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Transcultural Perspectives in Older Adults’ Care
Question 1
In developing a home care plan for a chronically ill 82 years old man living in a single-room hotel, the nurse must assess and consider a number of factors. The factors that the nurse must consider include resources available to the patient, their needs and limitations that would affect care while living at home. First, the nurse should assess the cultural values practices and availability of community resources. The presence or absence of formal and informal resources in the city will influence the client’s access to healthcare services. Cultural values such as those influencing the patient’s typical family structure will also affect their access to care. For example, Hispanic families tend to live together which means the sick and the elderly can be taken care of by members of the extended family (Miyawaki, 2016). The nurse should also consider social economic factors that affect access of the patient to care. It is important to understand whether the patient has enough money to sustain him at the hotel room and cater for health needs. For example, the nurse should assess whether the patient can afford home care services for his condition.
The nurse should assess resources based on the needs and limitations of the patient. The needs of the patient determine the type of resources and help that should be available to them. The nurse should assess both the healthcare and social needs and understand how they maybe affected by culture. For example, a diabetic patient may need access to a pharmacy or clinic where he can get insulin shots. Logistical factors such as transportation and language interact to determine access to healthcare by an elderly person. For example, the patient may need emergency treatment while staying at the hotel. The nurse should hence consider the presence of emergency transport or care in around the hotel. Cultural limitations may also affect the access to care for the patient while staying at the hospital. For example, among African American cultures, an elderly male should be taken care of by a male care taker (Bamidele et a., 2019). In such a case, the patient maybe limited if there are no male caretakers in the hotel.
Question 2
In conducting health assessment in order to develop a culturally appropriate care plan for Filipino and Chinese American clients, there are several key sets of information that a nurse should collect. First, the nurse must assess the influences of culture on how the people view aging. For example, cultural differences may define need for help among the elder (Andres & Bolye, 2016). Culture also determines whether an old person seeks traditional healthcare practice or family remedies. For example, among the Chinese there is a simultaneous use of western and traditional health practices such as focusing on the restoration or harmony and balance between the body and spirit (Andres & Bolye, 2016). A nurse should seek to establish whether the patient uses traditional healthcare practices as a result of cultural preference or due to inadequate access to biomedical therapy. Another factor to consider in the assessment is the cultural values in regard to family. Chinese and Filipino tend to live in a family setting made of nuclear and extended families rather than isolated (Miyawaki, 2016). As such, the nurse should enquire about the living situation at home. Unlike non-Hispanic whites, Filipino and Chinese elderly may prefer to live at home with their families than in a home for the elder. Also, due to the relatively limited numbers of Filipinos in the US, a nurse must also seek to understand the patient’s preferences in environment for care. For example, the nurse may try to connect the old adult with other people from his home country. In this case, an understanding of logistics such as the ability to make it to the venue for meeting is relevant.
Question 3
In acute care setting, nurses should understand that the patient’s view of illnesses are influenced by their cultural background. For example, pain is experienced based on the cultural experiences. As such, the nurses should assess each patient’s pain tolerance, past and present experience with pain, effect of pain on their quality of life, and their understanding of what pain means (Andres & Bolye, 2016). The nurses should also assess the patient’s expectations for the treatment of the pain. In the subacute unit, the nurses should seek to understand types of treatment that patients expect for management of pain. Patients may prefer traditional methods for the management of pain which would inform the nurse on the treatment modality to use. For example, Chinese people often prefer massage therapy to pharmacological methods of pain relief (Zhang et al., 2017). After proper assessment, the nurse may opt to integrate the preferred remedies of pain with western medicine to obtain optimum result. However, it is only through proper consultation with the patient that a quality option can be acquired. As such, the nurse manager should impart the skills for assessment of cultural based experience of disease and pain to effectively produce quality result in the subacute care.
References
Andres, A.M. & Bolye, J.S. (2016). Transcultural Concepts in Nursing Care (7th ed.). ISBN 978-1-4511-9397-8
Bamidele, O., Lagan, B. M., McGarvey, H., Wittmann, D., & McCaughan, E. (2019). “… It might not have occurred to my husband that this woman, his wife who is taking care of him has some emotional needs as well…”: the unheard voices of partners of Black African and Black Caribbean men with prostate cancer. Supportive Care in Cancer, 27(3), 1089-1097.
Miyawaki, C. E. (2016). Caregiving practice patterns of Asian, Hispanic, and non-Hispanic white American family caregivers of older adults across generations. Journal of cross-cultural gerontology, 31(1), 35-55.
Zhang, B., Xu, H., Wang, J., Liu, B., & Sun, G. (2017). A narrative review of non-operative treatment, especially traditional Chinese medicine therapy, for lumbar intervertebral disc herniation. Bioscience trends, 11(4), 406-417.
