It is very important for the health care workers to invoke the reflexive question when working with the Hmong elderly. The reflexive question asks, where am I in this encounter with culture? What is my point of view? How is that perspective affecting my view of these events? How is this inquiry changing my understanding of myself and my culture? How well tuned is my instrument, namely, me? Pg. 315 (Omohundro) When working with the Hmong elderly, health care workers should be mindful of the plight of the Hmong people.
Understanding where they came from and what their struggles were like to get here, will give health care workers a better sense of how to approach the elderly Hmong without putting them on defense. The United States pulled out of Vietnam in 1975 and many Hmong solders who served for and supported the U. S. military were left behind. The Hmong solders and their families had to survive on their own. These people had no one to help them escape the looming prosecution that awaited them.
The many travels of the Hmong people through treacherous Mekong River into Thailand, and relocation to countries such as the United States has resulted in many losses and further division of family members. Coming to the United States, the Hmong endured many losses. They had lost their homeland, identity, lifestyles and many of their friends and relatives. The loss of family members may have devastated the elders to the point of depression, and loneliness and may have resulted in isolation.
When compared to other refugee or immigrant groups in U. S. history, the Federal Office of Refugee Resettlement has identified the Hmong as having the greatest difficulty adjusting to life in America (Hund n. d. ). pg. 189 These losses were and are very traumatic. Their adjustment to living in the United States has been very difficult. Many of the Hmong elderly choose not to let others in their inner circle by speaking their native tongue, instead of English. Their resistance to speak English may just be their way of retaining their identity.
When encountering the Hmong elderly, health care workers should note the power differences between the Hmong and themselves and try to fill the gaps with opportunities to understand each other, and not put one above the other. It is up to the healthcare workers to be objective observers and not to pass judgments or assumptions and understand that the Hmong elderly are also observing and assessing the situation between you and them. The elders need to feel that they still command respect and that they are still needed and have a place in Hmong society.
The way that you greet the Hmong elderly can make or break the introductive meeting. Never treat them as an uneducated minority solely because they are not in tuned with the American culture. Education by our standards does not take into account the education that comes from life experiences. The health care worker can give back to the Hmong people the perception of understanding and guidance. They should bridge the gap between the cultures and help the Hmong people with their inability to adapt to life here in the United States.
Their inability to adapt has made it difficult to treat and diagnose the chronic illnesses of the Hmong elderly. When aiding or gathering information from the Hmong elderly, try not to offend them by asking questions that may be sensitive for them to answer. Be respectful of their past when trying to get information about immediate family members for an electronic health record. All of the Hmong elders speak Hmong as their sole language. Adherence to their language of origin may be viewed as a resistance toward acculturation and a means of preserving ethnicity. Gelfand 2003) pg. 203 Try to have someone who speaks Hmong as a translator to help ease the communication.
Be careful not to press them when trying to obtain their age. The Hmong age differently than Americans. Hmong couples began having children at a very young age and become grandparents sooner than the traditional American families. In addition, the traumatic life experiences and harsh living conditions suffered during the war in Laos and in refugee camps in Thailand, along with the difficult transition to the United States, have likely accelerated the aging process. Detzner 2004; Smith 1995) pg. 190 When trying to ascertain the age of the Hmong elderly be aware that, the Hmong people who were living in Laos may not know their exact age because age was not recognized as a number, it was dependent on physical abilities and capable dependency.
Rather than defining an elder by the number of years lived, elders were generally defined by important life experiences (i. e. , becoming a grandparent) and wisdom acquired throughout life (Gerner, Vang, and CulhanePera 2010; Yang 2005). g. 202 A person who is of young age numerically, can have the body and soul of an elderly person because of traumatic experiences with stress brought on by urgency and dependency. The age of an elderly Hmong is heavily based on dependency, weakness and chronic health issues. Hmong Americans consider the loss of strength and the onset of chronic illness as the precursor of old age. Many elderly Hmong feel social isolation and loneliness and seek traditional healers to heal their spirit.
Many elders identified the need for a shamanic healing ceremony when they felt “tired and weak” and sought the assistance of the shaman to perform ntxiv ntawy to bring back their spirit and regenerate their life span. (Paraphrased) pg. 197 Healthcare workers should understand that in the Hmong culture, especially the elders, there is a strong belief in spiritual medicine. The elderly Hmong may not be open to traditional modern medicine. Health care workers should evaluate their approaches and notes to see if they can be more reflexive when working with the Hmong elderly.
They should also reflect regularly on how their cultural inquiries are affecting themselves and how they perceive the culture that they are examining. Understand that the Hmong culture has other ways of healing elders through spiritual healers and that they should respect those values. The health care worker should be careful not to generalize the Hmong culture by presuming situations and conditions simply because they are Hmong. Understand that even though their culture is different, there is difference within the culture.
