Test 3 Flashcards
What is the descipline that systematically studies aging and how aging affects the individual and how the aging population will change society?
Gerontology
Why study aging?
To understand the physical and psychological implications that go along with aging
To learn how to provide care for the elderly
To prepare ourselves for those years
What are the categories of geriatrics based on age?
Young-old (65 - 74)
Middle-old (75 - 84)
Old-old (85+)
What are the categories of geriatrics not related to young-old old?
Chronological age
Functional age
Biological age
What is fastest growing segment of the Canadian population?
Seniors
What caused tha large shift in the aging populations?
Baby boomers getting older
Longer life expectancies
Lower fertility rates
What does increased life expectancy mean for dentistry?
Increased number of people retaining their teeth
Increased dental needs
Increased incidence of chronic illnesses to adapt tx to
With an increase in elderly individuals the social structure will change how?
Living in 3 or 4 generation families
Grandparents will still be working
92% of the elderly will live in community
8% of elderly will live in long term care
1/3 of elderly will live independantly
What will the predicted shrinking of the labor force do?
Lower the gross national product and increase costs
Shift in government service costs
Decrease education expense and increase in social security and health expenditures
What are the bonuses of an older population?
Lower crime rate
Increased concern for fitness
Diet and disease prevention
Improved economy
What is the term for prejudice against old people?
Ageism
What are the three most widely used social theories of aging?
Disengagement
Activity
Continuity
What aging theory proposed that the number of interpersonal relationships in which an individual is involved declines with age and that the individual becomes increasingly passive in relationship, introspective and withdrawn?
Disengagement Theory
True or False: In Disengagement Theory, the withdrawl is voluntary and satisfaction comes frombeing able to look back over a life well lived.
True
What discussion is based on some variation of the disengagement theory?
The right to die
What theory associates successful aging with vitality, mobility and life satisfaction based on retention of middle-age behaviours, activities and relationships?
Activity Theory
What aging theory suggests that the major focus of human behaviour is to maintain continuity and stability over a lifetime and if changes do occur the individual must focus on maintaining their old stability or move to a new level of stability?
Continuity Theory
What are the problems with those three common aging theories?
Each are true under some conditions but not under all or universally.
What theory attempts to formulate a whole life conception of aging where old age is a process of becoming socialized to new or revisited role definitions?
Age Stratification Theory
What aging theory is influenced by the relationship between the distribution of power and the form of economic organization?
Political Economic Theory
__% of adults 65+ have at least 1 of 1 common chronic conditions.
73%
What are the 10 common chronic conditions?
Hypertension
Periodontal disease
Osteoarthritis
Ischemic heart disease
Diabetes
Osteoporosis
Cancer
COPD
Asthma
Mood and anxiety disorders
What speeds up the aging process?
Smoking
Systemic illness
Environmental factors
Stress
Medications
Poor nutrition
Inactivity
Social isolation
What normal physiological changes are encountered with aging?
Decrease in bone mass
Drop in basal metabolism
Dysfunction in the regulatory syste
Reduction in lung capacity
Decrease in circulation and cardiac output
Loss of muscle mass and strength
Decline in brain volume
What is involved in stress reduction protocol?
Recognize degree of risk
Complete medical consultation if necessary
Monitor vital signs pre and post appointment time
Consider decrease anxiety tactics
Pain control therapy
Telephone for f/u after the appointment
Average appointment time accodingly
Calcium loss is partly age related by another major cause is
Dietary deficiency
What are the results of calcium loss?
Reduction in height
Poor posture
Increasing difficulty in breathing movements
Poorer circulation to the arms, hands, head and brain
Pinched nerves leading to pain or numbness in the arms and legs
What are the DH considerations for loss of calcium?
Shorter appointments
Joint replacement more common
NSAID or aspirin use - monitor bleeding
Watch for oral signs of dietary deficiency
True or False: Under stress the heart rate of an older individual increases more than that of a younger person.
False. Under stress the heart rate of an older individual increases less than that of a younger person.
What is the result of an older individual’s stress response of heart rate being less than that of a younger person?
Increases risk of a heart attack
Reduction of lung capacity in geriatrics is due to
Loss of elasticity in chest muscles
Increase rigidity of internal lung structures
Increase in dead air space at the bottom of the lung
The reduction of lung capacity is approximately __% from the age of 30 to 80.
50%
What happens causing a decrease in circulation and cardiac output in geriatrics?
