The Melting Pot
Shelly Mesure, MS, OTR/L
You might be thinking this is going to be about the intriguing restaurant chain The Melting Pot. While I do love fondue (especially the cheese and chocolate varieties), my actual intention is to discuss something crucial to our profession: cultural diversity.
Did you know that up to 40% of the U.S. population comprises immigrants or first-generation Americans? It is very rare to come across a skilled nursing facility or long-term care facility that only has one or two races or ethnicities. Some facilities specialize in a targeted demographic, but not every resident at these locations match the target.
For example, my first job after graduating from therapy school was in Chicago. This nursing home consisted of three floors, with the third floor completely dedicated to living space for the Korean population. They received Korean meal plans, activities and staff. However, the other two floors had a wide range of mixed ethnicities from many different backgrounds.
There is a growing need to not only be aware of these cultural differences, but also to learn about them so we can better understand our patients. What will motivate our patient's “personal goals” (as we commonly label them)? And how much of these personal goals are related to ethnic backgrounds and expectations?
Rehabilitation is perceived very differently in various parts of this world, so if this is the first time your patient is receiving physical, occupational or speech therapy and they're not originally from America, their expectations may be very different from American standards.
The best way to develop a deep enough understanding is by talking with the patient about his or her values, beliefs and traditional customs. If there is a language barrier, discussing this with an English-speaking family member may help provide better answers. A family member also might be a more reliable source of information, versus using a translator.
However, if a family member is not available, by law the facility must provide a translator. It might also be beneficial to educate the translator or family member on the best practices that can be expected, and using evidence-based practice to demonstrate successful outcomes.
The important thing to remember is not to let anything get “Lost in Translation.”
Shelly Mesure ("measure"), MS, OTR/L, is the senior vice president of Orchestrall Rehab Solutions and owner of A Mesured Solution Inc., a rehabilitation management consultancy with clients nationwide. A former corporate and program director for major long-term care providers, she is a veteran speaker and writer on therapy and reimbursement issues.