The article below appeared recently in New America Media. The author found that there was very little overt racism expressed by seniors needing home care. However, he did find a sometimes surprising combination of wonderful and not so terrific results when paid care givers of one culture were working with patients of a different race, religion, or ethnicity.
John Booker has seen it throughout his 35 years as a caregiver.
He
recalls meeting an Orange County, Calif., woman whose son moved her
from facility to facility hoping to find quality care. Finally, she was
placed in the hands of Booker – who is African American.
“She needed help getting to the toilet, and she didn’t want a damn n----r to do it,” laughed Booker.
“After she attacked me, I knew my reaction was extremely critical at that point. I put my best professional face on.”
Afterwards,
the tearful woman thanked Booker for his help, as did a young man
standing outside the room who watched the interaction – her son was also
an owner of the long-term care facility.
Overt racism, while
rare, is indicative of the continued struggles Americans face when it
comes to race – particularly in an intimate relationship like
caregiving.
During his own long career, Booker noted, who
founded the National Association for Direct Care Workers of Color, “I
would say 40 percent of the time there was some initial friction [over
race].”
Booker said his typically female colleagues – Latinos,
Filipinos, Caribbean Islanders and recent African Immigrants – are
acutely aware of race in the workplace.
“They will get some of
the same racial slurs and looks,” he said. “You hold back your emotions
and continue to give quality care.”
Cultural, Religious Impacts
A
Stanford University researcher says that race and ethnicity are often
linked to cultural and religious views – which may affect care. In fact,
her study of multicultural nurses in long-term care settings found
something shocking: During end-of-life care, some foreign-born Catholic
nurses felt the dying experience shouldn’t be altered by using
painkilling analgesics.
“They felt that experiencing pain and
suffering at the [end of life] afforded the dying patient an important
opportunity for spiritual redemption,” reads the small study of 45
Filipina nurses, led by V.J. Periyakoil, MD,
director of palliative care education and training at Stanford’s School
of Medicine. “None of the U.S.-born nurses endorsed this concept.”
Periyakoil
– who admitted “we were pretty surprised” at the results – described
the concept of “redemptive suffering” in this way: “Sometimes people
feel that God is giving them these experiences, and part of their faith
is to bear these experiences with as much patience as they can. How the
religious beliefs of an individual nurse – or doctor – affects how they
provide care is a bit of an unknown.”
She continued, “We do not
know how a nurse or doctor who believes in the concept of redemptive
suffering may respond to a dying patient in pain.... ... it is possible
that they may unconsciously withhold pain medicine to give the patient
an opportunity to redeem themselves.” In fact, she said, some patients
welcome this sense of redemptive pain, but doctors and nurses need to
give a patient the choice.
In another example of the enormous
influence of cultural and religious views on care, Periyakoil described
the family of a Chinese American patient with esophageal cancer. He
feared that if he died on an empty stomach “he would wander throughout
eternity as a hungry ghost,” she said. He was given a feeding tube.
Periyakoil adds that cultural differences strongly influence caregiving behaviors.
Caregivers
who acknowledge “familismo” and “respecto” within more collective,
group-oriented Latino families will gain their trust. Conversely,
Periyakoil said, more individualized cultures like Germans thrive on
care that fosters patient autonomy and more direct, factual
communication.
Compassionate Care Despite Language Limits
To many, cultural differences can actually prove beneficial.
Carla
Troutner said her tiny 4-foot-11-inch mother had two homecare aides in
the San Francisco Bay Area – one white, the other Haitian. While the
white caregiver provided acceptable care, the Caribbean caregiver
offered a uniquely calm disposition her mother adored.
“She just followed her around the house,” Troutner said of her mother.
Sadhna
Diwan recalled a long-term care facility staffed almost entirely with
Latino caregivers – some who spoke virtually no English.
“This
became a real bone of contention between the families and the hired
caregivers,” said Diwan, director of the Center for Healthy Aging in
Multicultural Populations at San Jose University’s School of Social
Work.
Yet the Latino workers’ compassionate care happily
countered the language barrier. “The love and affection and care they
show for my parents – even I don’t do that,” stated Diwan.
To read the rest: http://newamericamedia.org/2013/08/the-color-of-care-in-aging-america.php