Cardiac muscle fibers decrease
Oxygen used less efficiently
Decreased elasticity of aorta
Thickening of blood vessel walls
In geriatrics there is a decrease in phsyical strength due to
Normal atrophy of the muscles and the connective tissue losing elasticity
The basic component of connective tissue, ____, loses its flexibity and toughness with age.
Collagen
In geriatrics, decreased enzymes result in loss of
Gastric cells
True or False: Geriatrics experience a decrease in peristalsis
True
True or False: The primary organs of the immune system bone marrow cells and the thymus t-cells are thought to be affected most by the aging process.
True
The primary organs of the immune system bone marrow cells and thymus t-cells are thought to be affect most by the aging process. This results in
An increase in the amount of infections, autoimmunity, and cancer.
In geriatrics there is a decline in the body’s ability to secrete
Insulin
Thyroid hormones
Sex hormones
Adrenaline in blood
What is the result of the decline in the body’s ability to secrete insulin, thyroid hormones, sex hormones, and adrenaline in the blood?
Diabetes
Hypothyroidism
Decreased sex drive
Baldness
Depression
Slower response to danger
Why is there a decline in kidney function in geriatrics?
The rate of filtration of impurities from the blood is reduced, partly through reduced blood flow through the kidneys themselves. The weight and the mass of the kidneys reduce because of a reduction in the number of nephrons and the size of the nephrons
Kidney dysfuntion in the elderly often leads to
Deyhydration
Why does hearing deterioriate in the elderly?
Outer ear often builds up with waxy deposits that become so hard is reduces hearing. Most often the receptors for high pitched sounds are lost.
What is presbycusis?
Age-related hearing loss
What visual changes occur in the elderly?
Lens become more rigid, opaque and yellow
Reduction in pupil size
Less tears produced
What are the most common visual problems in the elderly?
Cataracts
Glaucoma
Macular degeneration
Why does touch deteriorate with age?
The collagen content of the skin decreases with age resulting in a decrease of the elasticity and strength of the skin. Intracellular deposit of lipofusin - age spots, a yellow-brown pigment
True or False: Studies show that there is a decline in taste buds that occur with age.
True
When a change in taste is noted, is usually manifests as an increase in the threshold for ___ and ___ due to an occlusion in the taste buds.
Salty
Sweet
True or False: Deficits in taste and smell tend to go hand in hand
True
Dental management guidelines for geriatrics?
Thorough medical history
Stress reduction protocol
Dental chair position
Adaptations to OHI
Communication to the individual
What are the three As?
Accessibility
Adaptations
Accommodations
Why is the number of elderly people seeking dental care increasing?
Decreased number of edentulous people
Increased disposable income
Increased awareness of oral health care and its potential links with systemic diseases
Poor oral health puts seniors at greater risk for developing or making worse serious health problems such as heart disease, stroke, pneumonia and diabetes
What are three barriers to dental care geriatrics experience?
New financial reality
Physical ability to access dental services
Increasing prevalnce of brain disorders
Are oral health problems among the most prevealent chronic problems that elderly people have to deal with?
Yes
Poor oral status is associated with
Pain
Poor oral and facial esthetics
Impairments with eating, chewing speaking, social interactions
Decreased self-esteem and a poor sense of well being
Provisions of regular oral hygiene is a challenging task for patients as it is complicated by
Reduced physical dexterity
Impaired sensory functions
Cognitive deficits
Behaviour problems and related communications
What does the OSCAR acronym stand for regarding factors for treatment planning?
Oral
Systemic
Capability
Autonomy
Reality
What are the oral concerns with the elderly?
OSC management
Caries management
Xerostomia
Hypersensitivity
Candidiasis
Denture irritation
Mucositis
Irregular tissue/bone development
Oral cancer
What are the oral physiological changes in the elderly?
Thinning of the mucosa
Loss of masticatory muscle
Tooth wear, loss of enamel
Limited attached tissues
How to reduce bacteria in the oral cavity for the elderly?
Use of chemoterapeutics like
Antribacterial toothpastes
Chlorhexidine
Mechanical improvements
Xylitol
Probiotic therapy
Demineralization of dentin is __x as fast as enamel.
2x
What is the critical pH for caries in enamel?
5.5
What is the critical pH for caries in dentin?
6.2-6.4
Two options for preventing caries
Reducing the amount of bacteria present in the mouth
Remineralizing the tooth when it is exposed to the acid
What elements have been shown to aid in remineralization?
Calcium
Phosphate
Fluoride
What is a combination of casein phosphopeptides (CPP) and amorphous calcium phosphate (ACP)?
