Group 6 Presentation

-Aging-
By: Kaylan Huff, Gechelle Binas, Evaristo Agular IV, Lizbeth
Morales, & Clarissa Ruelas-Gastelum
 Article 1: Catastrophe and Caregiving: The Failure
of Medicine as an Art

Synopsis: Physician’s failures observed:

✘ Failure to address what really

Kleinman argues: mattered to patients
Caregiving has failed ✘ Follow up visits only 1-3
minutes
the medicine as an art ✘ Quick, unthorough
due to structure of examinations
✘ Limited questions
training and ✘ Unempathetic
discouragement of ✘ No resources for patients

service delivery
Kleinman, A., ‘Catastrophe and Caregiving: The Failure of Medicine as an Art’, The Lancet, 371(2008),
22–23 AT: http://www.lancet.com/journals/ lancet/article/PIIS0140-6736(08)60057-4/fulltext

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 Caretakers:
Professional Caretakers:
✘ Skilled nursing
✘ Competent social work
✘ Rehabilitation efforts from
physical therapists
✘ Physical work for home-care
aide
Family and Friend Caretakers
Responsibility:
✘ Daily living
✘ Financial aid
✘ Legal and religious
advice
✘ Emotional support
✘ Meaning-making and
remaking
✘ Moral solidarity
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 Economist’s Perspective of Caregiving:

Caregiving

Clinical skill Cost

Social resources

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 What Changes are Necessary?

✘ Schools/programmes to teach narratives and their

interpretation to sensitize students to the
richness of the patient’s life and interests.
✗ Combine practical experience of caregiving
✗ Exposure to robust educational evaluation
✗ Require parallel attention to the structural
and cultural barriers that undermine
caregiving

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 Caregiving is a foundational
component of Moral experience
Family, network, institution, community

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 Article 2: The Cultural Influence of
Values, Norms, Meanings, and
Perceptions in Understanding Dementia in
Ethnic Minorities

Peggye Dilworth-Anderson and Brent E. Gibson

 Article 2: Introduction
To fully understand a family’s response to chronic diseases such as Alzheimer’s
then we need to explore it through cultural context.

What is culture? Cultural Frame

● A conceptualized set of
shared symbols, beliefs,
and customs that shapes
an individual’s behavior
● Always changing
● Exists in an individual’s
mind
● Learned externally through
social interaction
✘ Experiences, interactions,
and thoughts in a group
✘ Be in the same group but
different beliefs due to
personal experiences,
family traditions, and
expectations
Article 2: A study on Illness meanings
Individuals over the age of 50 years old
experiencing memory loss were interviewed and
then screened for dementia using Mini-Mental
Status Examination (MMSE)
✘ People who scored 17 and above on the MMSE were
identified as a person with dementia.
✘ 121 caregivers, divided by subset (7 african American, 12
chinese American, 8 european American, and 5 hispanic)

Descent (n)

