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Chapter 18: Appreciating Diversity and Enhancing Intimacy

Appreciating diversity. Diversity of eldersElderly cohort is becoming more heterogeneousAt present, most elders are white females, but this is changing with growth of minority groupsDifferences in diet, economic status, education, religious practices and the like. Diversity (cont'd). African Amer

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Chapter 18: Appreciating Diversity and Enhancing Intimacy

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    1. Chapter 18: Appreciating Diversity and Enhancing Intimacy

    2. Appreciating diversity Diversity of elders Elderly cohort is becoming more heterogeneous At present, most elders are white females, but this is changing with growth of minority groups Differences in diet, economic status, education, religious practices and the like

    3. Diversity (cont’d) African American females over 75 living alone are one of the most impoverished groups Focus should be less on ethnicity and more on common factors of health/illness across cultures

    4. Health care disparities: European Americans The top five health disparities (white non-Hispanic): smoking by pregnant women drug-induced deaths deaths from poisoning deaths from melanoma deaths from chronic lower respiratory disease before age 45 (Keppel, 2007)

    5. Health care disparities: African Americans The top five are: 1 and 2: new cases of gonorrhea congenital syphilis new cases of AIDS deaths due to HIV infection

    6. Health care disparities: Hispanic Americans The top five are: congenital syphilis new cases of tuberculosis new cases of AIDS exposure to particulate matter cirrhosis deaths (Keppel, 2007) Diabetes and Heart disease are two health problems that have an increased prevalence and mortality in Hispanic Ameri.cans.

    7. Health care disparities: Asian/Pacific Islanders The top five are: new cases of tuberculosis congenital syphilis no Papanicolaou (Pap) test among females older than 18 exposure to particulate matter carbon monoxide exposure

    8. Health care disparities: Native American Indians The top five health disparities are: fetal alcohol syndrome smoking by pregnant women alcohol-related motor vehicle deaths cirrhosis deaths new cases of gonorrhea (Keppel, 2007)

    9. Diversity (cont’d) Past and future of diversity and aging Strategies Continue to help minorities have a strong voice Use well elders as staff Focus efforts and resources on those who are most marginalized

    10. Diversity (cont’d) To promote diversity in the Health Care Team: Avoid stereotyping Learn about other cultures Learn from each others strengths Overcome racism Decrease language barriers Educate self and others

    11. Diversity (cont’d) Racist comments from Patients Reporting Educating Redirecting Providing culturally competent care Educate self about the culture that is unfamiliar Provide culturally appropriate care.

    12. Diversity (cont’d) Providing spiritually competent care Spirituality related to a sense of well being in the elderly Many use prayer and faith as successful coping strategies Provide opportunity to practice religion Incorporate spiritual leader into the team if needed

    13. Enhancing Intimacy Romantic relationships in the elderly Relationships continue, though they may change due to loss of health or death of spouse or partner Romantic and sexual relationships in long-term care Barriers Need to provide privacy Rooms for couples Stigma

    14. Intimacy (cont’d) Extinguishing sexually inappropriate behavior Redirect Do not tolerate Educate Consider disease processes such as dementia Confront behavior Use nurse managers Provide privacy as needed

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