Recaldent a remineralization program
What is casein derived from?
Cow’s milk
Is casein safe for those who are lactose intolerant?
Yes but not for those with a milk allergy
What paste is a remineralization program?
MI paste containing 10% recaldent
What allows for the greatest absorption of MI paste?
3-5 minutes of contact time
What is the most well known remineralization program?
Fluoride - topical fluoride
What is the active ingredient in Fluoridex?
1.1% neutral NaFl
What remineralization program is called a wood or birch sugar that is used as a sugar substitute and is a powerful inhibitor of bacterial growth?
Xylitol
What is a bioactive glass which releases calcium and phosphate ions when exposed to saliva?
Novamin
What is the prevalence of xerostomia in those 65 and older?
30%
A client does not perceive dry mouth until at least __% of the saliva is gone.
50%
What can xerostomia lead to?
Choking, dysphagia
Dificulty speaking
Dental decay
Halitosis
Dysgeusia
Swollen, red tongue
Ill fitting dentures
Painful, bleeding gums
What is the number one cause of xerostomia?
Medication side effects
How many drugs are known to cause xerostomia?
Over 500
What are other causes of xerostomia besides medications?
Factors affecting salivary centre
Factors affecting the automatic outflow pathway
Factors affecting salivary gland function
Factors affecting fluid or electrolyte balance
What factors affecting the salivary centre cause xerostomia?
Emotions
Neurosis
Organic disease - tumors
What factors affecting the automatic outflow pathway causes xerostomia?
Encephalitits
Accidents
CVAs
Medications
What factors affecting salivary gland function causes xerostomia?
Sjorgen’s syndrome
Sialoliths
Radiation
What factors affecting fluid or electrolyte balance cause xerostomia?
Diabetes
Cardiac failure
Anemia
What is the treatment for xerostomia?
Water
Limit caffeine
Sugarless candies or gum
Acoid alcohol and smoking
Humidifier
Avoid sugar and refined carbs
OHI - rinses, gels, remineralization process and removal of bacteria
What is saliva substitute?
Antibacterial enzyme system
Why is glycerin to be avoided for xerostomia?
Glycerin is hypertonic and therefore draws moisture out of tissues
True or False: Hypersensitivity is a common report in the office and has a high prevalence.
False. Hypersensitivity is surprisingly underreported in the office despite a high prevalence. It is frequently undiagnosed and untreated.
How to deal with hypersensitivity?
Evaluate habits - acidic foods and beverages
Evaluate oral care habits - scrubbing
Sensodyne has __% potassium nitrate, the maximum allwed by regulations.
5%
What infection in the oral cavity is characterize by a yeast like fungal growth?
Candidiasis
What local risk factors are related to candidiasis?
Poor maintained/ill-fitting dentures
Wearing dentures overnight
Inadequate vertical dimension of occlusion
Use of nonprescription liners
Inability to clean dentures as a result of decline in vision or digital dexterity
What systemic risk factors are related to candidiasis?
Blood spectrum antibiotics
Xerostomia
Immunosuppresion (chemo, corticosteroids, neoplasia)
What are the topical treatments for candidiasis?
Nystatin
Clotrimazole
How is Nystatin delivered?
Suspension
Tablets
Mixed with lubricant
Mixed with juices and frozen
How is Clotrimazole delivered?
Tablets
Cream
Denture irritation may cause the mucosa to appear
Inflamed
Ulcerated and secondarily infected with candida
Papillomatous
Hyperplastic
Keratotic
What are the signs of denture stomatitis?
Discomfort
Difficulty chewing
Rubbing the mandible
Removing dentures a lot
Treatment for denture stomatitis?
Reline
Remake
Adjust
Leave dentures out for tissues to rest
Topical for ulcers
What lesion is found primarily in the maxillary anterior segment adjacent to the labial flanges of the dentures?
Epulis fissuratum
What causes epulis fissuratum?
Ill fitting prosthesis
What is the treatment for epulis fissuratum?
Surgical removal
Adjustment or fabrication of a new denture
What condition causes inflammation of the oral tissues ranging from slight redness to extreme ulceration and pain?
Mucositis
What causes mucositis?
Systemmic diseases (leukemia, anemia, diabetes)
Nuritional deficiencies
Adverse drug reactions
Radiation and chemotherapy
Immunosuppresion and xerostomia
How to treat mucositis?
Keep mouth moist and clean
Pain management
True or False: oral varicosities in the sublingual area are common in the elderly.
