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 CULTURAL ISSUES > How Culture Shows Up

Below are topics that often arise during the end of life. How a person feels about a particular topic may be impacted by their culture.  

When working with others, approaching these topics with an open mind may be particularly helpful.

Decision Making

What is the philosophical value that serves as the foundation for the individual's approach to medical decision making?

  • Personal Autonomy

  • Family-based decision making

  • Physician-based decision making

  • Combined / shared decision making

How does the individual's culture influence his/her beliefs about who should make decisions for his/her loved one?

  • Assumption about who has this role

  • Filial Piety (Respect and honoring parents)

  • Honoring person means advocating for care

Truth Telling

Does the individual's culture influence beliefs about being candid and direct with the person who is dying?

  • Respect for patient

  • Protecting patient

  • Not wanting to invite bad spirits (sadness, hasten death)

Trust in the Healthcare System

What are the individual's personal or historical experiences with healthcare system?

  • Discrimination or harm (historical or personal)

  • Socio-economic status

  • Access to health insurance

  • Perception of healthcare providers as trustworthy

  • Respect educated professional

  • Finding Meaning

Finding Meaning

Does the culture provide a framework through which we make meaning out of our lives?

  • Meaning of disease

  • Meaning of suffering

  • Meaning of death

  • Death in the Home

Cultural beliefs may impact where a person wants to spend his or her last days.

  • Impact resale of house

  • Not wanting to burden family

Death in the Home
Hospice

Culture may impact a person's feelings about hospice

  • Allowing strangers (don't know language or culture) into your house.

  • Allowing strangers to provide basic care to your loved one

Cultural beliefs may impact where a person wants to spend their last days.

Does the culture provide a framework through which we make meaning out of our lives?

  • Meaning of disease

  • Meaning of suffering

  • Meaning of death

  • Death in the Home

Rituals

Culture often provides guidance on rituals to help people process important events in their lives.

  • Handling of body

  • Honoring the person

  • Expressions of grief and bereavement

Immigration

A person's immigration status or history may impact their cultural experiences.

  • Acculturation (a merging of cultures)

  • Assimilation

  • Generational differences

Language

A person's language skills may impact their cultural experiences.

  • Limited English Proficiency

  • Literacy level