Personal Preferences of the Elderly

Different individuals have different preferences. For that reason, assessing

Factors Contributing to Individual Differences

A. Culture
Culture refers to the behavior patterns, arts, beliefs, communications, actions,
customs, and values. They are linked together to racial, ethnic, religious, or social
groups. Cultural awareness and sensitivity are an important part of providing care to
the people being served by caregivers or healthcare workers.
We need to respect other cultures and try to learn more about the different
cultures. Then we can better understand the individuals being served. Keep in mind
not all people from one culture are the same. The following examples are generally
true, but they may not apply to all people.

Example:
1. Native American
-Usually want a caregiver/homecare workers from their own tribe
-Belief in non-traditional medicine
2. Asian
-Prefer more space between speaker and listener
-Limited contact, no hugging or back slapping
3. Latino
-Comfortable with close conversational distance
-More expressive
4. East Indian
-Believe that the head is fragile and should not be touched
5. Muslim
-Woman will not shake the hand of a man
Examples of some innocent gestures that could be misunderstood:
• Use of the left hand to touch or hand something to your patient. Some
cultures use their left hand for personal hygiene and think of it as being
unclean.
• Strong eye contact can be appreciated by one culture but by another. It
could be a sign of disrespect.

B. Age
A study suggests that patient perceptions of communication in health care
settings vary by age.

C. Economic
Theories about the relation between socioeconomic status and health
essentially focus on three mechanisms. First, those with higher incomes are
able to purchase better food, better housing, live in safer environments and
have better access to health care. Second emphasises behavioural or “lifestyle”
factors, such as smoking, diet, alcohol consumption and appropriate use of health
care, which may vary with cognitive skill and access to information. Third places
more emphasis on psychosocial factors such as empowerment, relative social status
and social integration, including exposure to stresses that may result from low status
and low autonomy in important arenas of life, such as work. Moreover, elderly
individuals, on average, have much lower family incomes than non-elderly adults.

D. Physical
The aging process contributes to changes and decline in the function of
multiple systems, causing significant anatomic changes in the elderly. Among these
changes, decreased muscle strength, flexibility and balance have great impact on the
functional capacity of the elderly, predisposing them to frailty and loss of autonomy
for daily life activities. In this context, functional capacity has been identified as an
important marker of health in the elderly, given that the presence of limiting factors
such as diseases or immobility can lead to great impacts on their quality of life.

E. Intellectual
Cognitive function is defined as the intellectual process by which an individual
becomes aware of, comprehends and perceives ideas. It includes all aspects of
reasoning, thinking, perception and remembering. Personal preference of patients may
be affected because older adults also experience a change in their speech perception.
They usually complain that talkers mumble or talk too fast and they cannot hear
clearly because of background noise. This change is attributed to deteriorating
cognitive processes like memory, attention span, language comprehension and lower
level sensory plasticity. Intellectual differences in elderly patients may also be caused
by anxiety, worry, sadness, or depression of which coping with these situations differ
among patients. Moreover, stimulation also becomes a factor. Mentally stimulated
patients differ also from those who are not.

F. Language
Cultural differences, disabilities, and language barriers affect care in a huge
way. Some words may have different meanings to older patients than to you
or your peers. Words may also have different connotations based on cultural
or ethnic background. For example, the word "dementia" may connote
insanity, and the word "cancer" may be considered a death sentence. Although you
cannot anticipate every generational and cultural/ethnic difference in language use,
being aware of the possibility may help you to communicate clearly.

Use simple, common language, and ask if clarification is needed. Offer to repeat or
reword the information: "I know this is complex. I'll do my best to explain, but let me
know if you have any questions or just want me to go over it again." Low literacy or
inability to read also may be a problem. Reading materials written at an easy reading
level can help.
Make sure the patient understands:
• What is the main health issue
• What he or she needs to do
• Why it is important to act
One way to do this is the "teach-back method"—ask patients to say what they
understand from the visit. Also, ask about any potential issues that might keep the
patient from carrying out the treatment plan. Try not to assume that patients know
medical terminology or a lot about their disease. Introduce necessary information by
first asking patients what they know about their condition and building on that.
Although some terms seem commonplace— MRIs, CT scans, stress tests, and so on—
some older patients may be unfamiliar with what each test really is.

G. Sex
Although recognized as a fundamental driving force, human sexuality is
frequently misunderstood and particularly in the elders, neglected. Human
beings are actually never too old to enjoy a happy and healthy sex life. Despite this,
many people, young and old alike, are astounded at the idea of people remaining
sexually active in their sixties and beyond. It is frequently assumed that elder persons
lose their sexual desires or that they are physically unable to perform. For the elders,
the ability to remain sexually active is a major concern in their lives. Fear about the
loss of sexual prowess in older males is common. Older women also express sexual
desire, but may fear their interest is undignified and disgraceful. Some elder persons
may even freely accept their interests in sex, but their children or grandchildren may
disapprove, making them feel guilty.
A study showed significant presence of sexual desire, activity and function even after
the age of 50 years; a decline by the age of 60 and above was a finding that reflected
more in women. Chronic illness did affect sexual function and desire.

H. Social
Evidence is accumulating about the association between strong family ties and the
emotional and physical welfare of older adults, and researchers have
identified negative consequences of being unmarried, being childless, and/or
living alone. These associations have been recognized in multiple contexts,
including in Asia where living with a spouse and/or grown children has been
shown in some studies to improve elderly well-being. Social support, especially
family support, is expected to continue to be important where populations are aging
and social safety nets are weak. Moreover, disease conditions and mobility also
affects social life of elderly patients