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Culture, Aging And Health

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This paper is an interview of a 65-year-old male J. R of Indo-Guyanese ethnicity currently living in New York. Indo- Guyanese are Guyanese with ancestors primarily from Eastern India. This interview discusses the how ethnicity and culture make differences in health care practices. J. R. tells the writer of how through illness he was able to restore his faith in Hinduism after many years of not being religious. He also comes to understand how his culture is highly influenced by the Hindu religion. This paper also includes research about the Indo-Guyanese of Hindu faith, comparison of Asian and Indo-Guyanese ethnicity as well as comparison between Hispanic and Indo-Guyanese ethnicity.

On September 16,2018 at 2: 00pm I visited J. R. at his residence in the Wakefield section of the Bronx accompanied by his daughter, where he lives with his wife of 45 years. For the duration of the hour-long interview, we sat in their living room. The living room is clean, organized and decorated very nicely with pictures of J. R, his wife, his three children, two grandsons and other family members on the walls and in their wall unit. They also have two small flags on both sides of their wall unit from their native country of Guyana. The living room furniture is arranged so that J. R. has enough room to move around freely with his side hemi walker. J. R. mentioned that they needed to rearrange the entire house after he had a stroke, so they could fit a wheelchair into different parts of the house before he learned how to walk again with a side hemi walker and they kept it arranged this way since. J. R. has some issues recalling memories at times and requires some time to answer questions.

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According to his daughter who is a close family friend for over 10 years, this does not affect his personality of being a happy, positive and witty man. J. R. is described by both his wife and daughter for being a hardworking man that retired from his construction job 8 years ago. J. R. is also a very sharp looking man is well groomed, clean shaven with a small mustache that has mostly gray hair. He is losing his hair mostly to the left side of his head, but the remainder of his hair he has combed neatly to the right side with some gray hair noted. He wears glasses regularly due to difficulty seeing both near and far. He has very little wrinkling to his face only on the forehead and neck. He has noticeable weakness to the right side of his body from a stroke he had 4 years ago. He is appropriately dressed for the weather with a patterned short sleeved button up shirt and neatly pressed slacks with orthopedic non-skid shoes.

General Assessment

Some of the age- related changes I noticed like mentioned previously were wrinkling and his forehead and neck. He has gray hair in both his facial hair on his head and is balding mostly on the crown of his head. J. R. has more muscle mass and strength to the left side of his body than his right. He can bear weight on his right side, but he is unable to use his right upper extremity and it hangs to the side of his body. He walks slowly and uses side hemi walker mostly but for long distances he uses a wheelchair since he tires easily. He wears glasses for both distance and reading for the last 20 years. J. R. said that after his stroke he would get sensations to his weak side but that they went away after a couple of months. He says he has pain in his back and legs from working construction for nearly 30 years but that it is bearable. J. R. talks about missing being able to move around more swiftly and wishing he didn’t need so much help but that he is thankful that he is able to do a lot for himself despite some limitations.

J. R. , his daughter and wife showed me that they needed to convert the basement into his bedroom after his stroke because he is unable to walk up and down the stairs too much. The basement has everything he would need to access without needing to climb up the stairs very often. He has side door access from outside, a full bathroom, small refrigerator, hospital bed, sit up recliner, big flat screen tv and a couch. He required assistance which showers and toileting which his wife helps with daily. He also has 2 private aides that come to help his wife 7 days a week while she is at work, but he is can do a lot for himself like feeding, washing the front of his body, brushing his teeth, combing his hair, and shaving his bread. He cleans up after himself for the most part and is can fix the sheets on his bed by using the bed remote to raise the bed high enough for easier access. He likes to help his wife in the kitchen and tries to even help her clean up the house. He believes that moving around and keeping active will only continue to help him get stronger.

