Cultural Sensitivity Speeds Up Recovery

Jane Danner, Director of Resident Engagement, Volunteers of America

Lovers have long insisted that home is where the heart is. It also may be where the health is.

The international journal Building Research and Information published a meta-study in January 2018 examining the relationship between “healing-built environments” and health outcomes. Upon reviewing 127 papers, the authors concluded that the environments conducive to healing share three home-like attributes: comfortable, well-functioning, and relaxing.

Of course, many patients’ medical needs prevent them from receiving care at home. That’s why healthcare providers like The Allure Group, which operates six senior-focused rehabilitation and recovery centers in New York City, are building the next best thing: facilities that mimic home for a wide range of patients.

“We see seniors from an incredible array of cultures,” The Allure Group CEO Joel Landau says. “We realized that if we weren’t catering to those cultures in our care environments, then we weren’t really doing all we could to help patients recover.”

One of The Allure Group’s most popular home-like programs is Longevity Garden. Designed for patients of Asian descent and staffed by speakers of various Chinese dialects, Longevity Garden hosts Mahjong games, serves authentic Chinese cuisine, and provides access to Chinese television and news media. Featuring soft hues, natural wood, and traditional Chinese decorations, the space feels closer to a living room than a doctor’s office.

Additionally, The Allure Group’s King David Center and Bedford Center offer rabbinical services and prayers, a Kosher menu, Shabbat dinners, and special holiday services for its Jewish residents. Its Romashka Gardens at the same center draw upon the many memories, activities, and sensory experiences familiar to patients of Russian descent with staff that speak their language and understand their customs, as well as authentic Russian/kosher cuisine prepared and served daily and Russian publications and television channels available at any time. All of these efforts help patients feel “at home” when they can’t be.

Trappings of a healthy home

Seniors in The Allure Group’s rehabilitation centers can count themselves lucky that they have access to home-away-from-home rehab and recovery facilities. For everyone else, the Building Research and Information study hints at a few factors that may help to re-create the comfort and healing prowess of the home environment:

Artwork: Sick or not, almost all of us would rather stare at a Picasso than a blank wall. But art does more than alleviate boredom: Multiple studies show that it actually improves well-being. In fact, the famed Cleveland Clinic recently found that 61 percent of patients who engaged with the hospital’s contemporary art collection reported a reduction in stress, and 39 percent reported it improved their comfort or pain level.

When looking for or recreating a home-like care environment, don’t get too hung up on the style or value of the art. The real question: Does the space inspire, intrigue, and relax you? Children’s art, impressionist paintings, and nostalgic photographs can all create a cozier, healthful care space.

Music or ambient sound: Everyone’s home sounds a little different. To some, it’s birds chattering outside the window. For others, it’s improvised jazz piano playing quietly in the background. For still others, it’s The Rolling Stones belting out “Beast of Burden.” Whatever it is, it’s the sound of nostalgia and respite. In fact, the healing power of music may be even more well-established than art’s. A 2017 study published in Musical Offerings found that music can help heal both mental and physical ailments. Particularly for those who’ve suffered a traumatic brain injury, such as a stroke, music supports motor function and improves visual awareness. Music can also enhance verbal communication and reduce anxiety, the study found.

Social support: If home can be defined by a single element, it’s the presence of friends and family. Social interaction is critical for mental and physical health, yet hospitals and clinics often struggle to create community within the facility. Patients’ friends and family are allowed to visit, but they cannot be there all the time. Curated communities can fill this gap. The Allure Group’s 52-bed Salud Latina, for example, gives Hispanic seniors a home away from home. Decorated in a colorful hispanic style, it features a large selection of Spanish publications, religious services, and cuisine options.Finding an inclusive home can be especially difficult for LGBT seniors.

Many folks who live out and proud lives for years are forced to return to the “silver closet” after moving to a senior care environment that’s less accepting of who they are. In fact, more than 75% of LGBT seniors say they fear entering a long-term care facility because of how they might be treated. Volunteers of America, a leading nonprofit provider of affordable senior housing and assisting living, sought to overcome this barrier to housing and care by tailoring its senior support services to the needs of LGBT residents. The organization developed an award-winning diversity training program now used by staff at dozens of long-term care and senior housing communities across the country. Volunteers of America was the first major long-term care provider to provide such training. In addition, measures taken by Volunteers of America to be more inclusive include updating terminology on forms and assessments to accommodate same-sex couples and transgender individuals; obtaining supportive resources specific to LGBT older adults; and featuring same-sex couples more prominently in marketing materials.

Scent: We grow accustomed to the scent of our home. We may forget it until we return from a week at the beach, but it welcomes us back, just like our creaky floors and family photos do.

Scent may still be a bring-your-own matter at most care facilities, but hospital surgical units are increasingly turning to aromatherapy for its ability to reduce stress, mitigate nausea, and even manage pain. Research supports sage for blood-pressure reduction, peppermint for stress relief, and rosemary for cognitive stimulation.

Interior design: The care space itself plays a surprising role in the wellbeing of those living in it. Environmental psychologist Roger Ulrich, in a landmark 1984 study, found that a window view can improve surgical patients’ recovery time. Since then, organizations like the Vermont Psychiatric Care Hospital, which sought to reduce patient aggression by patterning its interior after the Vermont landscape, have designed their facilities with home in mind.

Of all the factors listed here, the look and feel of a care space may be the most difficult to match with a home environment. Chances are the furniture, fabric, and flooring won’t be the same. Instead, look for cues: a pattern reminiscent of a favorite sofa, a living space as open as a typical living room, a window seat ripe for reading.

Healing doesn’t happen in a day, and it doesn’t happen in a vacuum. A recovering mind or body must eat, play, and live while mending itself. The comforts of home — the sounds, scents, spaces, scenes, and people — don’t just make that process more enjoyable; they support and speed it along.

- Jane Danner is the director of resident engagement at Volunteers of America and this article first appeared McKnight's Long-Term Care News.