The Older Hispanic - Background Information for Health Care Providers Treating Hispanic Elders Cultural Values The health care provider should remember that while cultural influences are significant in the perceptions and health care practices of many Hispanic elders, attitudes, beliefs, and health practices may differ from one population to another. Cultural values that may influence the quality of interactions with health care providers or the health care system include the relationship with physicians and key health care professionals, religion, and family. First, the value of trust and rapport within the relationship with the health care provider is an important element in the health seeking behavior of Hispanic elders. It has been documented that Hispanic individuals generally respond better to health care providers who initiate a congenial, personal relationship rather than those with a more formal approach. However, professional attire is expected as a symbol of respect. Once a health care or other helping relationship is initiated, an effort should be made to maintain continuity. Second, religion and spirituality are valued by many Hispanic elders. Studies indicate that older Hispanic immigrants tend to consider spirituality as a dimension of overall health, in addition to the physical and physiological elements. Assessment of the religious and spiritual beliefs of the individual elderly patient can help the provider to plan appropriate interventions which will be congruous with the patients’ beliefs. Maintenance of religious continuity, especially in the inpatient or long term care setting, may be of extreme importance; for example, access to religious objects or rituals allows the elderly to maintain an established routine. Consideration of patients’ religious beliefs and practices can strengthen relationships with the health care provider, and help the individual adjust to an uncertain or unfamiliar environment. Third, the value of family should be considered when interacting with Hispanic elderly in the health care system. Providers who manage the care of elderly Hispanics should assess the role of the family in making health care decisions. Interdependence between family members is highly valued among many Hispanic communities, and may be expressed through collective decision making. The traditional Hispanic family may incorporate members of the extended family, including parents, siblings, aunts, uncles, cousins, friends, and godparents; it is not unusual to find multiple family members visiting the elderly when institutionalized or at appointments or tests, to provide support to the individual, and to consult with each other regarding what is best for the elder. Health care providers may find that, in situations in which there is a strong family system, Hispanics may refuse to name a health care proxy, as this may be considered irrelevant or even potentially harmful as it may isolate one family member as the primary decision maker. Barriers to Care Multiple factors may affect access to care by Hispanic or Latino elders, including language barriers and socioeconomic status. Elderly Hispanics may seek preventive care and comply with medical treatments to a limited extent if hindered by socioeconomic barriers such as low income, low education or literacy, unemployment, or lack of insurance. Hispanic elders or their caregivers may be employed in positions that do not provide insurance, and may have difficulty obtaining coverage if they are recent immigrants, undocumented, or seasonal agricultural workers. As well, studies indicate that while Latinos often remain in the workforce beyond retirement age, only 54 percent receive Social Security benefits. The difference is often made up by Hispanic adult children, who provide informal family caregiving to a far greater extent than adults of other ethnic groups (http://www.hispaniconline.com/lstyles/health&fit/long.html). Second, lack of English proficiency may present a significant barrier for Hispanic elders served by English-only health care providers. Even Hispanics who are fluent in English may have difficulties discussing personal or emotional problems; and as well, expressions of love, anger, or hate may be difficult to translate. The use of technical or medical terminology may also hinder the communication process, as may an older individual’s reluctance to admit a lack of understanding. An assessment should be done to determine if language is a barrier for a given individual or family. << Back to En Espanol index | Demographics <top>