Culturally sensitive care: "Treating people equally and fairly but not the same"

 There are 80 million people living in Germany. This also means there are many different cultures living together. Schools and daycare facilities already provide special choices for children who speak another language. But what is the situation like in nursing homes and care facilities? And what exactly is culturally sensitive care?

In this interview with REHACARE.com, Yoshiko Watanabe-Rögner, President of the German-Japanese Association for Culturally Sensitive Care, talks about goals, problem areas, and continuing education programs in the care field for people with a Japanese migration background.

Ms. Watanabe-Rögner, your association is committed to helping different cultures find common ground. What projects are you working on right now?

Yoshiko Watanabe-Rögner: We try to make daily life easier in Germany for Japanese people in need of care. There are presently only very few Japanese-speaking skilled experts but there is a rapidly increasing demand. Many Japanese people live in and around Düsseldorf. Yet there are very few Japanese-speaking health care professionals in this area. Unfortunately, there are even less Japanese health professionals in the rest of the country.

Even though our association is not able to train staff, we are able to train voluntary helpers. We are trying to establish a nationwide network of people who assist persons affected by dementia in addition to health professionals and family relatives. To implement this goal, we have launched several projects. What’s more, we also want to set up meeting places for Japanese people – among others, those suffering from dementia — to prevent social isolation of the affected persons.

What are the current problem areas when it comes to culturally sensitive care?

Watanabe-Rögner: We primarily need qualified professionals who speak Japanese to care for dementia patients. During the progression of the illness, people lose the ability to speak their second language of German. Even though the Japanese are well integrated into the German culture, — something that is also very important to them — they yearn for their own culture as they get older. This is even reflected in something as mundane as food. We notice with Japanese nursing home residents that they have a huge desire for a daily life that reflects a sensitivity to their culture. Yet to implement this, health care professionals need to become even more aware and more voluntary helpers need to be trained for this.

It is particularly difficult for young people from Japan to train as health care professionals in Germany or have the training fully recognized. Oftentimes, it all breaks down due to the language barrier since you need to be fluent in German. The grammar and pronunciation of the Japanese language are very different from German. Plus there are also many bureaucracy issues that need to be resolved. Right now, there is an acute information issue. Japanese health professionals who want to come to Germany don’t know how to have their Japanese health professional or nursing education fully recognized as well as where there is a need for them and in which cities they can work and assist older Japanese citizens. This is where "DeJaK" tries to help.

We are also pursuing a German-Japanese group home and are considering group residences for older Japanese people.

What are some continuing education options that explicitly address this topic?

Watanabe-Rögner: Health care students and trainees in Germany don’t learn Japanese and what explicitly distinguishes our way of life from others. Our Association and voluntary helpers try to bridge this gap.

Culturally sensitive care is an important part of our volunteer training course curriculum. We learn what’s important in German health care and where we can apply our volunteer work in collaboration with German health care institutions.

You are also active in the forum for cultural sensitivity and awareness in the care of older persons. A memorandum from the year 2009 mentions that the same treatment ignores differences while an equal and fair treatment requires a need and biography- centered care relationship. Can you explain this particular point in more detail?

Watanabe-Rögner: It is important that people are not being treated the same but rather as equals. Care facilities, in particular, need to address the special needs of people with migration background. After all, treating people the same would neglect their differences. This also includes understanding the language that residents speak. These skills need to be imparted in training and continuing education. The objective of the memorandum is to implement these goals.

What successes were you able to achieve so far with your work in this area?

Watanabe-Rögner: In 2012, we qualified so-called Caravan Mates. This system is very successful in Japan. These are individuals who train people in understanding dementia. In the space of eight years, the Caravan Mates in Japan were able to reach about seven million people with their work. It had a huge positive effect on society there and eliminated reservations about people with dementia. We had 50 volunteer Mates in Düsseldorf trained by coaches from the central agency in Japan so they are able to train and educate people about this disease here in Germany. Some of them are now also visiting the Netherlands, Denmark and Switzerland. Starting this summer, the Japanese project is scheduled to be included in the German health care system.

It is very difficult for a very small group of people with migration background – as us Japanese are – to grow old in a foreign country. As an association, we would like to see a direct contact person in the health care legislative and policy-making arena to be able to accomplish even more in the area of culturally sensitive care.