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Supported by DHHS/HRSA/BHPR/Division of Nursing Grant #D62HP06858

Cultural Diversity

ELDER ProjectFairfield University School of Nursing

Asian Indian Culture


Asian Indian CultureObjectives: Upon completion of this session,

the participants will be able to ….Discuss the role of religion, traditional health

care beliefs, social values, and family structure of Asian Indian culture and the impact these factors have on health care.

Identify specific culturally sensitive practices that can be incorporated into your work with Asian Indian patients and Asian Indian American patients.


Asian Indian CultureIntroduction:The Asian Indian culture is a complex and diverse ancient

culture. Indian Americans, known more commonly as Asian Indians,

makeup the largest subgroup of South Asians consisting of people from India, Pakistan, Bangladesh, Nepal, and Sri Lanka.

They may refer to themselves as East Indians or Indo-Americans.

Their immigrant communities share some common cultural, social and linguistic characteristics and are often grouped together.

Some immigrants from the Caribbean, East Africa and Fiji also identify themselves as South Asian.


Asian Indian CultureIntroduction:While the majority of this discussion will focus on

those people from India, the surrounding nations have a mixture of cultures that include a mixture of religious beliefs. The discussion will center on Hinduism with

some reference to Buddhism, where appropriate.


Asian Indian CultureIndia Muslim

13.4%Hindu 80.5%Christian 2.3%Sikh 1.9%

PakistanMuslim 95%

Hindu 5%

Bangladesh

Muslim 89.5%

Hindu 9.6%


Asian Indian CultureSri Lanka

Muslim 7.6%

Hindu 7.1%

Christian 6.2%

Sikh 0%

Buddhist 69.1%

NepalMuslim 4.2%

Hindu 80.6%

Christian 0%

Sikh 0%

Buddhist 10.7%

Kirant 3.6%


Asian Indian CultureCommunication:The major language is Hindi; however English is

commonly used in many areas of life.Most Asian Indians are bilingual or multilingual.Eighteen languages are recognized in India.

Use of formal titles is expected (Mr. and Mrs.) until told otherwise.Addressing people older than you by their first name

alone is disrespectful.


Asian Indian CultureCommunication:Embracing members of the opposite sex is

unacceptable; however it is acceptable with members of the same sex.

Public displays of affection are not encouraged.Direct eye contact is limited.Traditional Indian greeting is “namaste” which is

uttered while joining palms together as if in prayer under the chin slightly nodding the head and looking down.


Asian Indian CultureFamily and Social Structure:Several generations will live in the same

household sharing a common budget.Older Asian Indians may be financially dependent on

their children.Grandparents play a role in raising children and

are highly respected and form a link to Asian Indian culture and heritage.

Respect is important and old age signifies wisdom.Strong family bonds exist with a close knit family

structure.


Asian Indian CultureFamily and Social Structure:Asian Indians practice patriarchal extended

families.The head of the house is the senior male, who also

makes all the decisions.In the US, the American Asian Indian tends to be

more a nuclear family.Joint families are temporary; once they are self-

sufficient they move out.


Asian Indian CulturePersonal Hygiene:Modesty is highly valued.Showers are more the norm as tub baths are seen

as unsanitary. The focus on bathing is being clean rather than on

eliminating body odors.Using deodorants is not a common practice.Odors are not seen as potentially offensive.


Asian Indian CultureView of Illness:Health is related to connectedness of the body, mind

and spirit.Mental illness is concealed and often presented as

somatic complaints.The elderly focus spiritually in preparing the soul for

life after death.Pain and suffering are viewed as due to bad karma

from a past life or past actions.Illness may be seen as something to be accepted and

endured rather than fixes or cured. Consequently Asian Indians may be stoic in their

expression of pain.


Asian Indian CultureView of Illness:The Asian Indian respects authority of the healthcare

provider and feels their own role is passive.They will not ask a lot of questions as this is viewed as

impolite.They would rather ignore suggestions if they do not

agree, which may result in missed appointments or excuses for not following the plan of care.

Offering a variety of treatment choices can make the physician seem incompetent as it is expected that the physician be confident.

Family and friends may want to provide personal care when in the hospital.


Asian Indian CultureFolk Medicine:Tend to use home remedies such as massage, ritual

bathing and herbal medicine before seeking a physician.Physicians are only sought for serious illnesses.The Asian Indian is less open to homecare or long term

care for elders.When caring for the ill, they will utilize behaviors such as:

ritual chanting by priests tying a thread around the sick person’s wrist writing protective verse and wearing it in a metal cylinder

around the neck or wrist promising temple god gifts if they recover


Asian Indian CultureFolk Medicine:Ayurvedic medicine is the traditional Indian

system of medicine. (ī'yər-vā'də, -vēc‘)Translated it means the meaning of the knowledge

of life.Relates to the complete human being, body, mind,

senses and soul. Focuses on attaining balance between the physical,

mental and spiritual.


Asian Indian CultureFolk Medicine:Ayurvedic Medicine

The belief is that every individual is made up of three doshas (fire, wind and water) that represent certain bodily activities.

Ayurveda uses specific lifestyle and nutrient guidelines to help decrease the dosha that has become excessive.

Mercury and sulfur based medications and herbs are used to treat ailments and emetic herbs to maintain body homeostasis or balance.

Surgical techniques are also used and are aimed at preserving life and promoting well-being.


