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  • Subject Name : Medical Sciences

Introduction

Good morning everyone. Today’s presentation deals with differing world views on ageing and the nurses’ role in promoting well-being for older people across contexts of care. Ageism pertains to discrimination based on age, encompassing prejudiced attitudes, stereotypes, and unequal treatment due to one's age. It predominantly targets older adults, resulting in their marginalisation and limited access to resources. Such biases wield considerable influence on healthcare service delivery across various contexts (Voss et al., 2018). This presentation also aims to discuss strategies for promoting cultural diversity among older individuals

Ageism and Healthcare

In the domain of healthcare, ageism can yield adverse effects. Healthcare providers might downplay symptoms or disregard the seriousness of conditions in older patients, as highlighted by a study by Wilson et al. (2021). This bias can compromise accurate diagnoses and treatment decisions. Furthermore, ageist assumptions can hinder effective pain management for older individuals, as reported by Bodner et al. (2018), leading to unnecessary suffering. Surgical interventions might also be influenced by ageism, with older patients potentially being denied procedures based on misconceptions about recovery capabilities, as shown by research in Chang et al. (2020). Mental health services for older adults might also be impacted due to negative stereotypes. Effective communication and shared decision-making could be compromised due to ageist tendencies (Swift et al., 2017). Moreover, the underrepresentation of older adults in clinical trials due to ageism leads to inadequate evidence-based guidelines for their care, as discussed in a study by Mace et al. (2022).

Perspectives in Australia and Korea

The perspectives on ageing within the Australian First Nations peoples and the Korean community exhibit both intriguing commonalities and distinct characteristics that are deeply embedded in their respective cultural contexts. Both groups emphasise reverence for their elders, valuing their wisdom and their role as carriers of cultural heritage (Mahal & McPake, 2017). Among Australian First Nations peoples, ageing is intricately linked to a cyclical perception of time, wherein the past, present, and future generations are interconnected (Shay & Oliver, 2021). The "Yarning About Dementia" project in Australia underscores the vital role of communal storytelling as a method of discussing ageing and dementia within these communities, reflecting their collective and holistic approach (Melbourne Medical School, 2022).

In contrast, the Korean cultural perspective is significantly influenced by Confucian values, resulting in the prominence of filial piety and structured familial caregiving. This reflects a more linear generational outlook, where the older generation serves as a guiding force for the younger members (Choy, 2018). Research conducted by Huang et al. (2018) delves into the intricate interplay between family dynamics and the well-being of older adults in the Korean context, elucidating the tangible impact of Confucian values on the ageing experience. Despite these variations, the shared emphasis on venerating elders and upholding cultural traditions underscores the profound role of cultural backgrounds in shaping diverse viewpoints on ageing.

Role of Nurses

Within the framework of the Australian Aged Care Quality Standards, nurses play a pivotal role in upholding dignity, respect, and choice in decision-making for older adults under their care. Adhering to the principle of dignity, nurses ensure that residents are treated with inherent worth and esteem. This involves sensitive communication, safeguarding privacy, and providing care in a manner that preserves residents' self-respect (Ostaszkiewicz et al., 2020). Concurrently, nurses cultivate an environment of respect by actively listening to residents' preferences, needs, and concerns. Acknowledging the diverse life experiences and cultural backgrounds of each individual is essential in this aspect. Additionally, nurses facilitate choice in decision-making by offering comprehensive information about available options and actively involving residents in care planning and goal-setting (Coyne et al., 2018). By adhering to these standards, nurses empower older adults to retain their autonomy and individuality within the aged care setting, fostering an atmosphere that meets the regulatory requirements and enhances the overall quality of care and life for the residents they serve (Seah et al., 2022).

Strategies for Dignified Healthcare

Aging research has yielded valuable insights into strategies that enhance the experience of dignity in healthcare for culturally diverse older individuals. One such strategy is culturally sensitive communication, which acknowledges the diversity in communication styles, language preferences, and cultural norms among older patients. This approach involves training healthcare providers to understand and adapt to these variations, thereby fostering more transparent and respectful interactions (Brooks et al., 2019). Another effective intervention is the implementation of culturally tailored care plans. By recognizing the significance of cultural values, beliefs, and practices, healthcare providers can create personalized care plans that integrate cultural norms into the patient's treatment and daily routines (Cain et al., 2018).