True
What causes varicosities?
Capillary fragility
Loss of elasticity in the venous wall
Blockage of venous flow
The decrease in vertical dimension results in decreased power in the
Muscles of mastication
TMJ problems in the elderly are primarily encountered by those who have
Degenerative joint disease
Osteoarthritis and rheumatoid arthritis may result in
Limited opening
Crepitus
Pain
Trismus
Swelling
One of the factors most strongly linked with oral carcinomas is
Age
There are __ of diffrent types of oral pathology based on colour, size and texture
Hundreds
Is it common to see a denture-sore like lesion that is actually cancer?
Yes
Brain weight decreased __% by age 90
20%
What condition is a collection of symptoms characterized by the development of multiple cognitive disturbances that are due to the direct physiological effects of the condition?
Dementia
What are the reversible risk factors for dementia?
Drugs and alcohol
Emotions
Metabloic
Endocrine
Nutritional deficiencies
Tumors/trauma
Infections
Arteriosclerosis of cerebral vessels
What are the irreversible risk factors of dementia?
Alzheimers
Parkinson’s disease
Lewy body dementia (=Alz + Park)
Vascular dementia
Creutzfeldt-Jakob disease
Multi-infarct
Incidence of dementia at age 60?
1%
Incidence of dementia over age 75?
4%
Incidence of dementia over age 85?
30%
What condition is characterized by loss of neurons and synapses in the brain that results in gross atrophy of the affected regions?
Alzheimer’s disease
What are the common symptoms of Alzheimer’s disease?
Impaired memory and thinking
Disorientation and confusion
Misplacing things
Abstract thinking
Trouble performing familiar tasks
Changes in personality and behaviour
Loss of motivation or intitiative
What are the warning signs of Alzherimer’s?
Easily distracted
Altered vision and hearing
Vacillates between poor and excessive appetite
Lacking feeling in mouth
Decreased fluid intake
Unable to distinguish between foods and other substances
How many cases of Alzheimer’s are early onset?
5%
How many cases of Alzheimer’s are late onset?
95%
When does late onset Alzheimer’s occur?
Over 65
What are the four stages of dementia?
Mild
Moderate
Severe
Terminal
What are symptoms of mild dementia?
Impaired memory
Personality changes
Spatial disorientation
What are the symptoms of moderate dementia?
Aphasia
Apraxia
Confusion
Agitation
Insomnia
What are the symptoms of severe dementia?
Resistiveness
Incontinence
Eating difficulties
Motor impairment
What are the symptoms of terminal dementia?
Bedfast
Mute
Dysphagia
Intercurrent infections
What cognitive medications help with dementia but only prolong the inevitable?
Acetylcholinesterase Inhibitors (Aricept, Exelon)
Atypical antipsychotics (Quetiapine, Risperidone, Olanzapine)
What are the oral symptoms of dementia?
Forget to brush
Decreased salivary flow
Non comprehension of what a toothbrush is
May resist assitance
Difficulty reporting pain
Negative cycle
Dental management for dementia?
Patient
Gentle persuasive approach
Communicate with short sentences, repeat instructions
Place on agressive 3 month program - maintain teeth condition
OHI - plaque, anticaries mangement, xerostomia
Refer to geriatric specialty
__% of long-term care residents require assistance with daily activites like getting out of bed or eating.
97%
__% of residents of long term care have two or more chronic conditions.
97%
__% of long term care residents have some form of cognitive impairment wth 1 in 3 being severely impaired.
90%
__% of long term care residents exhibit some level of aggressive behaviour.
46%
How to enter the mouth if you are afraid of being bitten?
Enter from the corner of the mouth with one or two fingers. Do not place your finger between the top and bottom surfaces of the teeth.
What is a Collis curve toothbrush?
It brushes all surfaces of the tooth at once (lingual, buccal, and occlusal)
The dental professional should ask the elderly to _____ to their initial appointment.
Bring all their medications with them
What is the primary goal for the terminally ill patient?
To make the patient as comfortable as simply as possible.
What is as effective as a toothbrush in removing plaque?
A chlorhexidine-soaked foam brush
What is the most common infection in long term care institutions?
Urinary tract infections
What is the second most common infection in long term care institutions?
Aspiration pneumonia
What are the risk factors for aspiration pneumonia?
Low salivary flow
Swallowing disorder
Periodontal disease
Poor OH
Bedridden
Dependent for feeding
Intubated
Ventilated
Known aspirator
Recently used antibiotics
All oral hygiene measures should be done ___ for the dysphagic patient.
