Cultural challenges in caregiving

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Sharon Brothers MSW

If you've hired a private caregiver you probably know this already: the nation's caregiving community is composed largely of individuals who are foreign born or from minority ethnic groups.

For many families, this is a challenge, but one that can be overcome.


Communication. Let's start with the basics: communication. It's tough to communicate with a caregiver who speaks limited English. It's even tougher to ask this caregiver to communicate with an elderly loved one who may suffer from hearing loss, dementia or other conditions that impair communication in the best of situations. Yet caregivers from other cultures, who speak very limited English, can be compassionate, gentle, reliable sources of care for our loved ones. Try these approaches to bridge the communication gap:
Make sure emergency communication is possible. Can the caregiver call 911 in case of an emergency and clearly express the emergency? Can she relay the address and phone number of the location? Ask, "Tell me what you would do if the oven caught fire and you needed to call the fire department." Listen carefully to what the caregiver says, and coach her if needed until you feel comfortable with her ability in this area. Print the address and phone number of the location clearly, and post it near the phone. We all know the feeling of forgetting our own phone number in a crisis - and that's without a language barrier.
Let the caregiver know what you need to know each time you visit or call. Do you want to know how your loved one ate or slept? What activities he did during the day? How he seems to be feeling emotionally? Try creating a task sheet with each of these questions written out for the caregiver, and space for her to write in answers each day. Many foreign born individuals learn to read English but are hesitant about speaking it.
Learn a few words in the caregiver's language. Try hello, thank-you and good bye, for starters. As you learn to respect the language of your caregiver, she will feel more comfortable in communicating with you in your language.
Encourage the caregiver to speak English by praising every attempt. Often people are reluctant to practice their English because they feel that their pronunciation is poor or they are embarrassed at their lack of skill. Try not to correct or criticize attempts, but praise them for each progressive success in the language.
Help your loved one communicate. If the caregiver is not able to freely communicate with your loved one, recognize that your loved one needs other companionship for communication. Spend as much time as you can simply talking to and listening to your loved one. Include the caregiver when you can to help bridge the gap between the two.
Values and traditions. Today's American values provide many opportunities for culture clashes with the values and traditions of a caregiver from another culture. These can range from the caregiver who is extremely uncomfortable speaking with a family member of the opposite sex, to the caregiver who comes from a background of strong familial responsibility and can't understand or accept our busy lifestyle. Learn as much as you can about the values and culture of your caregiver by asking questions and researching to avoid cultural misunderstandings and conflicts.

Diet. Caregivers often work through mealtimes, especially those that work full days or overnight. Many families assume that caregivers will eat with the client in the American family style. Talk about food with the caregiver, and your expectations for mealtimes. Your caregiver may not feel comfortable eating with your loved one, and may have distinctly different food preferences. Cover these topics to avoid misunderstanding:

Preparing food for your loved one. You may need to provide a menu and recipes or cooking instructions for even basic fare if this is not familiar to the caregiver.
Mealtime. In general, elders eat better in a social setting. If your caregiver isn't comfortable eating with your loved one at mealtime perhaps she would feel comfortable with a cup of tea, visiting with your loved one while he eats. Explore this with the caregiver.
Preparation of the caregiver's meals. Ask what the caregiver prefers to eat. Do you expect the caregiver to bring her own food? What about cooking meals in your loved ones' home? Explore this, as some foods from other cultures can be distasteful during preparation to the American palate (especially to the older person).
Cultural differences between client and caregiver are facts of life for many families today. That doesn't mean that care must be compromised, or communication limited. It does mean that we must learn to develop a greater awareness of the caregiver's culture and sensitivity to working together for the best care of your loved one.

In the end, taking the extra effort can result in a rich, rewarding experience for everyone involved.

Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here are more interesting dementia articles and activities