GRAPEVINE, Texas — When Ann Aikens, a certified case manager from Torrance, California, assesses a patient for the first time, she gathers a wide range of data. That information can include age, ethnic background, cultural barriers, physical needs, family dynamic and much more as she determines how to best advocate for the patient seeking medical care. With the unending shifts in healthcare policies and culture, it’s a constant puzzle with a limited amount of time to solve.
To learn how to adapt to ever-changing demands, case managers like Aikens gathered Thursday at the Gaylord Texan for the Commission for Case Manager Certification's New World Symposium. Allison Hickey, owner of All In Solutions LLC, led a session on cultural awareness and caring for those in need.
Starting with a practical exercise, Hickey asked everyone in the room to find a partner to conduct a one-minute assessment on. From that minute, Hickey asked if audience members picked up on specific information about their partner.
Did they know if the person is a first-generation immigrant? Did they know if he or she is affiliated with a helpful church? Did they know if the person is a caregiver for a special needs spouse or child?
While the expectation isn't to have all the answers in one minute, Hickey encouraged the audience to start exercising their "sensor" muscles by focusing on three different factors: me, you and culture.
When it comes to "me," self-awareness is the first step. Hickey stressed knowing one's own inherent biases.
"Acknowledge them," she said. "You may not be able to change them … but you at least know them so you can check them every time you are meeting with someone."
She then directed attention toward how one should approach patients and the importance of being authentic. When you are authentic, you get to people's authenticity faster because patients will open up by the nature of your authenticity. As one engages patients, Hickey said people can tell whether you genuinely care about them, so it's important to show this to patients and build trust over time.
Hickey also recommended knowing the demographics of the community in which one serves. If this information isn't known, there's always the internet. Case managers can check the Census Bureau website to find appropriate data on their area. From there, case managers can conduct a search based on state or zip code for demographics.
In addition to sharing practical ways to improve one's ability to assess and respond to patients, she also provided a snapshot of the current climate. Even if new limits are placed on immigration based on current policy discussions, Hickey said ethnic populations in the U.S. will still continue to grow.
"We are becoming more diverse and there’s no way to stop it," Hickey said. "We have to learn how to operate in this environment and that's what it's all about."
She also noted the increase in diversity is evident among aging veterans as well, with a much greater female population representing this group. This has been a large shift for the VA as more focus is placed on the medical needs of women.
One graphic that was highlighted showed an average of 2,979 immigrants added to the U.S. population each day. Immigrants are also arriving with higher levels of education, with about half speaking English. However, the struggle will be in communicating health information through the children of immigrants.
The challenge is you'll have a 13-year-old explaining to his mom, dad or grandparents why they have to take their blood thinner, she said.
Another trend is a move of ethnic groups and veterans toward the West and Northwest areas and places that are more rural, which will provide transportation issues if services such as Uber or a public transportation system are lacking.
Hickey ended by sharing two free resources to better equip case managers.
One was the National Resource Directory at www.nrd.gov. From there, Hickey said to reach out through the "contact us" page. According to their website, the NRD "is a resource website that connects wounded warriors, service members, veterans, their families and caregivers to programs and services that support them."
She also suggested Googling specific questions about people's situations, starting with, "What should I know about working with ..." and putting in different scenarios. Just double-check sites to make sure they're reputable, she added.
For case managers who attended such as Aikens, it was a good reminder that the demographics they are working with are constantly moving, so there will be a need to know more and more with the inevitable changes.