Culture and Care

By Kathryn Cherkas, MIPH Program Manager, Friendship Center Montecito With humans all so different, eldercare is not a one-size-fits-all kind of business. What works for one person may not for someone else, and an approach that worked before may even be offensive to another. There are many considerations in caring for a dependent adult, but for this article I will be discussing the cultural elements one must take into account. For the purposes of this article, “culture” refers to everything making up an individual’s background—heritage, familial structure, values, religion, and personal preferences and needs. Essentially, someone’s culture is all of the elements that made them who they are today, but might not be mentioned in their care plans or other official paperwork. In caring for those with dementia, understanding their culture is not only useful in addressing behaviors, but also in identifying challenges they face. Food is a common one--many adults with dementia struggle with eating too little or too much. Either has the potential for leading to health problems, so in an effort to combat these issues, caregivers might over- or under-serve their loved ones at mealtimes. While it is important to pay attention to appetite-related issues, giving especially large or small portions is not necessarily the best way to handle the challenge. Many seniors today grew up during the Depression and endured financial hardship. At that time, wasting food was unacceptable and, in some situations, a punishable offense. Serving large portions of food to someone with this background might trigger anxiety as they fear they won’t be able to finish it all and will be punished. If you understand the person’s culture, you’ll have a better idea of their history with food and can take a different approach to their diet. Perhaps you’ll find that providing smaller meals throughout the day works best. Names and titles are another example of the importance of understanding someone’s culture. Around the world, and even in our own communities, people view nicknames or “pet” names differently. Don’t assume Elizabeth wants to be called “Betty” or “honey.”  Though seemingly harmless, these nicknames might be tied to bad memories from her past. Titles are often held very closely to people’s identities, no matter their diagnosis. Many adults have spent most of their lives going by a certain title, whether Dr., Mrs., Captain, or Professor, and it may bother them to no longer be addressed in this way. Most important is to be flexible and roll with the changes that come. One day your loved one might refer to himself as “Dr. Charles” and the next he is “Chuck.” The current reality your loved one is experiencing can change rapidly, but remember their reality is informed by their life experiences. Make an effort to address them in the way that is most comfortable for them in the moment. Understanding and acknowledging the elements that form someone’s cultural background can be tricky but can also make the complex world of caring for them that much easier and more enjoyable for you both. Here are some links for further reading: https://www.alz.org/national/documents/asianoutreach_tipsandcitations.pdf https://www.scie.org.uk/dementia/living-with-dementia/keeping-active/culture-religion.asp