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African American Caregiving

Cultural sensitivity is as important in caregiving as it is in the everyday social situations. It is helpful for team members to evaluate their cultural competence prior to providing support to anyone of a different race or ethnic background. It is imperative that personal prejudice and stereotypes are contemplated and honestly assessed. This is true for team members as well as potential care partners (to the extent possible). The chance of a successful relationship increases if both you and the care partner are comfortable with each other. In supporting a care partner in need, here are a few things to keep in mind when working with African Americans. African Americans comprise ethnically diverse cultures; become familiar with the common culture of your care partner; Black American (even within this group you can observe distinct cultural differences usually based upon economic status with those in a higher economic status often exhibiting more mainstream culture) Caribbean (i.e., Jamaican, West Indian, Haitian, Puerto Rican, etc.) North, South, East, West African (each w/ distinct cultures) Asking questions about a persons ethnic background and culture can be a good way to generate rewarding and informational conversation. More than likely, your care partner will take pride in teaching you about his/her culture including food, religion, celebrations, etc. It will also be a good opportunity to share your background.

Family Ties The elderly are typically respected and viewed as a source of wisdom. African Americans, as well as other ethnic minorities, have a reputation of strong familial ties. The extended family has played an integral part in the African American community for both social and economic reasons. This strong sense of family connection/ cohesion results in a greater willingness to support dependent family members. As more and more African Americans embrace mainstream cultural values this has become less true. Contemporary African American families are finding it increasingly difficult to claim the strength and resilience of the kin network of the past.1 Nevertheless, African Americans typically exhibit stronger family ties than whites. Other factors to consider when relating to African American families: Co-residence is more prevalent among older African Americans than in other groups.2 Co-residence can be defined as living or residing together. blacks are more likely than other groups to rely on family and other informal services in times of personal or family crises.3

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

Informal caregiving is promoted within the African American extended family system because it is often highly integrated and is an important resource for survival and social mobility for its members.4 Many families have a strong matriarch that holds the family together. Typically, this is the eldest mother or grandmother. The matriarch is the center of the family sometimes even if a male is present. The lack of strong male presence in the family is usually a reason the matriarch thrives. The matriarch will possess strong feminine and masculine attributes by virtue of familial or societal need to survive.

It is not unusual for generations to live within the same household. When visiting your care partner you may encounter extended family members such as grandchildren, nephews, nieces, or even neighbors and non-relatives who have known the person and family for many years; all of whom may play an important role in the support of your care partner. Remember to acknowledge, understand, and respect each persons role. The acceptance of your help may be a last desperate attempt to manage the care of their loved one. A desire for privacy, skepticism, suspicion, guilt, and high stress levels may be initial reactions to outside support. Accordingly, it may take time to establish a rapport and eventually build a relationship. The Role of the Church and Religious Belief The church may play an important role in the lives of African Americans. Traditionally, the Black church has been a pillar in the African American community with regard to promoting/defending civil rights, as well as addressing social issues. The church remains an integral part of the lives of many African Americans even today. It provides a social, emotional, and spiritual support system. Studies have shown that older adults demonstrate a high level of religiosity and affiliations with churches and other spiritual institutions.1 Additionally, numerous studies have found that African Americans attribute God as their greatest source of support even with regard to physical care, as well as prayer being their major coping strategy! Do not think it strange when your care partner proclaims his/her great faith in overcoming, what may seem to you as, tremendous physical or financial barriers. Social Nuances Unless your care partner has given you the explicit permission to address him/her by his/her first name, it is respectable to address him/her as Mrs. or Sir. If you are comfortable with the southern custom of replying, Yes Maam, or Yes Sir, you are also safe. This gesture is appropriate for anyone considered your elder. Titles are very important in the African American community. It is best to know and use them until given permission to do otherwise. Using ones title or former title can also be a means of reminding a care partner with memory challenges of his/her former position/occupation/role. Therefore, you might refer to your care partner as Deacon Johnson or Mother Wilson, etc.

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

Because Alzheimers disease and dementia is often considered a normal part of aging in the African American community, you may want to refrain from naming a perceived normal condition as a disease. Otherwise, your care partner might be offended by such comments. Family members may respond to your desire to extend care and support with caution until you demonstrate that you can be trusted. Dont be alarmed by a reluctance to disclose personal information. In the meantime, provide as much information to your care partner and/or his/her caregiver about community resources and services that may benefit them. In time, your consistent care and support will be greatly appreciated. You will earn your right to become a trusted member of the extended family. Social Nuances This activity will help team members to learn how valuing and devaluing certain attributes, materials goods, etc. in society can ostracize those who do not possess those same things. Team members will learn how the advantages or disadvantages various ethnic groups experience can create feelings of rejection, frustration, resentment, etc. Create tokens (i.e., color paper cut into squares, etc.) that can be handed out to each team member. Give each participant 3-4 tokens. Make a few of them a little different from the rest of them. Announce to everyone that the tokens that have a certain attribute (i.e. blue in color, gold trim, etc.) are the most valued tokens. Announce that the tokens with a certain other attribute (i.e., orange tokens) have less value. Finally, announce that yet another token with certain attributes have no value at all. Ask the participants to begin mingling with each other and bartering/exchanging their tokens. Participants can be as creative as they can in convincing others to give (or exchange) them the valued token. Allow participants about 10-15 minutes for this exercise. Afterwards, ask participants to talk about the process. How did they feel when they were trying to barter/exchange the unwanted tokens? How does this exercise relate to prejudice, racism, or stereotyping? Some team members may experience rejection or hopelessness as you attempt to exchange the devalued tokens. Allow each team member to share his/her feelingseven those who possessed the valued tokens. Team members can talk about and share how it felt to be valued or devalued. Talking Points What has prepared me to be more culturally sensitive? How do I evaluate my ability to provide care to anyone of a different ethnic identity? How can I overcome prejudice I know I have (by the waywe all do)? How can I avoid placing my values on those I seek to care for? How is African American caregiving different from other racial or ethnic groups?

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org

References
1

Williams, S., Dilworth-Anderson, P., (2002) Systems of social support in families who care for dependent African American elders, The Gerontologist, Vol. 42, No. 2, 224-236. 2 Dilworth-Anderson, P., Williams, S., Cooper, T., (1999). Family caregiving to elderly African Americans: caregiver types and structures, Journal of Gerontology: Social Sciences, Vol. 54B, No. 4, S237-S241. 3 McGadney, B.F., (1995). Family and Church Support Among African American Family Caregivers of Frail Elders, University of Michigan, Perspectives. 4 Ibid.

Written by Veronica Seivwright

701 N. Post Oak Rd., Ste. 330, Houston, TX 77024 | 713-682-5995 info@interfaithcarepartners.org | www.interfaithcarepartners.org