Abstract
In this paper, the authors seek to discuss some of the complexities involved in cross-cultural working in relation to the communication and management of pain in older people. Specifically, the paper addresses the culture construction of ageing and how pain is often constructed as a natural part of ageing. The authors also suggest that with the rise of the ideology of active-ageing, many older people who are disabled or living in chronic pain, may feel a moral imperative to hide pain and ill-health. The discussion extends into looking at the impact of culture and the communication of pain, including specific idioms of distress, somaticize and the lay-management of pain through stoicism. The literature utilised in this paper was based on a thematic review, exploring the cultural dimensions of health, illness and pain in old age. The review also drew on the authors’ previous publications, as well as their extensive community research experience working with ethnic minority communities.
Highlights
The last national census has highlighted how we are living in an ‘ageing society’ with an estimated 18% of the population of England and Wales aged 65 years old and above and it is notable, that we are living in a more multi-cultural society, with the number of Black, Asian and other ethnic minority (BAME) people accounting for 14% of the total population in England andWales [1]
The paper is divided into two sections; initially, the authors briefly examine the cultural construction of ageing and how this can influence older persons’ expectations of pain as they age
While the alleviation and treatment of pain may be considered a moral and professional imperative for health professionals, as Puchalski reminds us [42], ‘compassionate care calls physicians to walk with people in the midst of their pain, to be partners with patients rather than experts dictating information to them’ and the following sections of this paper seeks to examine some of these issues in more detail as we consider some of the dynamics of communicating pain across cultures
Summary
The last national census has highlighted how we are living in an ‘ageing society’ with an estimated 18% of the population of England and Wales aged 65 years old and above and it is notable, that we are living in a more multi-cultural society, with the number of Black, Asian and other ethnic minority (BAME) people accounting for 14% of the total population in England and. In the future, health and social care practitioners will be working with an increasing number of older people from more ethnically diverse communities. The authors consider critiques regarding the causative role of culture that tend to focus on the relation between social structure and culture; and the political and policy implications that cultural perspectives can engender. They argue that to avoid ‘cultural determinism’ a nuanced approach to understanding the role of culture in the expression and management of pain encompassing its dynamic, generational and contextual aspects is required.
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