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Hispanic/Latino American Older Adults

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Hispanic/Latino American Older Adults Ethno MEd Health and Health Care of Hispanic/Latino American Older Adults http://geriatrics.stanford.edu/ethnomed/latino Course Director and Editor in Chief: VJ Periyakoil, Md Stanford University School of Medicine [email protected] 650-493-5000 x66209 http://geriatrics.stanford.edu Authors: Melissa talamantes, MS University of Texas Health Science Center, San Antonio Sandra Sanchez-Reilly, Md, AGSF GRECC South Texas Veterans Health Care System; University of Texas Health Science Center, San Antonio eCampus Geriatrics IN THE DIVISION OF GENERAL INTERNAL MEDICINE http://geriatrics.stanford.edu © 2010 eCampus Geriatrics eCampus Geriatrics hispanic/latino american older adults | pg 2 CONTENTS Description 3 Culturally Appropriate Geriatric Care: Learning Resources: Learning Objectives 4 Fund of Knowledge 28 Instructional Strategies 49 Topics— Topics— Introduction & Overview 5 Historical Background, Assignments 49 Topics— Mexican American 28 Case Studies— Terminology, Puerto Rican, Communication U.S. Census Definitions 5 Cuban American, & Language, Geographic Distribution 6 Cultural Traditions, Case of Mr. M 50 Population Size and Trends 7 Beliefs & Values 29 Depression, Gender, Marital Status & Acculturation 31 Case of Mrs. R 51 Living Arrangements 11 Culturally Appropriate Geriatric Care: Espiritismo, Language, Literacy Case of Mrs. J 52 & Education 13 Assessment 32 Topics— Ethical Issues, Employment, End-of-Life Communication 33 Case of Mr. B 53 Income & Retirement 16 Background Information, Hospice, Eliciting Patients’ Perception of their Patterns of Health Risk 18 Case of Mrs. D 54 Topics— Condition 34 General Health Status 18 Use of Standardized Instruments, Long Term Care, Case of Mr. JR 55 Mortality and Life Expectancy 19 Translation Methodology 35 Disease-Specific Clinical Assessment 36 Learning Resources: Mortality Rates, Functional Assessment 38 Student Evaluation 56 Morbidity 22 Topics— Cardiovascular Risk Factors, Culturally Appropriate Geriatric Care: Papers, Projects & Reports Dyslipidemias 23 Delivery of Care 39 Objective Questions 56 Topics— Essay Questions 57 Smoking, Health Promotion & Cerebrovascular Disease Disease Prevention 39 References 58 & Stroke, Hypertension 24 Treatment Issues, Malignancies, Complementary and Alternative End-Stage Renal Disease (ESRD) Medicine & Healers 40 25 Working With Families 43 End-of-Life Care, Cognitive & Emotional Status 26 Ethics & End-of-Life Decision Making, Psychological Distress & Hospice, Dying & Death 45 Depression, Functional Status 27 Access & Utilization 47 Topics— Primary & Acute Care, Long-Term Care 47 Copyright/Referencing Information Users are free to download and distribute eCampus Geriatrics modules for educational purposes only. All copyrighted photos and images used in these modules retain the copyright of their original owner. Unauthorized use is prohibited. When using this resource please cite us as follows: Talamantes, M, MS & Sanchez-Reilly, S, MD: Health and health care of Hispanic/Latino American Older Adults http://geriatrics.stanford.edu/ethnomed/latino/. In Periyakoil VS, eds. eCampus Geriatrics, Stanford CA, 2010. © 2010 eCampus Geriatrics VJ Periyakoil, MD, Course Director & Editor in Chief [email protected] 650-493-5000 x66209 visit us online: http://geriatrics.stanford.edu eCampus Geriatrics hispanic/latino american older adults | pg 3 DESCRIPTION This module in the Ethnogeriatric Curriculum for Hispanic/Latino older adults is designed to introduce MODULE CHARACTERISTICS health care trainees to important issues in the care of older Americans from Hispanic/Latino backgrounds. Included are: Time to Complete: 2 hrs, 0 Mins • Explanations of the terms used to describe the populations Intended Audience: Doctors, Nurses, Social Workers, Psychologists, Chaplains, • Demographic data and sources of data available Pharmacists, OT, PT, MT, MFT and all other clinicians caring for older adults. • A review of mortality and morbidity data • Background information on: Peer-Reviewed: Yes 1. Historical background on the specific ethnic groups Course Director & Editor-in-Chief of the 2. Cultural traditions, health beliefs and values, Ethnogeriatrics Curriculum & Training including complementary and alternative VJ Periyakoil, MD medicine, palliative and end-of-life care Stanford University School of Medicine • Background and skills needed to provide a culturally competent geriatric assessment Authors • Treatment issues with Hispanic/Latino older adults Melissa Talamantes, MS Department of Family and Community Medicine, • Review of access and utilization of health care University of Texas Health Science Center, San Antonio Information in the content section is based on evidence