Week 2: Cross-Cultural Caring And Aging; Cognition And Learning; Communication With Older Adults Flashcards
Culture
Learned values, beliefs, expectations and behaviors of a group of people.
Enculturation
Cultural beliefs passed down from one generation to another.
Acculturation
A process where persons from one culture adapt to another culture
Cultural Diversity
Is the existence of more than one group with differing values and perspectives.
Diversity in the United States usually refers to
Six ethnographical groups including: African American, Asian American, Native Hawaiian/Pacific Islander, American Indian/Alaskan Native, White and Hispanic
Increased diversity caused the US Census to expirament with subcategories like
“Mixed race”
Even among or within groups, other kinds of diversity exists such as
Gender, power or status.
Health Disparity
Refers to differences in health outcomes between groups.
Ethnocentrism
The belief that one ethnic/cultural group is superior to another.
Stereotyping
Application of limited knowledge of race, ethnicity, age, or culture to an individual.
Cultural Destructiveness
Systematic elimination of the recognized culture.
Cultural Blindness
Belief that there are no differences.
Rae
A phenotype as expressed in observable traits such as eye color, facial structure, hair texture and especially skin tones.
Ethnicity
Refers to the cultural group with which one self-identifies
Cultural Proficiency
The ability to move smoothly between two worlds for the promotion of health and caring of persons
Cultural Proficiency allows for
Increased ability to build relationships with members of a variety of cultures as a part of natural daily practice.
On Lok Program
Most well-known model for cross-cultural Gerontological care of program all inclusive care for the elderly (PACE)
Components of On Lok Program include
- access to a professional interpreter
- programs reflect diversity of participants
- consider monocultural facilities or units
- staff reflects diversity of residents
The Learn Model
- Simple and Effective
- Guides nurses in clinical setting while interacting with elders of any ethnicity
- Based on a negotiated plan of care that includes identification of availability of culturally appropriate and sensitive community resources.
Cultural Identity
One of the major elements of self-concept and key to self-esteem
Nuclear or extended family is the chief avenue of
Transmitting cultural values, beliefs, customs and practices.
Cognition
The process of acquiring, storing, sharing and using information.
Components of cognitive function include
- language
- thought
- memory
- executive function
- judgement
- attention
- perception
Research suggests that cognitive function and intellectual capacity is a
Complex interplay of age-related changes in the brain and nervous system.
Other important factors of adult cognition include
- education
- environment
- nutrition
- life experiences
- physical function
- emotions
- biomedical and physiological factors
- genetics
Know Box 5-1 Dispelling myths about cognition
May be on exam
Know Box 5-2 Aging changes in the CNS
May be on exam
Neuroplasticity
Adults can strengthen and increase neuronal connections - positive neuroplasticity
“Use it or lose it”
Is important in both cognitive and physical health
Stimulating the brain can
Increase cognitive reserve.
Cognitive reserve capacity
Varies among people
Comparison of brain function in older adults vs young adults
- Older adults are thought to use both hemispheres more equally than younger adults.
- Have a greater density of synapses
- More use of frontal lobe (abstract reasoning)
- Better problem solving and concept formation
Fluid intelligence
(Street smarts)
-Consists of skills biologically determined, independent of experience or learning.
Crystallized intelligence
(Book smarts)
-is composed of knowledge and abilities acquired through education and life.
Memory
Ability to retain and store information and retrieve when needed.
3 Components of Memory
- Immediate recall
- Short-term recall
- Remote or long term recall
Recall of Information tends to
Decline with age
What factors remain intact and sufficient as one ages?
- Processing
- Reaction time
- Perception
- Capacity for attentional tasks
- Majority of function
Cognitive Health is define as
“The development and preservation of the multidimensional cognitive structure that allows the older adult to maintain social connectedness, an ongoing sense of purpose, and the abilities to function independently, to permit functional recovery from illness or injury, and to cope with residual functional deficits.” (Hendrie et al., 2006)
Nurses need to educate people of all ages about
The effective strategies to enhance cognitive health and vitality
Health promotion education activities should be tailored to
Specific communities and cultural subgroups
Health Literacy
The capacity to which individuals can obtain, process and understand basic health information.
Health Literacy is linked to
- Health disparities
- Poor health outcomes
- Inadequate preventative care
- Increased use of health services
- Higher health care costs
- Higher risk of mortality for older adults
- Safety errors including medical and medication errors.
Box 5-10 Healthy 2020 goals and objectives for improving health literacy.
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Box 5-11 Available resources to assess health literacy and design effective education
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Health Literacy: Methods for teaching
- Use plain language and provide information at a level no higher than 6th grade.
- Use teach back and show me strategies
- Increase understanding of medications
- Serve as the patient’s advocate
Ageism*
Stereotyping and discriminating against people due to age.
Elderspeak*
- A form of ageism where speech patterns are changed based on assumption that older people have difficulty communicating and understanding.
- Similar to “baby talk”
Examples of elderspeak include
- Using a singsong voice, changing pitch, and exaggerating words.
- Using short, simple sentences
- Speaking more slowly
- Using limited vocabulary
- Repeating or paraphrasing what was just said
- Using pet names such as “honey” or “dear” or “sweetie”.
- Using collective pronouns - “would we like to eat now?”
Older adults may need more time to respond because
They are drawing from a larger life experience
Communication that is most productive with older adults initially focuses on
Major concerns
What are important communication strategies with older adults?
Listening carefully
Clarifying
Patience
What position should you be in when communicating with older adults?
Should position yourself at their level as much as possible.
Listening to life stories provide
Important information about etiology, diagnosis, treatment, prognosis and the experience of living with an illness.
Life Story
An important developmental task to make sense of and feel satisfaction for a life lived
“Ego integrity versus self-despair”
Reminiscing in Older adults
Cultivates a sense of security through recounting of comforting memories belonging through sharing and self-esteem through uniqueness.
Reminiscing can
- increase quantity and quality of communication
- contribute to stress reduction
- reduce behavioral problems
Cognitively impaired older adults can benefit from
Memory-enhancing activities based on their level of cognitive ability
The TimeSlips Program
An evidence based innovation that uses storytelling to enhance person’s lives.
Life review may be especially important for older people experiencing
Depressive symptoms and those facing death
Life Review occurs most frequently as
An internal review of memories, an intensely private soul-searching activity.
Add notes from weekly review PowerPoint
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