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Indicators of Cultural Understanding

A key indicator of relationship-centered care is understanding culture. Culture includes the attitudes, beliefs, behaviors, and characteristics common to a group of people.

This can be as limited as a close family to as broad as a community, state, region, or nation. While we frequently say we honor other people and their ideas, many times this does not play out in reality. It is difficult to understand a "foreign" idea when we have never lived it, studied it, wondered about it, and made it part of our thinking.

It can even be difficult within a family. Generational expectations vary from grandpa to Aunt Sue, to my cousin, to my siblings, to me. Perhaps we have each lived together to a certain degree, celebrating customs and traditions, but in the in-between time, we each live our own lives. Our encounters, our friends, our jobs, our communities have differences, each of which may have an influence on how we think, believe, and behave.

Image from living abroad
Image from living abroad

Cultural competence is the integration and transformation of knowledge about individuals and groups to create standards, policies, acceptable behaviors, practices, and attitudes within that group, with degrees of variation, of course. Laws are part of our cultural competence, and while there may be some rules with which I do not agree - like 65mph in wide-open spaces where 75mph would do just fine. Here I confront a choice - obey the law and travel within the designated speed or rev up my engines and prepare to pay the consequences should a red, spinning light appear in the rearview mirror.

Cultural humility encompasses the ability to maintain a relationship that is different from our own, to honor and respect others for who they are, not who we think they should be. In caring for others it is valuable to listen and learn. What does the individual really want? believe? need? And how can I assist in meeting these wishes without foisting my own views onto the center stage?

If Grandma wants to move into assisted living, and she has a room selected and funds to pay for it, who am I to deny her this choice even if I have a spare bedroom and plenty of space for her to love with me. The thought of her moving to Gentle Acres may break my heart, but I must respect her decision. And if, in time, she changes her mind, I must stand by her and support her new choice.

It is impossible to understand every aspect of a culture; it is easy to generate stereotypes. That is one reason why it is so important to remain open to learning new ideas and ways of doing things and responding to life. This helps design a partnership of awareness and acceptance. Instead of basing our own attitudes on a generalization of culture, we seek to learn about the individual, what makes him/her a unique and viable person within that culture and within our realm of friendship.

From the outside, a culture may appear to be simple food, games, language, customs, and dress. But when you dig deeper, that is when you find many of the other aspects of culture: values, religious beliefs, notions of beauty and norms, thought processes, and the concept of fairness, to name just a few. Instead of drawing assumptions and tossing people into convenient packaging, cultural humility means listening, being open-minded, asking questions and accepting the answers, and learning. We are all different - and that is OK. (Gini Cunningham )


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