Asian Indian CultureFolk Medicine:Unani (or Yunani) Medicine:

Can be traced back to HippocratesBased on the ancient Greek theory of four basic

elements (air, earth, fire and water) and four bodily humors which determine one’s temperament and health - blood, phlegm, yellow bile and black bile.

When a person is in perfect balance - a person is healthy.Treatment is aimed at restoring natural balance by

dietary modifications. The use of ripening, purging, cupping, sweating,

diuresis, herbal bath therapy, massage and exercise is common as well.


Asian Indian CultureFolk Medicine:Siddha Medicine:

One of the oldest systems of medicine in India.Has close similarity to Ayurveda, with specialization

in Iatrochemistry (seeking chemical solutions to disease and medical aliments).

According to this system, the human body is the replica of the universe and so are the food and drugs irrespective of their origin.

Uses calcined metals and mineral powders to heal illness.


Asian Indian CultureNote:Though categorized under Folk Medicine,

Ayurveda, Unani and Siddha Medicines are practiced medical systems supported and promoted by the government in India.


Asian Indian CultureDietary Habits:Dietary staples include rice, grains and breads.Many are vegetarians or vegans.

Have diets rich in carbohydrates, poor in protein and deficiencies in calcium.

If they do eat meat, it usually is not beef (Asian Hindus).The cow is recognized as a life giving role:

producing dairy products pulling plows fertilizing fields

Gelatin based products are avoided because the processed collagen comes from cows or pigs.


Asian Indian CultureDietary Habits:Asian Muslims do not eat pork and consume halal

foods which are religiously accepted.Lactose intolerance is very common in the older

person.Fasting is common; believe it improves the

welfare of the family.Chew betel leaves because they act as anti-

flatulent and anti-inflammatory.Often chewed with tobacco, which can lead to oral

cancer.


Asian Indian CultureDietary Habits:Use a lot of spices:

Curcumin is an active ingredient in turmeric, a key ingredient in Indian curry that has anti-inflammatory and antioxidative properties.

Thought to be a protective factor in the aging brain and dementia.

Eating and drinking from another person’s plate or glass or using dishes that have been used by someone else is not acceptable.


Asian Indian CultureTime Orientation:Believe things will happen when they have to

happen. Bulk of Indian population live in villages or in

the country and time is measured by seasons instead of dates and watches.


Asian Indian CultureReligious Beliefs:Religion is central to the way of life.80% Hindus:

Believe everyone goes through a series of births or reincarnations that eventually lead to spiritual salvation.

With each new birth, one moves towards enlightenment. Believe in a cast system.Other religions include:

Muslim, Christianity, Jainism (nonviolence towards all living creatures) Buddhism Sikhism (intended to bring the best of Hinduism and Islam

together)


Asian Indian CultureReligious Beliefs:Hindu religion has aspects that affect health care

decisions:“Karma” involves the actions of past life that affects

circumstances in which one is born and lives in this life.

Often believe illness is caused by Karma and that every action leaves an imprint on one’s soul and spirit.

Believe good actions produce good results and bad actions produce bad results.

Karma greatly influences the patient’s world view of health, death and dying and model of illness.


Asian Indian CultureReligious Beliefs:Hindu religious paraphernalia include:

Mangalsutra - a 9 sacred necklace which is worn by a married woman.

Women also may wear a bindi or tilak (dot on forehead).

Other symbols of marriage are bangles and toe rings.

Men wear a sacred thread around the torso. Both sexes may be reluctant to remove these items.


Asian Indian CultureReligious Beliefs:Buddhism adheres to non-violence and advocates

giving up worldly desire to attain nirvana (salvation).Believe in four truths:

Life leads to suffering, Suffering is caused by desire, Suffering ends when you give up desire and attain

enlightenment, Reaching this state is achieved by the eight fold path.

Sikh men do not cut their hair and wear a bracelet and a truban.


Reference About the Systems. Retrieved on March 10th, 2010 from

http://indianmedicine.nic.in/index.asp?lang=1 . Asian Indian Culture:Influences and Implications for Health Care. Retrieved March 10th,

2010 from http://www.molinahealthcare.com/medicaid/providers/common/pdf/asian%20indian%20culture%20-%20influences%20and%20implications%20for%20health%20care_material%20and%20test.pdf?E=true.

Health and Healthcare of Asian Indian American. Retrieved December 18, 2010 from

http://www.stanford.edu/group/ethnoger/asianindian.html . The World Factbook: South Asia: India. Retrieved March 25th, 2010 from

https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html . Periyakoil, V.J. and Dara, S. (2010). Health and Healthcare of Asian Indian American Older

Adults. Retrieved February 5, 2011 from http://stanford,edu/ethnomed/asian_indian.

Working with People with Disabilities: An Indian Perspective. Retrieved December 12, 2010 from http:// cirrie.buffalo.edu/cultural/monographs/India.php.

http://indianmedicine.nic.in/index.asp?lang=1

http://www.molinahealthcare.com/medicaid/providers/common/pdf/asian%20indian%20culture%20-%20influences%20and%20implications%20for%20health%20care_material%20and%20test.pdf?E=true



http://www.stanford.edu/group/ethnoger/asianindian.html

https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html


Power Point Presentation Created by:Joyce Cunneen, MSN, RNFairfield University School of NursingELDER Project Education Coordinator

Monica Starr, BSN, RNFairfield University School of NursingELDER Project Program Coordinator

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