Caring for Diverse Elders

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Is your HME business prepared to meet the needs of our growing, diverse senior population?

Written by: Lalaina Rabary, People for Quality Care

Dramatic demographic shifts are occurring in the United States. 

According to a 2013 UCLA Report, 1 out of 5 seniors are members of a racial or ethnic minority, more than 1/8 were born outside of the United States, and by 2050, Latinos are projected to make up 20 percent of those 65 and older. The Diverse Elders Coalition states that, “In the next 15 years…the lesbian, gay, bisexual and transgender older populations will double in size to at least 4 million.”

As the texture of our senior communities changes, cultural competency is of great importance. Health care services and delivery must shift to meet the needs of diverse seniors. This article highlights steps to cultural proficiency that your HME business can implement now to ensure quality care today and in the future.

Step #1: Establish why being a culturally competent business is important to you

Most of us tend to spend time with people who look like us, speak the same language we do and share the same values. Although natural, this tendency can lead to cultural incompetency and can make connecting with diverse seniors difficult.  Without cultural competency, the quality of care your HME provides will be viewed as sub-standard and in some cases, discriminatory.  This label hurts business, intimidates potential customers and ultimately, takes a hit at your bottom line. These are just a few reasons why cultural competency is important. What are some others? Sit down with your leadership team and specifically discuss why being a culturally competent business is important to you.

Step #2: Assess where you are at on the cultural competency continuum. 

Before you begin working on strengthening your business’s cultural competency foundation, look inward.  Honestly assess you and your staff’s opinions on how you feel about people who are different than you and identify where your business falls on the cultural competency spectrum. After you have done this, you are ready to make conscious actions to improve the way you work with diverse groups.

Scale of Cultural Competency:

  • Cultural Proficiency: Bicultural and Bilingual – Can easily interact with people of different cultures
  • Cultural Competency – Deep respect and appreciation for another culture. Can interact adequately
  • Cultural Pre-Competency – Beginning to understand and respect other cultures
  • Cultural Blindness – Unaware of cultural differences, tends to think that their own culture is universal and absolute
  • Cultural Incapacity – Significant dislike and deliberate separation from other cultures
  • Cultural Destructiveness – Wants elimination and destruction of other cultures.  

Source: Caring for Diverse Seniors: First Edition, Yeheili, Grey, Vander Werff

Step #3: Develop an action plan!

After you have established where your business falls on the cultural competency scale, develop an action plan to increase cultural competency within your building. Your action plan can be simple or extensive, but should always include education, research and staff training.  Below are some action steps that can be included in your personalized plan: 

  • Identify various cultural, ethnic and racial communities within your community and learn about the role of seniors and attitudes towards health.
  • Understand the unique health care needs and challenges of the diverse seniors you serve. Minority and LGBT seniors face specific health care challenges.
  • If some of your senior patients don’t speak English, make an effort to learn at least a few phrases of their language. This simple action goes a long way as you work to establish a friendly relationship with them.
  • Consider hiring staff who are members of the cultural, ethnic and racial communities in your area. This helps break down cultural barriers and creates a more vibrant environment in your workplace.
  • Discuss programming and policy ideas that can ensure your staff and the seniors you serve can feel respected and safe.


Please keep in mind that cultural competency is an ongoing process. The practice takes patience, honesty and resources, but is an important element of business that should not be overlooked. Becoming culturally competent will not only strengthen your business’s ability to work with patients of all backgrounds, but open you up to new business opportunities as well. 

To learn more about aging and cultural competency take VGM Education’s class, Aging and Ethnicity online. Other resources include: and