Culture may not make our hearts beat, but it shapes the rhythm and texture of our lives from birth to death. Elders passed down the traditions our families shared at our first birthdays, first Christmas, bar mitzvahs, and quinceaneras. Long after elderly dementia patients forget how to eat, many still remember the holiday songs they learned as children. When families must place a loved one in a care facility, some find it challenging to find a setting where the power of these cultural memories will be honored and preserved. For Zulma, a caregiver with Latino roots, finding culturally sensitive care ranked high in importance, along with safety and quality of services.
From the beginning, Zulma found that placing her mother in a skilled nursing home was a wrenching experience. It is a transition that many Latino families avoid. I asked Zulma to explain why Latinos are so reluctant to let their parents get care outside the home. She said, “The relationship between Latino parents and children goes very deep and Latinos feel the need to preserve that.” She also mentioned that many Latinos are Catholic, “So the guilt of putting a family member in a nursing facility would be very great.” She was only persuaded to place her mother in a skilled nursing facility when she was told by her doctor “that her own health was in jeopardy and she had to make a choice” if she wanted to preserve her well-being.
Another deterrent for Latino families is the potency of negative media stories about nursing homes. Latino children strive to protect their parents as they would a child. Zulma says that “The attachment between Latino parents and children may not always be healthy but it’s very, very strong.” When it was time to move her mother, language issues were also key. Zulma’s parents were born and raised in Puerto Rico, then moved to Pennsylvania as teenagers. Although Zulma’s Mom learned English and raised a bi-lingual family, dementia had erased much of her ability to communicate in English. Before choosing a home, Zulma visited ten skilled nursing facilities. In the end, she picked a site because it employed multiple Latino staff members and she appreciated the accessibility of the dementia care unit manager. Zulma liked the way the manager took time to speak with her – while still stopping the conversation when a resident needed attention. The manager also embraced the idea of family members taking an active role in the care of their loved one.
At first, the transition from providing home care to visiting a nursing home was difficult for Zulma. But her activism as a volunteer has allowed her to continue playing a significant role in her mother’s care. With Zulma’s help, the staff at the home has added a Spanish mass and Latin music sessions to their regular schedule of activities. Zulma has also worked to introduce domino games and traditional foods like rice and beans to the facility’s menu of offerings. While she still misses her mom, Zulma is gratified to see that she is well-cared for and has built strong friendships with other residents. It amazes Zulma to see her mother speak Spanish to a resident who doesn’t know the language. The friend replies in English and somehow the two understand each other perfectly. Relationships like this show exactly where the limits of culture break down, and the power of humanity steps in.