Film educates Latinos on home health services
Goal is to overcome cultural factors that are barriers
Eldery Mexican-Americans have higher rates of chronic illness than their non-Latino counterparts, but many don't receive the care they need because they and their caregivers resist home care services, says Janice Crist, RN, PhD, associate professor at the University of Arizona College of Nursing.
Crist has been conducting research and pilot studies on home health services in the Latino community for the past 10 years.
She's recently received a research grant from the National Institutes of Health to fund the professional production of a short film portraying a family considering home health care.
"As a home care nurse, I saw that home care services help improve outcomes for elders and their family caregivers. However, Mexican-American elders do not use home health care as much as they should," Crist says.
When Crist conducted studies to determine the cultural factors that were barriers to eldery Latinos receiving home health, she found that familism, or the belief that all of the elders' needs should be met by their family members — most often grown daughters — was the biggest factor.
"In the Latino culture, family members are expected to take care of their own. Having home health services is asking a stranger to come in. It feels like an intrusion, and family members feel they are letting the elder down by not doing everything themselves," she says.
In the traditional Latino family, several generations lived together, and the daughter, who didn't work outside the home, handled child care as well as elder care, Crist points out.
That's all changed now that many women do work out of the home, and family members can't take care of everything that the chronically ill elder members need.
"We also know that family members don't intuitively know everything that needs to be done, like how to change a dressing or diabetes care. They need experts in the home health field to come in and teach them how to take care of the elders," she says.
Crist based her proposal for the grant on studies that show that telenovelas, or short dramatizations of a compelling story, can demonstrate the value of home health services in a culturally relevant manner.
"We pilot tested an amateurish version with a group of grandmothers as volunteer actors. We didn't have enough participants for a statistically significant sample, but we did show that people who saw the film had increased knowledge of home care services and were more likely to use them," she says.
Through the National Institutes of Health grant, Crist and her fellow researchers will produce a telenovela that will be shown to Latino elders who are likely to need home care services and their caregivers in the hospital setting. A control group will see a similar film on another subject, such as the benefits of senior health screenings.
"What we want to do is to teach family members about how home health professionals can be their partners in providing care for the elders. We want to show that these services promote the family ideal of keeping the elders at home as long as possible," she says.
In the eight-minute film, an elder is hesitant to have home health services for many reasons. For example, she believes she would have to clean her home to get ready for a visit from a stranger and because she doesn't think she can afford it.
"In the film, her sister tells about her experiences with home health, and we respond to all the barriers to receiving the service," Crist says.
In the end, after talking to a relative who used home health services, the elder says she believes she is able to more fully participate in family activities again.
Crist and her team will track the patients to see if the study group used home care more than the control group.
"Eventually, we want to get a larger grant and test the telenovela at neighborhood associations and community centers. We think that hospitals, home care agencies, and physician offices might be able to use a DVD to show clients to help promote understanding about the benefits of home care," she says.
The nine-year-old ENCASA (Elders' and Caregivers' Assistance and Support at Home), an advisory council with Mexican-American members, has helped design research questions and recruit study participants.
"A key element of my research has been strong community partnership to ensure that the research is focused on real community concerns," she says.
Eldery Mexican-Americans have higher rates of chronic illness than their non-Latino counterparts, but many don't receive the care they need because they and their caregivers resist home care services, says Janice Crist, RN, PhD, associate professor at the University of Arizona College of Nursing.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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