Guidance from AGS Proves “Seeing” Older Patients is About More than Seeing Age

As we look toward a not-so-distant future in 2050 when more than 80 million Americans will be aged 65 years or older, new guidance from the American Geriatrics Society (AGS) aims to transform approaches to health and long-term care for a nation where “minorities” will soon account for nearly 40% of all older adults. Developed by a committee of experts in ethnogeriatrics, a new AGS position statement titled “Achieving High-Quality Multicultural Geriatric Care” outlines existing health disparities and the need for sensitivity to culture and health literacy when working with older individuals.

“With 10,000 people across the US turning 65 years old every day, virtually all doctors, nurses, social workers, and other long-term care professionals will soon be caring for older adults—and importantly, older adults who are more diverse than ever before,” explains VJ Periyakoil, MD, chair of the AGS Ethnogeriatrics Committee. “The AGS believes that providing high-quality care for older adults means helping health care professionals practice self-awareness, develop interpersonal skills, and become adept at providing respectful care that meets the unique long-term needs of our older population,” Dr Periyakoil added.

While health inequities are already well documented among older people, they are even more pronounced for multicultural older Americans. Minority individuals over the age of 65 years have higher rates of disease and disability than Caucasian men and women. Of the 36% of Americans who report limited health literacy, most are older, less educated, and not white. And mistrust of medicine and medical research among minority individuals still remains a persistent barrier to high-quality multicultural care. 

As outlined by experts in the position statement, published online ahead of print in the Journal of the American Geriatrics Society, the delivery of culturally effective care requires exploring and being responsive to the unique needs of each patient during every clinical encounter. Putting processes or systems in place to ensure that patients are asked about their ethnicity, their preferred language, their level of education, and their familiarity with helpful resources like interpreter services, for example, can go a long way toward incorporating an older person’s identity into her or his care.

Interestingly, trends data also suggest that seriously ill long-term care residents increasingly will be cared for by nurses and other health professionals with cultural backgrounds other than their own. As such, individual health care professionals also need to become skilled in communicating effectively with people from different backgrounds, particularly because a provider’s personal values and beliefs might inadvertently impede care without a healthy dose of self-awareness. The new AGS position statement walks health care providers through several questions for self-reflection, each exploring an aspect of personal identity that can impact the provision of the complex, coordinated care that many older people need.

“Culturally sensitive care isn’t just about language or helping ‘someone else.’ For a health care professional, it’s also an honest and deeply personal reflection on the stigmas and health disparities attached to certain groups. It means looking at ways our own personal journeys influence perspective and how we might respond to older people who look different, sound different, need different resources, or approach well-being with unique values and beliefs,” said Steven R Counsell, MD, AGSF, AGS president. “As a tool for recognizing how we are different, this new guidance from the AGS also helps to uncover what we have in common: a desire for care that is high-quality, person-centered, and supportive of the values and expectations that inform who we are.”

The new AGS position statement on high-quality multicultural care for older individuals can be accessed for free at https://geriatricscareonline.org. Ethnogeriatrics recommendations like these are among several topics slated for discussion at the 2016 AGS Annual Scientific Meeting (May 19-21; Long Beach, CA).