Page 192 - Encyclopedia of Nursing Research

ETHNOGERiATRiCS n 159

cohort historical experiences, explanatory Association and the Philippine Nurses
models, spirituality, and access and utiliza- Association of America (Mezey, Stierle,
tion of health care (Yeo, 2001). These topics Huba, & Esterson, 2007). E
are important in relation to human responses More research is essential to understand
to health and illness, management of chronic the factors and cultural contexts that influ-
physical and mental illnesses, caregiving, ence health beliefs and illness, availability
sensory loss, elder abuse, disaster prepared- and accessibility of health care, patient–pro-
ness, decision making, advance directives, vider trust, and confidence in achieving the
end-of-life care, and other health care events desired outcomes. These factors include
(Adler, 2006; Adler & Kamel, 2004; Gerdner, indigenous practices, English-language profi-
Cha, Yang, & Tripp-Reimer, 2007; Graves, ciency, health literacy, cohort historical expe-
Rosich, McBride, & Charles, 2010; Grudzen, riences, immigration patterns, family and
2008; Hendrix & Swift Cloud-LeBeau, 2006; support network, internet technology, econ-
Lewis & McBride, 2004; McBride, 2006; omy, and changes in public policies (Adler,
McBride & Lewis, 2004; McBride, Fee, & 2006; Adler & Kamel, 2004; Graves et al, 2010;
Yeo, 2004; Talamantes, Trejo, Jimenez, & institute of Medicine, 2008; McBride & Lewis,
Gallagher-Thompson, 2006). 2004; Pavalko & Wolfe, 2009; Smedley et al.,
in 1987, the Stanford Geriatric Education 2003; Yeo et al., 1998).
Center introduced ethnogeriatrics to the Although racial/ethnic populations may
national multidisciplinary network of geri- share some values, belief systems, and
atric education centers and health sciences behavioral norms, the mode of expression
programs (Lewis & McBride, 1996; Wallace & varies among the groups across historical,
McBride, 1996). The Stanford Geriatric social, psychological, and health domains.
Education Center multiethnic, multidisci- This heterogeneity requires that health pro-
plinary faculty developed core competen- viders become more aware and sensitive to
cies to guide curriculum development and cultural nuances to tailor health care to the
research and produced Web-based resources ethnic elders’ needs (Adler, 2006; Adler &
available at http://sgec.stanford.edu/. in Kamel, 2004; Xakellis et al., 2004). Thus, cul-
1997, a chapter on ethnogeriatrics was part tural context adds an important dimension
of a publication of priorities for geriatric to the complexity of decision making related
education from a national workshop of fed- to health promotion, long-term care, advance
erally funded Geriatric Education Centers directives, end-of-life care, and other health
(Henderson et al., 1996). care issues (Adler, 2006; Adler & Kamel, 2004;
Mather institute on Aging, one of Gerdner et al., 2007).
the three Health Resources and Services in 2008, approximately 1.89 million
Administration grantees, trained advance older adults, 65 years and older, lived in
practice nurses to teach geriatrics, focus- households with a grandchild and 25%
ing on ethnogeriatrics and managed care had primary parenting responsibility for
(Hollinger-Smith, 2003). in 2002, the Nurse their grandchildren or great grandchildren
Competency on Aging project, developed (Administration on Aging, 2009). Divorce,
a Web-based, on-demand geriatric nursing illness, substance abuse, or incarceration
modules including one on ethnogeriatrics. often lead to this role. Diversity and struc-
The Nurse Competency on Aging’s out- ture of contemporary families brought about
reach to minority nurses organizations to by teenage pregnancy, delayed parenting
increase members’ knowledge and skills by women, childlessness, stepgrandparent-
on eldercare resulted in small grants to two ing, and same-sex couples have implications
groups that focused on ethnogeriatrics— for social support, caregiving patterns, and
the Asian American Pacific islander Nurses family economics. immigrants 65 years and