African 29

Chinese 29

European 32

Hispanic 31

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 The Semi-Structured Interview
In this interview, all of the participants were
given a question based on their cultural
definitions and meanings associated with
dementia. The semi-structured interview
was divided into seven sections:
1. Ancestry, family structure, and
migration
2. Ethnicity and race
3. Dementia explanatory model and
initial recognition of the problem
4. Patterns of care seeking, meaning of
diagnosis, and experience of care
5. Community context and stigma
6. Impacts of illness on caregiver and
family
7. Ideals of aging
The main research question that helped guide
the analysis:
★ “What meanings were assigned to
behaviors associated with dementia
across the four ethnic groups of
caregivers?”
Some key questions that were included in the
interview:
➔ “Looking back, what do you think
brought on dementia-related term (DRT)
or caused it? Can you tell us more why
you think that?”
➔ “When DRT first began, what did you
notice at that time?”
➔ “At that time, what did you think was
causing the symptoms?”
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 Findings on Cultural Illness
The 3 main categories of Illness Definitions
1. Aging Process: Caregivers used to refer to dementia as a normal or natural
result of aging rather than the result of a disease.
-This category was found across all four ethnic groups.
-Ex. Chinese Culture: Care provided mainly by caretakers from family member
● Reinforced interaction with family and community members.
● Culturally valued
● Future generations lack the reinforcement of providing care for their elders.
2. Disease Process:The disease process category represents constructions
of illness meanings for dementia that are based on biomedically defined diseases.
-This category gained cultural meaning through caregivers' expressions of Western
biomedical culture, which is an integral part of mainstream American culture.
-Ex. 1 Hispanic: Mentioned abnormalities appearing to the mother in the family. (After a
stroke)
● Gave an expression to hispanic cultures to seek help.
-Ex.1 Chinese: A Chinese caretaker still believed that dementia was due to age processing.
 Findings on Cultural Illness II
2. Disease Process (Continued)
● Incorporated biomedical diagnosis with age processing.
-Europeans: Values and Beliefs were the most consistent with Western
biomedical paradigm and mainstream American culture.
- European Culture tends to consider conditions more in terms of the
Western Biomedical factors.
-Ex. 2 Europeans: A Woman was told by the first doctor she was just getting
older. Took her mother to a second doctor and discovered her mother had
“Probable Alzheimer’s”
● Chinese culture tend to neglect the medical treatment
3. Pressure Process
- Used to describe illness definitions and meanings of dementia that are
related to the sufferers experiences of pressure, stress,worry, anxiety,
trauma, and/or family discord.
 Findings on Cultural Illness III
3. Pressure Process (Continued)
- Evident across all four ethnic groups.
-Ex. African American: Mother of a 42 year old woman having pressure of having his kid
arrive on time for school,
● The care for the grandson was too much for the woman, leading to cognitive
decline.
- The pressure was not obvious amongst the Chinese culture, but can still occur to the
Cultural group.(Aging process was more favored.)
● An example could be a Chinese American woman who had suffered from
overworking and was young when her husband left.
● Pressure from Cultural Revolution and Religion.
*-Worry is one of the seven emotions in Chinese medicine and culture.
● Causes imbalance physically, psychologically, and morally.
● Maybe stigmatized for their moral failings to achieve balance.
● Universal to all ethnic groups.
Europeans see this as a process outline from Biological Western Medicine.
-Hispanic and African culture did not correlate Pressure with the Disease process.
 Cultural Preference based on the Three Processes

Aging Process Disease Process Pressure Process

-*Chinese Culture greatly -*Chinese culture highly -*African Americans
favors this viewpoint of neglect this idea as a
found this illness to be
illness. possible illness .
favored as the process.
-African Americans see -Hispanic culture have
-*Hispanics do not view
this as a possible illness acknowledged disease as
pressure as a main aspect
viewpoint. an illness.
of illness.
-European culture can -*European culture favor
- Chinese culture
apply this as an illness. Western Biomedicine as
associate pressure as a
the process of illness.
possible illness
probability.
 Conclusion
Overall findings:

- All across the board the significance of dementia is dependent

on the values and beliefs of people in the respective cultures.
- Findings show that family caregiving processes and help
seeking are influenced by the meanings family members
assign.
- Such values and beliefs can also influence who gives care and
where such care is seeked.
- Often times because of such held beliefs people of age who
show symptoms of dementia do not seek the aid of medical
professionals (because of cultural values and beliefs held about
illnesses and disease)
 Conclusion (continued)

Implications & Awareness:

- We have a greater understanding of the significant influence
that culture has on our perception of illnesses and we project
those perceptions to the world around us.
- Throughout this research we have learned that the cultural
values have a heavy impact of our perception of illnesses,
including dementia and Alzheimer’s
- There must be further research to be done on how cultural
values and norms influence on physical and emotional
health of those affected by these cultural values and norms