Conclusion

In conclusion, the deleterious impact of ageism reverberates through healthcare, perpetuating disparities in diagnosis, treatment, and overall well-being among older adults. Australian First Nations peoples and the Korean community showcase distinct yet interconnected cultural viewpoints on aging, illuminating heritage's profound influence. Within the Australian Aged Care Quality Standards, nurses wield a pivotal role in upholding dignity, respect, and autonomy for older adults. Through culturally sensitive communication and personalized care plans, healthcare can bridge gaps and foster equitable treatment. By dismantling ageist biases and embracing diverse cultures, we can forge a more inclusive, respectful, and dignified healthcare landscape for our elderly population.

References

Bodner, E., Palgi, Y., & Wyman, M. F. (2018). Ageism in mental health assessment and treatment of older adults. Contemporary Perspectives on Ageism, 241-262. https://doi.org/10.1007/978-3-319-73820-8

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian26(3), 383-391. https://doi.org/10.1016/j.colegn.2018.09.007

Cain, C. L., Surbone, A., Elk, R., & Kagawa-Singer, M. (2018). Culture and palliative care: Preferences, communication, meaning, and mutual decision making. Journal of Pain and Symptom Management55(5), 1408-1419. https://doi.org/10.1016/j.jpainsymman.2018.01.007

Chang, E. S., Kannoth, S., Levy, S., Wang, S. Y., Lee, J. E., & Levy, B. R. (2020). Global reach of ageism on older persons’ health: A systematic review. PloS One15(1), e0220857. https://doi.org/10.1371/journal.pone.0220857

Choy, M. (2018). Obeying an evolving cultural value: Influences of filial piety and acculturation on Asian-Americans. https://dukespace.lib.duke.edu/dspace/bitstream/handle.pdf

Coyne, I., Holmström, I., & Söderbäck, M. (2018). Centeredness in healthcare: A concept synthesis of family-centered care, person-centered care and child-centered care. Journal of Pediatric Nursing42, 45-56. https://doi.org/10.1016/j.pedn.2018.07.001

Hwang, E., Kirkham, R., Monk, A., & Olivier, P. (2018). Respectful disconnection: Understanding long distance family relationships in a south korean context. In Proceedings of the 2018 Designing Interactive Systems Conference (pp. 733-745). https://doi.org/10.1145/3196709.3196751

Mace, R. A., Mattos, M. K., & Vranceanu, A. M. (2022). Older adults can use technology: Why healthcare professionals must overcome ageism in digital health. Translational Behavioral Medicine12(12), 1102-1105.  https://doi.org/10.1093/tbm/ibac070

Mahal, A., & McPake, B. (2017). Health systems for aging societies in Asia and the Pacific. Health Systems & Reform3(3), 149-153. https://doi.org/10.1080/23288604.2017.1356429

Melbourne Medical School. (2022). Yarning about dementia. https://medicine.unimelb.edu.au

Ostaszkiewicz, J., Dickson-Swift, V., Hutchinson, A., & Wagg, A. (2020). A concept analysis of dignity-protective continence care for care dependent older people in long-term care settings. BMC Geriatrics20(1), 1-12. https://doi.org/10.1186/s12877-020-01673-x

Seah, S. S. L., Chenoweth, L., & Brodaty, H. (2022). Person-centred Australian residential aged care services: How well do actions match the claims?. Ageing & Society42(12), 2914-2939. https://doi.org/10.1017/S0144686X21000374

Shay, M., & Oliver, R. (Eds.). (2021). Indigenous education in Australia: Learning and teaching for deadly futures. Routledge. https://books.google.co.in/books?hl=en&lr=&id=sa4WEAAAQBAJ

Swift, H. J., Abrams, D., Lamont, R. A., & Drury, L. (2017). The risks of ageism model: How ageism and negative attitudes toward age can be a barrier to active aging. Social Issues and Policy Review11(1), 195-231.  https://doi.org/10.1111/sipr.12031

Voss, P., Bodner, E., & Rothermund, K. (2018). Ageism: The relationship between age stereotypes and age discrimination. Contemporary Perspectives on Ageism, 11-31. https://doi.org/10.1007/978-3-319-73820-8

Wilson, G., Windner, Z., Dowell, A., Toop, L., Savage, R., & Hudson, B. (2021). Navigating the health system during COVID-19: primary care perspectives on delayed patient care. NZ Med J134(1546), 17-27. https://www.researchgate.net/profile/Geraldine-Wilson-3.pdf

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