Cultural Assessment Research

In Guyana there are two main ethnicities Afro-Guyanese or Indo-Guyanese. J. R. ethnic background is Indo- Guyanese. Indo- Guyanese are Guyanese with ancestors that came from East- Indians over 150 years ago for work after the abolishment of slavery in South America. Indo- Guyanese have kept many of their traditional Indian culture practices but have also incorporated many Afro- Caribbean practices as well. Similarly, to that of Indian culture, most Indo-Guyanese are Hindu. Hinduism weighs heavily on the beliefs, values and practices of this ethnicity. In Indo-Guyanese culture because of the close correlation with the Hindu religion health and illness are viewed to have a supernatural foundation. In Hinduism, belief in dharma, karma, rebirth and purity influence health and illness. Karma are actions that you do in life to reach your dharma which is your destiny. These actions are believed to follow you from your past life into present life and ultimately forever. For Hindu’s, it is believed that having illness is viewed as a punishment for bad behaviors in current or previous life.

In Hinduism, food is believed to do more than nourish the body but also the mind. Hindu’s respect all livings things and for that reason it discourages the consumption of meat however; some Hindu’s eat meat except beef and pork. In Hinduism, the cow is sacred to the religion and pork is unclean. Hindu’s strongly believe that abiding by the diet code is imperative to maintain the balance between spirit and body. Food categories in the Hindu diet code are separated into three categories based on how they effect the body and the consumers mood. Hindu’s believe that eating foods from the wrong one of the three categories can cause illness or disease. Fifty years ago, in the beginning of their independence from Great Britain, Guyanese health care was not advanced. Due to the topography of the country, healthcare workers would take boats down rivers to different remote villages and see as many patients as possible. Due to lack of access to proper healthcare use of religious healers, traditional healers and traditional medications were highly used. Today, utilization of both western medicine and traditional medicine varies on where individuals live and religious beliefs.

Most Indo – Guyanese that still live in Guyana are becoming more open to western medicine, but some still practice some traditional practices. Utilization of traditional practices also pertains to Hindu religion. Indo-Guyanese of Hindu belief utilize a variety of Ayurvedic medicines. The purpose of Ayurvedic medicine is to incorporate and balance the mind, body and spirit. In Ayurvedic medicine a dosha is the persons basic condition. To maintain health, it is believed that the three doshas must be balanced. The three doshas of Ayurvedic medicine are vata, pitta and kapha. If one of the doshas is out of balance, the person will begin to display signs and symptoms of illness or disease. Treatments that are practiced would correlate with the specific dosha that is unbalanced. Common examples of treatment are nutrition, exercise, herbs, mediation, yoga and aromatherapy. Yoga is an example of complementary and alternative therapy as mentioned in Chapter 27 of TLL. Yoga is a practice of Ayurvedic medicine.

Traditional yoga is meant to make a spiritual union between the mind and body. Yoga combines breathing exercise, posture awareness, spiritual practices and mind – body centering (Lynn, 2014, p. 736). Elders are highly respected in the Indo-Guyanese ethnicity. In most Indo-Guyanese households the husband is the most common decision maker. Some Indo- Guyanese of Hindu or Muslim faith elders still arrange marriages amongst younger family members however, it is not very common. Most Indo- Guyanese that live in America choose spouses of their own and tend to marry other Indo-Guyanese of the same faith. Indo – Guyanese of Hindu faith believe that it is the family’s responsibility to care for the elderly and sick. It is stated in Hinduism that the family is encouraged to take an active role in the actual care of the family members.

Comparative Analysis

One similarity between the Asian and Indo-Guyanese culture is the traditional health care practices. In the Asian culture, they believe that good health is achieved and maintained through a balance of ying and yang. Indo-Guyanese that are practicing Hindu’s also have the same belief that health is achieved and maintained through a spiritual and physical balance to strive to achieve dharma. Both Asians and Indo-Guyanese still utilize ancient practices of herbs, diet and medicines to help with illness and disease. J. R is not a devout Hindu, but he does abide by many of the Hindu beliefs because they are closely linked with the Indo-Guyanese culture. After having his stroke, J. R. did utilize some forms of folk/traditional medicines to assist him in being able to speak again. Family members that came from Guyana brought some mixture of herbs from a healer. This herbal mixture was then placed under his tongue to assist in speaking again. He said that he did abide by the hospital’s policy and only after getting approval from the speech therapist, he would have his wife place some of this powder under his tongue every day. He believes that this folk medicine as well as the help of the hospital staff did help him speak again. A second similarity that both Asian and Indo-Guyanese have is a high respect for their elders as they are the authoritarians in the families.