Upright with the patient’s head turned sideways
Nearly ___ of all medications, both prescriptions and over the counter are taken by the elderly.
One third
Side effects from medications are __x more likely in the elderly than in any oher age group.
7x
What contributes to this high percentage of side effects from medications being more likely in the elderly?
Increasing age
Multiple medical problems
Complicated drug therapies
What are the most common medication types of the elderly?
Anti psychotics
Cardiac control
Arthritis
Thyroid
Osteoporosis
Stool softeners
Metformin
As we age, a ___ dosage of drugs should be considered.
Lower
Why should a lower dosage of drugs be considered as we age?
Reduction in total body water
Decreased blood flow
Decrease in albumin levels
Reduction in renal function
Weight loss
Approximately __ of all outpatients fail to take the medication that has been prescribed
Half
What is defined as abuse that takes place in the family, in an intimate relationship, or in a situation of dependency or trust?
Family violence
Knowing the red flags or abuse indicators can help determine
The level of risk or suspected abuse of our clients
What are the types of abuse?
Physical
Emotional
Sexual
Financial
Neglect
Who is most at risk for abuse?
Child
Women
Older adults
In __ of family violence cases, the accused is a parent.
17%
In Canada, __ out of 10 family violence victims are female.
7
Exceptions to confidentiality from DH
As required by law
As required by the policy of practice environment
In an emergency situation
In situations where disclosure is necessary to prevent serious harm to others
To client’s guardian or substitute decision maker
On average, every __ days a woman in Canada is killed by her partner.
6
True or False: Violence is usually caused by alcohol or drugs.
False. Alcohol or drugs may be used by the abuser but they are not the cause of the violence.
Emotional abuse is a pattern of overt
Rejection
Belittling
Blaming
Accusing
Finding fault
Shouting
What is the definition of a child according to part 3 of The Child and Family Services Act?
As a person under, but not including 16 years of age
What are the predominant soft tissue injuries of abuse?
Lacerations of the labial mucosa of the upper lip near the frenum
What are the indicators of child abuse?
Fractured teeth
Oral lacerations to soft tissue
Fractures of the jaw
Bruising to the face
Adult bite marks
Behaviour
Bruises on the face and side of the head may suggest
Blows with a first or open hand
Clues to detect child abuse
Child wearing long sleeves all year
Child who falls often (injures knees, elbows, surfaces are scratched, bruised, or skinned)
Injuries around the shoulders or back
What is the role of the dental hygienist for abuse?
Increase their awareness of the issue
Recognize inficators of child abuse
Understand legal requirements for reporting child abuse
Know how to access community support services for children and their families
What do we do when we suspect child abuse?
Include a standard question on the medical history
Documentation of lesions
Documentation of symptoms of abuse
Consult
Report
What to do when suspecting domestic violence
Ask
Validate
Document
Refer
How to communicat with suspected domestic abuse clients?
Assure confidentiality
Listen to the client
Respond to their feelings
Provide options for the patient
Document all in the chart
Schedule a follow up visit or call
Is there a legal requirement to report woman abuse?
No
What are the violence at home signals for help?
Palm to camera and tuck thumb
Trap thumb under fist
Elder abuse occurs at a rate of about __% of the senior population
4%
Every day, __ seniors are victims of family violence in Canada
8
The health impacts of senior abuse beyond the physical are
Poor mental health
Psychological and emotional distress
Suicide
Increase risk of chronic diseases and conditions like cancer and heart disease
What is defined as a single or repeated act, or lack of appropriate action, occuring in any relationship where there is an expectation of trust that causes harm or distress to an older person?
Abuse and neglect of older adults
Why is elder abuse significantly under reported?
They are afraid reprisals
They are under the control of the abuser
They fear they will be put in an institution
They do not know who to speak to
They do not want to involve the police
What are the indicators of abuse in older adults?
Behaviour change
Lack of medical/dental attention
Unpaid bills
Unkempt appearance
Malnutrition
Physical injury
What is the community victim profile of elder abuse?
Over the age of 75
Widow or living alone
Socially isolated
Under the control of the abuser
Some degree of mental incapacity
Physically frail
What is the EAO?
Elder Abuse Ontario
What is the DH role of treating survivors of abuse?
RIR:
Recognize indicators of abuse
Interact with the senior
Respond when necessary
What is trauma informed care?
A system of organizations, programs, and services intended to promote healing and reduce the risk of re-traumatization of patients and staff
What are the three main elements of trauma?
