cognitive decline. This website provides English and Spanish instructions for developing a daily care plan (https://www.cdc.gov/aging/caregiving/pdf/Complete‐Care‐Plan‐Form‐508.pdf) and lists important resources.
Family Caregiving Alliance National Center on Caregiving Learning Center (https://www.caregiver.org/caregiver‐resources): An online learning community offering information, training, classes, and more to busy caregivers on their own schedule. The website offers articles, fact sheets, videos, webinars, family‐friendly publications, and slide shows that are relevant to caregivers. Facts and tip sheets cover health topics, caregiving issues and strategies, and statistics and demographics. Selected tip sheets are provided in six languages: English, Spanish, Chinese, Korean, Vietnamese, and Tagalog.
MOVE! (http://www.move.va.gov): A national weight management program designed by the US Department of Veterans Affairs (VA). This program is designed to help veterans lose weight, keep it off, and improve their health. The entire program, from philosophy to handouts, from motivational messages to references, can be found on the Internet and is free. The website has sections for both patients and providers in English and Spanish. There is a patient recruitment message about why this program is important to health and well‐being, followed by questionnaires to help patients determine their degree of readiness to participate in the program. Multiple handouts address barriers that patients may face, such as depression, lack of time, and boredom. These handouts offer solutions to those barriers.
There are instructions for providers about administering the patient questionnaire and how to run successful group sessions. Reference tools are well labelled and accessible and include discipline‐specific information on such topics as nutrition, physical activity, medications, and surgery. Links to recommendations for preventive services, such as screening tests and immunisation, can also be accessed from this website.
Chronic Disease Self‐Management Education (https://www.ncoa.org/article/evidence‐based‐chronic‐disease‐self‐management‐education‐programs): In the United States, about 80% of older adults have at least one chronic conditions, and 68% have at least two chronic conditions. Stanford University developed a suite of chronic disease self‐management programs covering general health, diabetes, arthritis, and enhancing wellness to educate older adults on how to manage those conditions themselves. Trainings are delivered in a variety of settings such as senior centres, churches, libraries, and hospitals. People with different chronic health problems attend together. Workshops are facilitated by two trained leaders, one or both of whom are non‐health professionals who have a chronic disease. Subjects covered include (i) techniques to deal with problems such as frustration, fatigue, pain, and isolation; (ii) appropriate exercise for maintaining and improving strength, flexibility, and endurance; (iii) appropriate use of medications; (iv) communicating effectively with family, friends, and health professionals; (v) nutrition; and (vi) how to evaluate new treatments.
It is the process in which the programme is taught that makes it effective. Classes are highly participative, and mutual support and success build the participants’ confidence in managing their health and maintaining active and fulfilling lives. Courses are offered in multiple modes and in both English and Spanish.
Key points
Individuals with limited health literacy have less access to health knowledge, worse self‐management skills, less frequent use of preventive services, higher hospitalisation rates, and more premature mortality than individuals with adequate health literacy.
Medicine is a culture that is not easily understood by, and often intimidates, older adults.
Common areas of cultural conflict between provider and older adult that negatively impact health care delivery include misunderstandings about the role of the family in the patient’s care, lack of common verbal and non‐verbal communication styles, misconceptions about cultural norms, and ageism by both the older adult and the provider.
Health literacy in older adults can be improved by using written material that is in the primary language of the patient, is written at the sixth‐grade level or lower, uses pictures and illustration, is age‐appropriate, and presents a limited amount of information.
Health literacy in older adults can be improved using auditory material that is in the patient’s primary language, is spoken slowly, and is delivered one‐on‐one by a trusted individual.
Many resources are available on the Internet to assist with overcoming language barriers and developing culturally appropriate health promotion programs.
Examples of improving communication include simplifying communication; confirming comprehension for all patients to minimise the risk of miscommunication; using technology to assist with rapid communication, making the health care system easier to navigate; and supporting patients’ efforts to improve their health.
References
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