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Chapter 3
Diversity
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Introduction
• The older adult population is becoming
increasingly racially and ethnically diverse
• Increasing numbers of Hispanic and black older
adults in the U.S. population
• Essentials of culturally competent care
• Lack of research related to cultural influences of
aging
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Characteristics Shared by Ethnic Groups
• History
• Language
• Customs
• Beliefs about aging
• Key point: there are individual differences
within ethnic groups so it is important not to
stereotype
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Factors Influenced by Ethnic Norms
• Diet
• Response to pain
• Compliance with self-care and treatments
• Trust with health care providers
• Responsibilities and roles in old age
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Hispanic Americans
• Variety of Spanish-speaking persons
– Immigrants from Spain, Mexico, Cuba, and
Puerto Rico
• Increasing percentage of the population
• Different immigration periods for each Hispanic
subgroup
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Hispanic Americans
• Perspectives related to health and illness
• Traditional practitioners: curanderos,
sobadores, espiritualistas, brujos, señoras
• Views of older adults in the Hispanic culture
• Expectations of children as caregivers
• English as a second language
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Black Americans
• 13% of the American population is black, but
older black adults represent only 8% of the
population
• Commitment to family and aging relatives
• Lower standard of living and less access to
health care
– Lower life expectancies
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Health-Related Characteristics of
Black Americans
• More health problems
• May hold unconventional beliefs related to
health and illness
• Family decision making versus formal health
service agencies
• Cautious while interacting with health care
providers
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Assessment and Health Conditions of the
Older Black Population
• Differences in assessment for people with black
skin
• More prevalent health problems:
– Hypertension, heart disease, cancer,
diabetes, and HIV/AIDS
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Asian Americans
• Currently 4% of the population of the
United States
• Diverse group of individuals from various
countries:
– China, Japan, the Philippines, Korea,
Vietnam, and Cambodia
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Chinese Americans
• Life as an early immigrant
• Cities with the largest Chinese population
• Chinese medicine and medical traditions
– Yin and yang
– Traditional treatments
• Older adults are held in high esteem
• Role of the family unit
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Japanese Americans
• Japanese immigration
• Lower unemployment rate and higher
percentage of professionals
• States with the largest Japanese populations
• Japanese traditions and generations
• Families care for elders
• Aged are viewed with respect
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Other Asian Groups
• Filipino
• Korean
• Vietnamese
• Cambodian
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Jewish Americans
• Jewish faith
• Immigration
• Leadership in business, arts, and sciences
• 2.2% of the total population
• Religious traditions
• Modern medical care
• Death rituals
• Family bonds
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Native Americans
• Population increasing
• States with highest population rates
• Indian Health Service
• Reverence for the Great Creator
• Health beliefs
• Spiritual rituals and treatment of illness
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Native Americans
• Ambivalence related to health care services
• Death rituals
• Rise in preventable diseases: diabetes, obesity,
hypertension, stroke, and rheumatoid diseases
• Lowest cancer survival rate
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Older Prisoners
• Older adult prisoners as a subculture
• Poorer health and significant health challenges
related to poor socioeconomic status and prior
lack of access to health care
• Need for improved gerontological care and
advocacy in the prison setting
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Nursing Considerations for Culturally
Sensitive Care of Older Adults
• Unique histories, beliefs, and practices
• Respect for diversity
• Accommodation of dietary preferences
• Adaptations for special practices
• Understanding of health practices
• Culturally and linguistically appropriate services
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