It was unexpected
The person was unprepared
There was noting the person could do to stop it from happening
What are the types of trauma?
Acute trauma
Chronic trauma
Complex trauma
Secondary trauma
What type of trauma is a single stressful or dangerous event like a car accident?
Acute trauma
What type of trauma is prolonged exposure to traumatic experiences like bullying, child abuse, family violence or neglect?
Chronic trauma
What type of trauma results from exposure to multiple sources of trauma like living in a war-torn country?
Complex trauma
What type of trauma is when someone develops trauma symptoms due to close contact with someone who has experienced trauma?
Secondary trauma
What is caused by experienced traumatic life events?
PTSD
What does ACE stand for?
Adverse Childhood Experiences
What is the ACE study?
Between 1995-1997 one of largest investigations of child abuse and neglect and household challenges and later-life health and well being was done.
What were the 3 key findings of ACE?
- 64% of those surveyed repotred at least one or more ACE
- The more ACEs a person had the more likely they are to have unwanted health, behavioural and social outcomes.
- ACEs are associated with early mortality
What is trauma that is passed from one generation to the next.
Generational Trauma
True or False: Genetic changes and responses can be passed down to further generations even if the trauma has not occured to that individual.
True
There is a strong link between ongoing childhood abuse and
Dissociation
How can disassociation be treated?
Psychotherapy and medications
What is TIP?
Trauma Informed Practice
What are the four principles of TIP?
Awareness
Safety and Trustworthiness
Choice, Control and Collaboration
Strengths-based empowerment
What are some TIP approaches in the dental office?
Involve patients in the treatment process
Help clients undersand outcomes of tx
Be open to stopping procedures and taking breaks
Use consent based language
What categorizes humans by biologically distinct physical traits and geographic origin?
Race
What is a group that shares a common identity such as shared history, traditions, language, nationality or cultural heritage?
Ethnicity
What defines a person’s values, beliefs, customs and behaviours?
Culture
How many immigrants are there to Canada per year?
250,000
What is the belief that one’s own cultural values, beliefs nd behaviours are the best, preferred and most superior ways?
Ethnocentrism
What refers to the view that the values and beliefs of a particular culture must guide the situation or decisions?
Cultural bias
What are the three reasons providers need to be in constant pursuit of cultural competence?
- Social realities of the changing world
- Influence of culture and ethnicity on human growth and development
- Challenge of providing effective and quality healthcare to all people
Canada’s history is built upon three key elements of diversity. What are they?
- Aborignal population
- Linguistic duality
- Ethnic, racial, cultural and religious diversity
__ Ontarians self-identify as belonging to a racialized group (visible minority)
1 in 4
What are the foundational competencies for working with diversity?
Humility
Truth
Accountability
Development
Awareness
What is a population-specific difference in the presence of disease, health outcomes or access to health care?
Health Disparity
What are two important points to remember in cross cultural communication?
- Do not expect to completely understand a culture that is not your own
- Do not fall into stereotyping or over-generalizing
What are two models of cultural competency?
Cultural Competency Education Model
Cultural Competency Continuum
What cultural competency model focuses on developing cultural competency in health care practices and divides into 3 areas of intervention, self-exploration, knowledge and skill?
Cultural Competency Education Model
What cultural competency model is a framework extensively referred to in literature which is described as a ladder which steps that range from cultural destructiveness to cultural proficiency?
Cultural Competence Continuum
What are the levels of cultural competence?
Individual Cultural Competence
Organizational Cultural Competence
System Level Cultural Competence
What does LEARN stand for in the LEARN Model for Cross-Cultural Encounter Guidelines for Health Practitioners?
Listen
Explain
Acknowledge
Recommend
Negotiate
What model questions what, why, how and who are asked to understand and implement individualized health care encounters?
Explanatory Model to Elicit Health Beliefs in Clinical Encounters
What emphasizes the need for organizational change by focusing on organizational structure, governance, policy and programs?
Organizational Clinical Competence
Organizational interventions address systems issues for 2 main reasons:
- To increase access
- To increase the organizations capacity to serve
What are the 9 organizational cultural competency techniques?
- Interpreter services
- Recruitment and retention services
- Training
- Coordination with traditional healers
- Use of community healthcare workers
- Culturally competent health promotion
- Inclusion of family and community members
- Immersion into another culture
- Administrative and organization accommodations
What are some strategies for improving intercultural communications?
Increase awareness
Build sensitivity
Develop knowledge
Avoid sterotypes
Avoid ethnocentrism