Transcultural Perspectives in the care of Older Adults.
Read chapter 7 of the class textbook and review the attached PowerPoint presentation. Once done, read the following clinical case below and answer the questions;
Diabetes has been emerging as a major public health concern among Native American communities in the United States for the past 40 years. The Pima Indians in Arizona currently have the highest recorded prevalence of diabetes in the world. On average, American Indian and Alaska Native adults are 2.6 times more likely to have diabetes than non-Hispanic Whites of similar age. Diet is a key factor in controlling blood glucose levels and preventing serious cardiac, renal, peripheral vascular, and retinal complications such as heart attacks, renal failure, limb amputations, and blindness.
An Indian Health Service (IHS) nurse visits a patient in her mobile home, located on an Arizona Indian reservation. The patient is a 72-year-old, obese, female Pima Indian with a blood glucose level of 280. She is at risk for serious complications of type 2, or non–insulin-dependent, diabetes mellitus. With type 2 diabetes, the body either resists the effects of insulin or doesn’t produce enough insulin to maintain a normal blood glucose level. The patient lives with her adult daughter, two grandchildren, and five great-grandchildren. The nurse’s goals are to use culturally appropriate diet education to repattern the patient’s eating habits for the purpose of reducing the blood glucose level to normal (between 70 and 110 mg/dL); promoting steady sustained weight loss (5 pounds per week); encouraging increased exercise and activity. The nurse also asks the patient to participate in group sessions at the Pima Community Center focused on healthy food preparation and eating a balanced meal.
- If you were a nurse who just began doing home health care on the Pima Reservation, how would you learn about the specific cultural beliefs and practices related to nutrition and diet for this patient as a member of the Pima Indian Nation, versus stereotypes about the diet of Native Americans in general?
- Given that the patient’s family doesn’t own a vehicle, how will you encourage her to shop for healthy foods, prepare them, and actively participate in weight loss and exercise programs held free of charge at the Pima Community Center?
- How would you assess the patient’s eating habits, for example, type of food, method of preparation, amount eaten, etc.?
- Each of the patient’s children, grandchildren, and great-grandchildren is obese. How would you involve the patient’s family in the plan of care and motive them to lose weight as well?
APA format word document, Arial 12 font, A minimum of 700 words is required(excluding the first and reference page).
Expert Solution Preview
Introduction:
As a nurse caring for a 72-year-old, obese, female Pima Indian patient with type 2 diabetes, it is important to understand and respect her specific cultural beliefs and practices related to nutrition and diet. Additionally, considering the patient’s family situation, lack of transportation, and the presence of obesity among her family members, it is crucial to develop a comprehensive plan of care that involves and motivates the entire family. This essay aims to address the questions posed in the clinical case using evidence-based information and culturally sensitive approaches.
1. If you were a nurse who just began doing home health care on the Pima Reservation, how would you learn about the specific cultural beliefs and practices related to nutrition and diet for this patient as a member of the Pima Indian Nation, versus stereotypes about the diet of Native Americans in general?
To learn about the specific cultural beliefs and practices related to nutrition and diet for this patient, I would engage in cultural immersion experiences and seek guidance from cultural liaisons or community leaders who have an in-depth understanding of the Pima Indian Nation’s traditions and values. Additionally, conducting interviews and open-ended conversations with the patient and her family members would provide valuable insights into their dietary practices, traditional foods, and food-related rituals.
It is important to note that Native American tribes have diverse dietary practices and lifestyles, and generalizing them can perpetuate stereotypes. By focusing on the patient’s specific cultural background as a member of the Pima Indian Nation, I can better understand their dietary patterns, including the use of traditional foods, food preparation methods, and preferences. Respectfully exploring their unique cultural practices will enable me to tailor the patient’s care plan to align with their beliefs and values.
2. Given that the patient’s family doesn’t own a vehicle, how will you encourage her to shop for healthy foods, prepare them, and actively participate in weight loss and exercise programs held free of charge at the Pima Community Center?
Considering the lack of vehicle ownership, I would explore alternative transportation options available within the community, such as public transportation or community-based transportation services. Collaborating with local resources and community organizations could help arrange suitable transportation for the patient to access healthy food options and attend weight loss and exercise programs at the Pima Community Center.
Additionally, I would educate the patient and her family about the benefits of meal planning and budgeting to maximize their resources and make nutritious food choices. Guiding them to local farmers’ markets or affordable grocery stores would enable them to access fresh and healthy food options. Emphasizing the importance of involving the entire family in meal preparation and making it a shared responsibility can help motivate the patient and enhance adherence to the prescribed diet.
3. How would you assess the patient’s eating habits, such as type of food, method of preparation, amount eaten, etc.?
To assess the patient’s eating habits, I would employ culturally sensitive and non-judgmental communication techniques. Conducting open-ended interviews with the patient and her family members can offer valuable information about their food preferences, traditional dishes, portion sizes, and cooking methods. It is crucial to approach the assessment with cultural humility, respecting their unique dietary practices, and avoiding assumptions or judgments based on personal beliefs or values.
I would also utilize dietary assessment tools, such as food diaries or 24-hour dietary recalls, to gather detailed information about the patient’s daily food intake. This would help identify potential areas for improvement, such as excessive consumption of sugary or high-fat foods. Additionally, collaborating with a registered dietitian would provide valuable insights into the patient’s nutritional status and dietary needs, allowing for a more comprehensive assessment.
4. Each of the patient’s children, grandchildren, and great-grandchildren is obese. How would you involve the patient’s family in the plan of care and motivate them to lose weight as well?
Recognizing the familial obesity pattern, involving the patient’s family in the plan of care is vital for long-term success. I would start by fostering an open and non-judgmental conversation about the impacts of obesity on health and well-being. Educating the family about the intergenerational consequences of their current dietary habits and weight status would create awareness and motivate them to make positive changes together.
Implementing a family-centered approach, I would encourage the patient’s children, grandchildren, and great-grandchildren to participate in group sessions at the Pima Community Center focused on healthy food preparation and balanced meals. These sessions would not only provide a platform for learning but also create a supportive network where they can share experiences, tips, and success stories. Additionally, organizing family-oriented physical activities and exercise programs, such as walking groups or family sports events, could promote a positive mindset towards a healthier lifestyle.
Regular follow-up appointments and ongoing support would be essential to track progress, address barriers, and provide continual encouragement to the patient and her family. Collaboration with other healthcare professionals, such as social workers or psychologists, might be beneficial in addressing any underlying psychological, emotional, or socioeconomic factors influencing their dietary behaviors.
Conclusion:
Culturally sensitive care is crucial when addressing health issues among individuals from diverse backgrounds. For this patient, understanding her specific cultural beliefs and practices related to nutrition and diet as a member of the Pima Indian Nation is fundamental to provide effective care. Furthermore, involving the patient’s family and tailoring interventions to their unique circumstances can enhance motivation and improve long-term outcomes. By integrating cultural competence into nursing practice, healthcare providers can ensure holistic care for older adults from transcultural perspectives.
