Question

GERMAN CASE STUDY Margaret Schmidt, a terminally ill 60-year-old American of German descent, was recently admitted to a hospice service and is receiving care at home. Diagnosed with metastatic breast cancer, Margaret’s prognosis is less than 6 months 7.How do you deal with cultural health practices unlike your own? 8.Discuss Margaret’s desire to control her life even through terminal illness. 9.Relate Margaret’s strong spiritual beliefs in an afterlife to her ability to cope with her impending death. 10.Describe a plan of care that is culturally sensitive to the patient and her family. 11.How can your knowledge of the German American culture positively influence health outcomes for Margaret? 12.Discuss the cultural filters you may use as you assist Margaret in her health-care decisions. 13.Describe the enculturation you, as a health-care professional, have experienced and how this influences your own health-care decisions.

Answer 1

ANSWER 7) As a nurse, we face patients who belong to varied cultural diversities. Not only cultural diversities but also diversities in race, gender, religion, values, ideas and beliefs do exist. Acccording to the code of ethics in nursing every patient should be considered as human and should be treated equally irrespective of the various diversities. Therefore while dealing with Marget who is undergoing a phase of terminal illness, should be considered with respect. Although her cultural health practices are unlike our own, every values, ideas and belief should be respected and one should pay attention towards her concerns and needs.

ANSWER 8) The person who is experiencing a phase of terminal illness will have to cope with stress and grief that is associated by the fear of death or willingness to live more. Margaret who have been controlling her life prior to illness still wants to continue to do so. Her behaviour predicts the use of defence mechanism to cope with the stressful situation. Being patient's care giver, Margaret should be allowed to make decisions and to control her life as her wish as she is nearing death. Her decisions should be respected and should be supported except if it do not cause any further deterioration to her condition. This will help her to adjust to the various changes that have been resulted from illness.

ANSWER 9) Margaret appears to be religious lady, who believes in a life after death. Although the terminal illness have put forward a great stress to be coped up with, her regious belief will support her emotionally and mentally to get prepared to face death. The prognosis of the disease have placed a challenge before Magaret who needs to develop the ability to cope with impending death. As per the religious teaching, the believe in after life is a hope to receive salvation and redemption from once sins. This strong belief will create a hope in the patient to have a peaceful experience with death and to cope with the situation.

ANSWER 10) As we are dealing with the patient who is of American German culture, an understanding about the cultural practices is important while developing a plan of care. The care plan should not violate any cultural belief of the patient and complete respect should be given to all her needs and concerns. Mainly supportive is planned for the patient with metastatic breast cancer who is near death. It includes mainly the five domains:

• Physical domain of care: Patient may experience chronic pain and other symptoms which may be acute requiring continous monitoring, interventions and rehabilitation. Adequate care should be given to ease her suffering and to reduce her ailments at the phase nearing death.
• Social domain: Care plan should deal with the social and political issues. Adequate social interactions, emotional support and financial concerns should be considered.Adequate social and family support will help her to cope with the changes in her lifestyle and body image.
• Psychological domain: care plan should provide opportunity to patient to express their concerns, fears and anxiety. It should focus on patient's mental health wellbeing and personal relationships, family support.
• Spiritual domain: should provide a moral support and giudance to develop positive hopes and help her to cope with this stressful event of life. Spiritual beliefs should be respected and should include the visit of religious leaders who have influence on patient's life.