a saying! They speak a foreign language!”frightening place …
Non-English-speaking patients can feel intimidated and vulnerable.
Families often use children or friends to interpret.
84 hospitals surveyed about interpreter services
71 said they do not hire interpreter services
(utilize staff, housecleaning persons, clerks)
20 hospitals request that patients bring their own interpreters
2 hospitals require patients to bring their own interpreters or go elsewhere for treatment.
J. Dunlap and Faye Hutchinson
America’s Newcomers: Health Care Issues for New Americans
While Interpreters are helpful, the use of interpreters is not without its problems:
Interpreters can often …
construe their own meaning of certain words or phrases:ahora = “now” or “at this time” (most Spanish-speaking countries) ahora = “24 hours from now” (Mexico)
be a hindrance in obtaining information that a Latino patient feels is very personal or sensitive.
interpret incorrectly if the interpreter is a child.
Poor comprehension and understanding of messages from providers;
Non-adherence to physician instructions;
Lower quality of patient care;
Poorer health outcomes.
personalismo not without its problems:
“formal friendliness” or personalized approach
Value is placed on how individuals work together as a group versus individual accomplishment.
Often refer to health care workers by name rather than by job title or name of institution.
Individuals should be kind, agreeable, flexible, loyal, honest, generous, willing to help others.
Latino patients often expect to form a personal, friendly relationship with their health care provider.
Some bring food as a personal gesture, and expect the provider to graciously accept it.
dependence upon each other
Latino patients often view their illness and treatment as a FAMILY MATTER.
Include family in decisions regarding treatment.
Illnesses as well as decisions about treatment are often kept private and away from family and friends.Through familismo…
“macho”= male, one who carries great honor, responsibility and respect
Religious figure or specialist who receives his/her gift of healing in 3 ways:
1. Born to heal
2. Learn through apprenticeship
3. Through a trance or dream during adolescence or midlife.
curanderismo feeling of intimidation of large medical institutions, many Latinos turn to: OR doctor??
Close, personal relationships
Just as a certain race or ethnicity lives according to its own cultural beliefs, providers of health care follow a set of rules and principles from which they carry out specific practices, habits, and norms.
What happens when providers of health care from one culture encounter recipients of health care from another culture?
Health care providers often expect Latino patients to willfully submit to invasive testing without prior discussion or verbal preparation.
Often ask outright explicit and often embarrassing questions with minimal preamble.CultureClash!
The results are often…
According to the American Public Health Association (APHA), Hispanics and Latinos are commonly distrustful of physicians and modern medical practices.
About 33% of Latinos believe that home remedies are more effective at treating illness than prescribed medications.
Different forms of alcohol
By integrating home remedies with prescribed treatments, health care providers can often win the trust of the patient which can then increase patient compliance to treatment.
American Public Health Association
Type I: willfully submit to invasive testing without prior discussion or verbal preparation.
Deficiency in pancreatic secretion of insulin: < 5% of diabetes cases in the United States.
Insulin deficiency and/or insulin resistance: > 90% of diabetes cases in the United States.Diabetes and I.D.E.A.L. Latino Patients
Fifth cause of death for Latinos
Main obstacle to treatment:
How Do We Resolve Linguistic and Cultural Differences?
“… identifying the differences among people will enable better understanding of one’s own culture, as well as the ethnic culture of others” (77).
The most important things to note: