This article is the first of a two-part series where we explore the subject of cultural diversity in healthcare and how it relates to clinicians. Learn how rehabilitation therapists can improve patient outcomes through understanding and cultural sensitivity.
Working in any human service profession undoubtedly brings you in touch with people of all ages and backgrounds, and this is exactly the case for rehab therapists, especially in a place like New York City. No matter our level of experience as a clinician, we can always use reminders to maintain an awareness of and appreciation for the diversity in every person we treat.
Recognizing Cultural Diversity in Healthcare Patients
It’s been said in countless instances that our country is a melting pot. I am easily reminded of this every day as a locally based occupational therapist (OT) in metro New York where working in nearly any part of the city can be akin to visiting another country. In no other major U.S. city have I ever encountered so many enclaves and, amazingly, in such physical proximity to one another. I have now been practicing in home health for nearly the last decade, and it never ceases to surprise me how many different people I come across in just a single day. Even as a facility based therapist in prior years, the diversity among patients with whom I worked was equally present.
Admittedly, though, I personally tend to find that my work in home health places me in the most diverse of situations I could experience relative to other practice settings. Surely, most rehab therapists practicing in New York City come across a wide variety of people regardless of setting. Home health, however, brings the added dimension of entering another person’s home and existing fully in their environment. This inevitably expands our most basic notions of diversity as we’re now not only face to face with what makes us different, we are a living, breathing part of it.
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If we consider our patient interactions in an institutional setting (e.g., a hospital, nursing facility, private clinic), we clearly recognize that while every person we treat is of a different background, the setting in which we treat them remains static. Thus, our patients themselves become the sole markers of diversity, presenting physical and linguistic differences, as well as behavioral and attitudinal differences influenced by factors including religious beliefs, ethnic culture, socioeconomic circumstance, even political leanings. It’s easy then, in a practice setting that places each and every patient in the same surroundings, to remind ourselves to take patient diversity into account in our practice. With an unchanging external treatment environment that presents no bias and only patients that differ standing out against this backdrop of sameness, it can also become an apparent reminder to be mindful of cultural sensitivities.
In a home care setting, however, where patients are treated directly in their own homes, the diversity factor multiplies. Not only do patients present the more obvious markers of diversity (language, physical characteristics) but others such as cultural preferences, values, and behaviors display more pointedly. Because the home environment is where we are our most natural selves, working with patients in this setting calls upon an even greater recognition of and sensitivity to cultural differences. When utilizing a person’s home as treatment space, we must be cognizant of cultural customs that could dictate what is and isn’t acceptable (e.g., practicing dressing ADL in the bedroom may be inappropriate for some individuals; or, utilizing certain household items to substitute for formal exercise equipment could be found offensive). With our first encounter at the front door, in fact, we are already called upon to consider our patients’ customs on receiving people into their homes.
Regardless of treatment setting, embracing the diversity in our patients is much more than recognizing and accommodating that which physically, linguistically, or behaviorally distinguishes us from one another; it is equally a genuine desire to understand and respect the foundations of our patients’ values, beliefs and customs. In doing so, we build and foster respectful relationships, positive rapport, and meaningful interactions with our patients which altogether result in improved treatment efficacy in a clinical sense and a positive rehab experience for patients on a personal level.
For rehab therapists, it’s imperative that while we take diversity into account we remember that our patients are coping with changes in their health, well-being, and independence. Such changes are difficult for many of our patients so that creating a positive therapeutic experience also becomes an important part of our practice. By being able to respect patients’ diversity and understand how it influences their treatment and outcomes, we can be better therapists all around. But doing so effectively requires us to examine our own biases and the way in which we define the concept of being different.
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