Cultural Diversity in Care Giving

Caregivers Need to be Culturally Sensative to Their Patient’s Needs

Cultural sensativity is important in primary care
Cultural sensativity is important in primary care
As the world has become smaller, interaction with other creeds, cultures and races has become more prevelant in all aspects of life.  Caregiving is no exception as doctors, nurses, pastoral counselors and other caregivers find themselves in direct contact with different cultures who demand and deserve certain care.
Within the area of grief, it is essential, according to John Bowlby, that we understand cross-cultural ideals, especially in grief to better provide the vital care patients need.  Rituals, mourning, and family interaction varies from culture to culture and  health care providers need to respect these particular cultures in their  treatment.  By becoming educated with the basics of religious and cultural ideals a care provider can be better equipped to treat his/her patient.  Yet, before generalizations enter into one’s mind, the caregiver must also realize that there are deviations from the norm and not to expect certain reactions from a particular group merely because of their background.
Unfortunately, they did not teach this in medicial school and sadly, it may not have even been considered important but only an after thought.  However, as trained caregivers who aspire to a certain level of professionalism, it is important to be educated in regards to the world and potential patients.

The “House” Syndrome

Photo property of Kristin dos Santos: Hugh Laurie who plays the notorious and brilliant Dr. House, always right but never culturally sensative
Photo property of Kristin dos Santos: Hugh Laurie who plays the notorious and brilliant Dr. House, always right but never culturally sensative
The lack of bedside manner by many caregivers has given rise to pastoral caregivers to become a crossroad between patient and provider, but the “cultural malpractice” by primary providers still remains a concern.  Doctors and many health care providers seem to care only about the healing of the body or the cure of the disease instead of the treating the entire person.  This “House” syndrome, from the celebrated television drama, is only too many times the norm.  The doctor is more concerned with the puzzle and relates very little to the humanity or cultural diversity of the individual they are treating.
Primary caregivers need to understand the spirituality and the culture of each patient.  This is why it is so important for primary providers to do spiritual assessments of patients.  This can be done by a simple conversation with the patient or with the family.  In this assessment, you can become familiar with how the person views life and what religious affiliations he/she has.  Also in doing this, a doctor can treat the whole of the person.  A patient who is beyond saving, sometimes wants someone to pray with them.  Although doctors need to keep a certain distance to maintain objectivity, there are certain times when praying with a patient may be acceptable, especially if requested or both share the same faith.   Spiritiual assessments not only help the doctor become more sensative to the cultural element of the patient but also enables the doctor to be more than a guy in a “white coat” but also a fellow human being who cares.
If you are interested in Pastoral Care Giving, please review the program.
(Information for this article was found in “Helping Grieving People-When Tears Are Not Enough” by J. Shep Jeffreys)
Mark Moran, MA, GC-C, SCC-C

Who Cares About the Pastoral Caregivers?

Pastoral Care for the One Who Cares the Most

The vocation and task of care usually falls to the spouse who then becomes the primary caregiver
The vocation and task of care usually falls to the spouse who then becomes the primary caregiver
My grandmother cared tirelessly for my grandfather and as his health gradually deterioated he became more needy in his everyday activities.  Fortunately for my grandfather, my grandmother was a nurse and knew how to care for someone who was gradually becoming less and less physically capable.  Her energy level was amazing and my grandfather through the final two surgeries received top notch care and affection.  After my grandfather’s eventual death, my grandmother finally slowed down some herself, almost as if her body knew she no longer was needed everyday.   Still alive, still moving, but now with a cane, my grandmother showed her own pastoral and emotional care for my grandfather through the fulfillment of her vow-“in sickness and health”.
Many primary caregivers are not as energetic or well trained in end of life care as my grandmother, however, even my grandmother showed the tired face and burnout that accompanies caring for a loved one.  This can be twice as draining on someone with little knowledge or training to care for the sick.  The constant pressure and beat of the drum that pushes the primary care giver to doctor visits, prescription and medication study, dosage delivery, feeding, cleaning and the emotional realization that the one you love is going to die soon is overbearing.
Professionals recognize this as caregiver grief.  This type of grief not only affects the primary caregiver emotionally over the loss but it also strips from them the loss of a future and loss of freedom.  The vacation that was once planned by a couple is now forever gone as a faithful wife tends to a crippling disease that is killing her husband.  Or, that special 50th wedding anniversary will not become a reality because one’s wife will not live to experience the 49th one.  In addition, the loss of freedom strips the primary caregiver of the ability to go to the movies, or visit others at a picnic.   Gradually, the vocation of caregiving for their loved one, forces these people to give up on extra curricular activities because the demand of care is so overwhelming.  This was not only the case with my grandmother, but also my other grandmother who also gives up much of her time and energy for care of her husband.  How many times do we see our loved ones becoming burnt out because we will not take that simple step to offer an hour or two of our day?
Pastoral counselors need to let the primary caregivers know that it is alright to be tired and it is alright to take time off.  Pastoral counselors need to emphasize occasional relief through other family members or respite care.  Respite care is available within hospice and can help the primary caregiver have a few days to him or herself.  The National Family Caregivers Association sometimes helps charitablly with the fees for hospice in this service.
Who holds the hand of the primary caregiver?
Who holds the hand of the primary caregiver?
Most importantly, pastoral caregivers need to let the primary caregiver know that is alright to feel emotions of guilt, resentment and anxiety at times towards the dying loved one.  These are natural emotions and do not mean that one does not love or wish to not care for one’s dying partner or parent.
In fact, after the death of a terminally or chronically ill person, sometimes the primary caregiver is known to have some relief.  Not in a relief that the one they love has died but a relief that they have performed their duty with courage and devotion and that their loved one is now free from suffering.
With these things in mind, who cares about the primary caregiver?–everyone should.
If you are interested in Pastoral Care Education, please review the program.
Mark Moran, MA, GC-C, SCC-C