Communicating with Elderly African Americans

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Communicating with Elderly African Americans
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Overview

• Demographics
• Culture considerations
• Practical application

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Growth of minority elderly population
Source AARP
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Diversity in the African American community

• Recent immigrants
• Caribbean Blacks, Africans,
• Black Hispanics, and others
• Cultural and language
• differences
• Vary in SES, educational
• attainment, health status, and
• access to support services

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Where African American elderly live

• One-fifth live in
• nonmetropolitan areas
• (vs one-fourth of Whites)
• More than 50 are in the
• Southeastern states
• Source National Council on the Aging

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African American elderly stay in the community

• Family, friends, and
• relatives care for the
• elderly
• Nursing homes are
• the last resort

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Family caregiving

• Estimated that 5 of the 2 million Black
  caregivers find themselves sandwiched between
  caring for a child and an older family member
• Caregivers are more likely to live with the
  elderly person and spend an average of 20.6 hours
  per week providing care
• Source Administration on Aging

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Education

• Many educated in US school systems with few
  resources
• May use folk language
• Not an indication of intellect
• Still have facility with standard English

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Marital status

• Of Blacks age 65 and
• older, most of the
• men are married
• most of the women
• are widowed.

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Poverty status

• Urban areas 1 in 3 elderly African Americans
• lives in poverty (34)
• Nonmetro areas nearly 1 out of 2
• 46.4 of Black women over 65 in nonmetro areas
• are poor compared to 15.5 of White women
• over 65
• Source AARP

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Elderly African American women

• 41 of Black women 65 live alone
• Of these, 50 live in poverty
• They are twice as likely to live in poverty as
  their
• male counterparts
• Source AARP

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Lack of preventive health care

• African American elderly cited these reasons for
  not
• seeking preventive care
• Inaccessible services
• Out-of-pocket costs
• Resort to using the ER
• Spend more time living with disabilities
• Source AARP

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Health status of African American elderly

• African American elderly are more likely to be
• sick and disabled
• More see themselves as in poor health than
  their
• White counterparts
• Higher rates of chronic disease, functional
• impairment, and risk indicators such as
  high
• blood pressure

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Health behavior impacted by experiences

• Tuskegee study
• Forced sterilization of
• women in their youth
• Family stories of medical
• abuse and neglect

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Practice cultural humility

• Respectfully admit what we do not know about
• each other
• Never assume we know what is best for the
  target
• population
• Source Journal of the American Society on Aging,
  Fall 2002

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Establish a level of trust from the outset

• Answer questions
• and concerns
• Dispel myths and
• clarify misconceptions
• Demonstrate interest
• in the individual and
• the community

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Listen and learn from African American elderly
clients

• Where and how they live
• Who shares their homes
• Daily responsibilities
• Perceptions of their health status
• Religious beliefs and practices
• Health beliefs and practices

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Watch for what is not said

• Body language and other nonverbal clues may
  provide useful information

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African American elderly expect to be respected

• Tone of voice
• Eye contact
• Address as Mr., Mrs., or Ms.

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Focusing on self is atypical behavior

• Recognize that many African Americans,
  especially women, are not accustomed to focusing
  on themselves

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Religious beliefs may affect health behavior

• Some believe in spiritual healing use it with
• Western medicine
• May not readily admit this belief
• Try to assess knowledge of their health status
  and
• health beliefs

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Community is key

• Community relationship building is crucial
• Establish project as a trusted presence
• Identify credible gatekeepers
• Will be found in various settings across the
  community

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Reach out to gatekeepers

• Physicians, nurses, and other health
• professionals
• Local chapters of national and local
• organizations
• Commit time to nurture relationships
• Close the loop

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Partner with minority health providers and other
caregivers

• Educate through professional meetings,
  conferences, and publications
• May require more time to nurture partnership to
  accomplish project goals

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Take information to the target audience

• Go to places where the target audience naturally
• congregates
• Social service agencies
• Hospitals, clinics, physicians offices
• Beauty and barbershops
• Grocery stores and local businesses
• Shopping malls
• Libraries
• Restaurants

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African Americans and the media

• Preferred media in order of preference
• Television
• Radio
• Newspapers and magazines
• Cable TV
• Internet
• Source US Census Bureau, 2001

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African American Newspapers

• Partner with local newspapers and community
• newsletters
• Often need additional copy
• Provide prepared articles and announcements for
• placement

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Culturally relevant materials

• Develop publications in the language of the
  target population
• Incorporate culturally relevant pictures and
  graphics
• Include reviewers from target group

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Keep it simple

• Write in plain English
• Use clear, conversational style
• Limit number of key points
• Expect readers to take words literally
• Reader may read slowly, one word at a time, and
• miss the meaning

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A picture is worth

• Use culturally relevant images
• Depict African Americans
• Show only the right way
• Symbols may not be familiar

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Thank you
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Communicating with Elderly Hispanic