New Directions in Geriatric Behavioral Health: Serving Older Persons of Different Cultures The Mental Health Association of Southeastern Pennsylvania

Latinos are united by a common language. Latinos or Hispanics have some differences, but generalizations can be made. Certain attitudes and values are common in Latino culture.

• Familalism.
• Simpatia.
• Personalismo.
• Respeto.
• Religion.

(Sue & Sue, 1990).

In Latino cultures the elderly are believed to have inner strength. The elderly also consider themselves to be important members of the family and not ashamed to ask for help (Holmes & Holmes, 1995; Paz, 1993).

Latino elderly continue to occupy a central role in the family and are treated with respect (respeto), status (su lugar), and authority (su experiencia y sabiduria) (Paz, 1993).

Frequent visits by children play a major role in caring for the aging and providing assistance. This is particularly true for daughters. Older women expect to be taken care of during old age by the adult children. The assistance by the children is expected and does not result in diminished feelings of self-worth (Holmes & Holmes, 1995; Paz, 1993).

When a parents' condition severely deteriorates formal services may be used by the family. Institutionalization, however, is rare (Holmes & Holmes, 1995).

Mental disorder (enfermedad mental or crisis nerviosa or ataque de nervios in English nervous crisis) is less severe than being "insane" (estar loco). Nervios is a culturally acceptable and nonstigmatizing term for distress and illness among Latinos. If a person is loco then they have a complete loss of control or withdrawal (Paniagua, 1994).

• In Latino cultures depression manifests itself in physiological symptoms. Headaches. (Kaiser, Katz, & Shaw, 1998).
• Delusions and hallucinations more likely to take the form of ghosts, spirits, or animals. Often incorporate elements of cultural myths, legends, and beliefs into their delusions.
• Latino schizophrenics tend to have a later age of onset and exhibit more somatization (Esobar, Randolph, & Hill, 1986).
• Teatment for Latinos consists of traditional healing practices, Western medicine, and therapy (Trevino & de Viesca, 1995). Latinos as a group, however, appear to be reluctant to seek mental health services.
• The acceptable pattern of behavior is to handle one's problems discreetly from within the family (Casas & Vasquez, 1996). When help is sought, the family is also included in the therapy (Paniagua, 1994).
• The cultural value of respeto may lead Latino women to feel that it is not acceptable to voice opinions that conflict with others who are relationally significant to them or in "authority" positions (Ginorio, Gutierrez, Cauce, & Accosta, 1995). This obviously may interfere with necessary self-disclosure.
• Males may believe that talking about problems with others is a sign of weakness (Wing Sue & Sue, 1990).-Adults, specially males, delay getting professional help until the problems have become more complicated and severe (Trevino & de Viesca, 1995).
• Curanderismo, a Hispanic folk healing belief system, is the basic idea that life is holistic and no artificial boundaries between mind and body exist. Ailments are treated with a combination of psychosocial interventions, mild herbs, and religion (Trevino & de Viesca, 1995).
• Espiritism (spiritism) is seen as both a cause and a treatment to some Puerto Ricans. The espiritista is an accessible "treater" of mental illness, charges reasonable fees, offers solutions, speaks the same language as the client, and includes the extended family in the healing process (Canino & Canino, 1993).

References

Canino, I.A., & Canino, G.J. (1993). Psychiatric care of Puerto Ricans. In A.C. Gaw (Ed.), Culture, ethnicity, and mental illness (pp.467-489). New York: Wiley.

Casas, J.M., & Vasquez, M.J.T. (1996). Counseling the Hispanic. In P.B. Pedersen, J.G. Draguns, W.J. Lonner, & J.E. Trimble (Eds.), Counseling across cultures (pp. 146-176). Thousand Oaks, CA: Sage.

Esobar, J.I., Randolph, E.T., & Hill, M. (1986). Symptoms of schizophrenia in Hispanic and Anglo veterans. Culture, Medicine, and Psychiatry, 10, 259-276.

Ginorio, A.B., Gutierrez, L., Cauce, A.M., & Acosta, M. (1995). Psychological issues for Latinas. In H. Landrine (Ed.). Bringing cultural diversity to feminist psychology (pp. 241-263). Washington: American Psychological Association.

Holmes, E.R., & Holmes, L.D. (1995). Other cultures, elder years. Thousand Oaks, CA: Sage. Kaiser, A.S., Katz, R., & Shaw, B.F. (1998). Cultural issues on the management of depression. In S.S. Kazarian & D.R. Evans (Eds.), Cultural clinical psychology: Theory, research and practice (pp. 177-214). New York: Oxford University Press.

Paniagua, F.A. (1994). Assessing and treating culturally diverse clients. Thousand Oaks, CA: Sage.

Paz, J.J. (1993). Support of Hispanic Elderly. In H. McAdoo (Ed.), Family ethnicity (pp. 177-190). Newbury Park, CA: Sage.

Trevino, C.V., & de Viesca, M.R. (1995). Ancient beliefs and psychiatry in Mexico. In I. Al-Issa (Ed.), Handbook of culture and mental illness (pp.231-238). Madison, WI: International Universities Press.

Wing Sue, D., & Sue, D. (1990). Counseling American Indians. In Counseling the culturally different: Theory and practice (pp. 175-188). New York: Wiley.

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