In the Indo-Guyanese culture especially those of Hindu faith, they are very family oriented. J. R. came to New York City along with four out of five siblings to have more financial stability to help his parents and remaining family that stayed in Guyana. J. R is the oldest sibling so when he had his stroke it was not only a hard time for his wife and children but as well as the rest of the family. He is the eldest and he is highly respected. He has always helped his other siblings and their families for years so when he was sick it caused some tension throughout the family. During his time of illness, many of his family members took turns staying with him and helping with the direct care which is common amongst Indo-Guyanese of Hindu faith. J. R. says that although only him and his eldest sister are still close to the Hindu religion; during his time of illness, he saw that the other family members became more spiritually aware. He said that this harmony is needed to help restore the balance and helped him return to a state of health. A third similarity that I found between the Asian culture and the Indo-Guyanese culture was related to religion and theory. In Taoism, the basis is to have balance in all things. Hinduisms core belief is the balance of spirit, mind and body. By maintaining their balance Hindu’s believe they will reach their dharma. Imbalance in both Taoism and Hinduism is attributed to eating the wrong foods and having bad feelings. Illness in both Taoism and Hinduism is believed to have an origin cause of a spiritual background not mainly scientific. Illness is also believed to have a more significant background such as being apart of God’s will.

Some differences between the Asian culture and the Indo-Guyanese culture I noticed is that in the Indo-Guyanese culture they do express their complaints and what is bothering them. In the Asian culture it is uncommon that they will complain about what is bothering them. Nonverbal cues are needed to identify what they are honestly feeling. Although Asian and Indo-Guyanese of Hindu faith believe food is important to health, the way foods are interrupted are different. Asians classify foods and diseases with hot and cold. Indo-Guyanese Hindu’s have three main categories of foods that are divided to represent foods good for your spirit and health and ones that are not. A third difference I noticed between Asian culture and J. R. personal practices are that some Asian’s have a difficult time understanding the importance of a medication regimen. J. R. had a stroke while abiding to a medication regimen for his hypertension and unfortunately still had a stroke. Asian’s have difficulties abiding to these regimens because of many folk treatments utilizing herbal remedies. J. R. utilizes some therapies from folk healers but he says that he takes his medication as prescribed by the doctors.

Reflection

While doing my interview with J. R. , I realized that some of our practices of herbal therapies are similar. Whenever I am sick, my mom makes me drink teas made of naturals herbs that she mixes together depending on the illness and insist to rub Vapor rub all over my chest and neck. My mom believes eating or boiling certain herbs can help feelings of anxiety, anger and depression go away as well. Food is very important to the Hispanic culture and to my mom certain dishes such as soups and meat stews can help heal the body when is tired or sick.

I do not live close with my extended family like J. R. but I do have a big family. For the Hispanic community, family is very important. Most decisions in my house are made with consideration of the entire family especially since my father became sick when I was around 13. When he got sick my parents’ roles switched, my mom took on the responsibility of being the sole provider in the family until my brother and I were old enough to work. A situation much common to J. R. ’s family as well. J. R. was considered the head of the family until he had his stroke and was no longer able to financially or physically provide for his family. This change in the family dynamic can be difficult for any family especially in cultures where the man is the head of the family.

I was raised Roman Catholic and attended church every Sunday with my aunt until, the age of 15 when I decided to accept an invitation to a non-denominational Christian church by a classmate. Since that first time visiting Christian church, I never attended another Catholic mass. This angered most of my family because being Catholic is very important to my aunt and most of my eldest family members. J. R. was raised Hindu and he prays daily. He says he is not a devout Hindu but after his stroke, he decided to become more in touch with his faith again. I personally do not attend church every Sunday however, I pray often. Although our religions are very different we both believe that if you do good in life, God will repay you.

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