The case of a 75-year-old Hispanic woman living alone whose children want her to move to an assisted living facility encompasses the acts of communication and collaboration that must be used effectively in patient- or client-centered care. This will ensure that the woman has access to appropriate care and safety measures while abiding by her life wishes to all extents possible. It also allows for cultural differences and norms to be observed, so the family unit can be at peace with the decision-making process.
In this case, Mrs. G’s husband has passed away, and most of her children live out of state. She’s has lived in her home for 35 years, and she may feel like her home is the only stable connection she has to the life she once had with her husband and children. To remove her from that environment in her mind would be the equivalent to ending her life. Being Hispanic, Mrs. G has likely seen other aged members of her family taken care of by friends and loved ones, as the Hispanic population is often reluctant to make their elderly leave their homes until that is the only available alternative. The average Hispanic resident in care facilities has poorer health than other residents, which is a reflection of this cultural difference (DiMaria, 2006). Mrs. G’s response to her daughter’s urging to move to assisted living was that she would live the rest of her life in her home, and this is not surprising because of Mrs. G’s background and culture. She may feel she has to be firm with her responses in hopes that her children or a friend will care for her until she is no longer able.
The Hispanic culture may be influencing Mrs. G’s decision to stay home, as it tends to be linked to stronger familial help. The amount of admissions to care facilities among the elderly is directly related to how much help they have available from friends and family. Despite Mrs. G not having a lot of nearby children, half of all people expect that they will have the help they need when they age. This is often a truer statement among Hispanic populations because of their culture (Thomeer, Mudrazija, and Angel, 2014).
There may be a time when it is not possible for Mrs. G to stay home, and her daughter should make sure her communication now shows care and compassion. Addressing issues that involve a person’s independence are difficult. Verbal communication that may be effective could be acknowledging that many people go through similar circumstances, or it could be the use of anecdotes (National Institute on Aging, 2008). Non-verbal communication is equally important. The use of appropriate facial expressions has been shown to lead to less confusion and the appearance of more concern or empathy (Koo, Rosenthal, and Winograd, 2002). As Mrs. G is elderly, she may have trouble with hearing or other impairments that make non-verbal communication crucial. Additionally, she may distrust those who are trying to move her, and eye contact and genuineness through expression can ease those feelings.
In many cases, a person cannot be persuaded to leave their home despite any arguments for assisted living, and there are many resources available to facilitate that option or to make the transition to assisted living smoother. Collaboration with home health care services and family members can increase the safety for those who are able to remain at home. Especially with the use of home health services, patients are able to remain at home for a longer amount of time, and it decreases the burden on the family or friend caregivers.
- DiMaria, F. (2006). Hispanics shun nursing homes. Hispanic Outlook. Retrieved from http://www.homecareoptions.com/HispanicOutlookArticle.pdf
- Koo, N., Rosenthal, R., and Winograd, C. (2002). Physical therapists’ nonverbal communication predicts geriatric patients’ health outcomes. Psychology and Aging 17(3), 443-452. doi: 10.1037/0882-7974.17.3.443
- National Institute on Aging. (2008). A clinician’s handbook: Talking with your older patient. Retrieved from file:///C:/Users/Robert%20Rahim/Downloads/talking_with_your_older_patient.pdf
- Thomeer, M., Mudrazija, S., and Angel, J. (2014). How do race and Hispanic ethnicity affect nursing home admission? Evidence from the health and retirement study. The Journals of Gerontology. doi: 10.1093/geronb/gbu114
