Healthcare for Chinese-American elders

Chinese-American immigrants are the largest subgroup of Asian Americans living in the United States. Most of the first generation of these Chinese-Americans are born in China, and have moved to the States in their twenties. Because of the acculturation, language, and traditional beliefs, it makes healthcare communication difficult dealing with this group of population – Chinese-American elderly.

There are four major traditional religions/philosophies in China, Confucianism is one of those. Its primary purpose is to achieve harmony, which is the important social value. Because of this belief, the way patients communicate with their physicians are way different from western people. Chinese patients may not verbalize anxiety or doubts regarding their medical care in front of medical personnel, but then not follow through with treatments. For western physicians, they might see this as patient noncompliance.

Besides, Chinese people value their “face”. They may not want to question or disagree with physician to their face, since they think respect to the physicians is very important. As a result, they will not come back, or not take medication as prescribed. Furthermore, they might not inform family members of illness to “protect” both themselves and the family members. In order to keep the perfect mage in front of others, they need to lie or hide.

Immigrants rely heavily on health care practitioners who speak their native language for their primary care. They do not have to worry of any misunderstanding or communication difficulty. They trust people like themselves, and that can put them at ease.

Regarding these two big factors, there may be a conflict with Western concept of patient-physician relationship of partnership vs. the doctor as authority. They must be viewed as trustworthy, caring and willing to help. “To put the elder patient at ease, it is important to take a little time to “talk story” before beginning the clinical interview, to address patients with respect (Mr. or Mrs.), and to try to pronounce names correctly.” (Elliot, Di Minno, Lam, & Mei, 1996)