Chapter 58 - Cultural Competence

Summary

The rapidly growing proportion of older Americans who are from very diverse ethnic and racial minorities will produce an ethnogeriatric imperative for geriatricians and other health-care providers. Many older adults from minority backgrounds experience disparities in the quality of their health care and disparities in their health status by their higher risk for diseases such as diabetes, heart failure, and dementia.

To provide effective ethnogeriatric care for this culturally diverse older patient population, health-care organizations need to become culturally competent by applying the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care, including providing trained interpreters for providers to use in care with limited English proficient older adults. The geriatric providers themselves need to become culturally competent in their: (1) attitudes such as developing cultural humility and reducing their bias; (2) knowledge of cultural values and health risks of their older patients; and (3) skills in showing culturally appropriate respect, eliciting patients’ explanatory models of their illness, and working appropriately with interpreters.