Sandra Sanchez-Reilly, MD, AGSF GRECC from research, and citations to the published studies South Texas Veterans Health Care System, Division of are included. Geriatrics and Gerontology Department of Internal Medicine, University of Texas Health Science Center, San Antonio, Texas Special thanks to Mary Garza for assistance with the tables. © 2010 eCampus Geriatrics VJ Periyakoil, MD, Course Director & Editor in Chief [email protected] 650-493-5000 x66209 visit us online: http://geriatrics.stanford.edu eCampus Geriatrics hispanic/latino american older adults | pg 4 LEARNING OBJECTIVES After completion of this module, learners will be able to perform the following in relation to Hispanic/Latino older adults: 1. Define the terms Hispanic/Latino as used in 8. Describe strategies for development of its broad form to describe Mexican American, culturally appropriate verbal and nonverbal Puerto Rican, and Cuban older adults; communication skills discuss the use of the terms and describe 9. Identify validated assessment instruments the populations 10. Recognize cultural issues that affect 2. Identify demographics and the major sources treatment plans of information on the growth patterns available for the above ethnic older 11. Describe influences on health care access adult groups and patterns of utilization 3. Identify the major risks of diseases that face 12. Describe health promotion and disease Hispanic/Latino older adults prevention strategies for Hispanic/Latino and their implications older adults 4. Recognize the important role that history 13. Identify types of medication use including plays in the lives of Hispanic/Latino traditional folk remedies for various illnesses older adults 14. Discuss treatment issues, working with 5. Describe culturally based traditions, health families, caregiving and social support issues beliefs, values, attitudes and behaviors characteristic of this population 6. Identify and describe culturally appropriate 15. Present information on access and palliative care and end-of-life health care utilization of services, including decision-making long term care 7. Conduct a culturally appropriate ethnogeriatric health assessment for Hispanic/Latino older adults and their families using methods and strategies recommended in the Culture Med Ethnogeriatrics Overview Curriculum © 2010 eCampus Geriatrics VJ Periyakoil, MD, Course Director & Editor in Chief [email protected] 650-493-5000 x66209 visit us online: http://geriatrics.stanford.edu eCampus Geriatrics hispanic/latino american older adults | pg 5 introduction and overview Terminology N The diverse use of the terms w E Regional Differences in Terms among Hispanic/Latinos S “Hispanic and Latino” in the literature can be attributed to the diversity of the subgroups of Mexican American, Cuban American and Puerto Rican populations within a broader context. State and or regional differences in the use of terms are frequently noted in the Southwest. CALIFORNIA Latino, or Latina See the map to the right. is typically the favored term. The term emphasizes Latin American origin. U.S. Census TEXAS Definitions NEW MEXICO In Texas, where there New Mexicans usually is a large Mexican American The U.S. Bureau of the self-identify as population, the identifiers Census uses the term Hispanic or Hispanos. Hispanic or Mexican American “Hispanic” as an ethnicity are primarily used. category referring to persons who trace their origin or For a discussion on biases in using the various terminologies descent to Mexico, Puerto Rico, Cuba, Central or see Hayes-Bautista & Chapa (1987), Latino Terminology: South America, or Spain. Since 1980, according to Conceptual bases for standardized terminology. the Census Bureau, Hispanics can be of any race. In an order mandated by the Executive Office of the For purposes of this curriculum, when a specific President, revisions were made to the Statistical Policy ethnic subgroup is not identified, Hispanic and Directive No. 15, Race and Ethnic Standards for Federal Latino will be used interchangeably. Statistics and Administrative Reporting by the Office of Management and Budget (OMB) and the Office of Information and Regulatory Affairs. In the 2000 census the term Hispanic was changed to “Spanish, Hispanic or Latino” and “Not Spanish, MORE INFORMATION Hispanic or Latino”. The definition is as follows: “A person of Cuban, Mexican, Puerto Rican, South Statistical Policy Office, Office of Information & Regulatory Affairs, or Central American, or other Spanish Culture or Office of Management origin, regardless of race.” The term, “Spanish origin” & Budget, NEOB, in addition to “Hispanic” or “Latino” can be used. The Room 10201, 725 17th Street, N.W., OMB’s justification for the change was that the regional Washington, D.C. 20503. use of the terms differs, with the eastern region
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