Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:

• Do you agree with your peers’ assessment?
• Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
• Share your thoughts on how you support their opinion and explain why.
• Present new references that support your opinions.

Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Be sure to review your APA errors in your reference list, specifically you have capitalization errors in some words of the titles.Include the DOI. Also, be sure you are italicizing titles of online sources.No more than 200 words maximum.

These are the questions my peers had to answer:Review the assessment of cultural and social factors relevant to the geriatric client.In your initial post, relate a client scenario that you recently encountered that brought out the importance of this assessment.Review the literature, and evaluate three evidence-based articles that support your findings from the assessment.In subsequent posts,provide consultation to your fellow students.

Sara’s Response:

Cultural and Social Factors

Assessing cultural and social factors are imperative in all populations, but deserve additional attention in the older population. Ageist stereotypes, prejudice, and discrimination are potential barriers for health equality, in terms of the quantity and quality of care provided to older patients and their health-related outcomes (Wyman, Shiovitz-Ezra, & Bengel, 2018). Ageism provides people with a rationalization for not valuing or taking elders seriously because of perceptions associated with aging. Often times, “old age” can be used as an excuse for common health complaints among the elderly population both by both providers and patients alike. One recent qualitative study on back pain, which is one of the most common medical conditions among older adults, found that many older patients believe that pain is a “normal” part of old age and to be expected (Makris et al. 2015). This poses a great concern for providers because older patients will often not seek medical evaluation for these physical ailments. Elders are less likely to seek treatment for unmet medical needs, due to low expectancies of being helped because of their advanced age (Wyman, Shiovitz-Ezra, & Bengel, 2018). These situations can be chalked down to common bias about the elderly population being frail and interdependent. A culturally-sensitive approach to caring for the elderly population promotes independence and autonomy, which is something that this population often struggles with as the body ages and becomes less resilient. Understanding the patient’s underlying values, beliefs, and identities can help establish provider awareness of each individual as a unique, aging patient. The older patient`s home, cultural landscape, employment history and mother tongue are important for an elderly`s subjective health history and their individual assessment of quality of life (Minde , 2015). Not only does this establish a relationship and connection with the patient, but displays a sense of respect while avoiding stereotyping. The culturally competent health worker needs to understand his/her views of this population, as well as those of the patient, while avoiding stereotyping, ageism, and misapplication of knowledge (Minde , 2015).

Client Scenario

I had the pleasure of caring for a Hispanic eighty-eight-year-old female who was brought into the hospital by her granddaughter after staying at home for the past two days with right-sided upper extremity paresthesia and neck pain. This patient became a stroke alert, due to the paresthesia presentation in the emergency department. She was consequently educated on stroke-like symptoms and possible treatment options for stroke. When asked why she did not call for emergency help, she persisted to respond that she was “old and did not want to be treated because she was old”. So, although she ended up have cervical radiculopathy, she equated her symptoms to a “normal” aging process and expected health deteriorations as a natural part of life. Her granddaughter further explained that she was the matriarch of the family and was expected to “be strong” and not seek medical help for “getting older”. Working with racial/ethnic groups such as Latinos requires knowledge of additional diversity factors such as acculturation and familial structural beliefs that can have direct influence on aging issues, end-of-life concerns, and physical illness (Tazeau, 2018). This challenges providers to have multicultural knowledge on how to address health concerns, advocacy, and health promotion in a culturally competent, gerodiverse manner.

References

Minde , G. (2015). A culturally-sensitive approach to elderly care. Journal of Gerontology &

Geriatric Research, 4(241). doi:10.4172/2167-7182.1000241

Tazeau, Y. N. (2018). Multicultural aging. Retrieved from https://www.apa.org/pi/aging

/resources/guides/multicultural

Wyman, M. F., Shiovitz-Ezra, S., & Bengel, J. (2018). Ageism in the health care system:

Providers, patients, and systems. Contemporary Perspectives on Ageism, 19, 193-212.

Retrieved fromhttps://link.springer.com/chapter/10.1007/978-3-31…

Nora’sResponse

In order to provide culturally sensitive care to the elderly population, or any population, it is important to have a clear understanding of their beliefs, as well as their “culturally specific incidence and prevalence of health conditions” (Mareno & Hart, 2014). As part of our health assessment, based on a patient’s culture, we are more likely to expect certain illnesses that lead us to direct our health promotion and provide care. Because the elderly are classified as a frail population and the number of older Americans is increasing each year, it is important that those caring for them can meet their needs. Ideally, they would stay in their homes and care for themselves as long as possible (O’Donoghue, Botha, & Van Rensburg, 2014). However, caregivers may mention that tasks of normal daily living are becoming more and more difficult. In my clinical rotation, we had an 82-year-old patient that was very realistic about what he thought he could and could not do following his proposed surgery. It was encouraging and heartbreaking at the same time to hear he and his wife discussing what they thought they could manage at home and then coming to the decision, that as much as it was not their first choice, they knew he would need to go to a rehabilitation facility following surgery. I am sure that this was a difficult choice to make, but both of them knew that for the best possible outcome, due to her failing health as well, he would need a brief stay away from home. As a practice, we were able to be sensitive to these issues and plan for the safest possible discharge plan to eliminate other complications. Key areas of providing cultural and socially sensitive care include open communication between the provider and patient, setting plans for what each persons expectations are for the situation at hand, and understanding that not all patients have the same beliefs, but we have to support those of each patient we are with related to culture (O’Donoghue, Botha, & Van Rensburg, 2014). Because our population is growing older each year, it is more important that ever for us to be prepared for those we will care for. “Nurse practitioners care for patients from a wide variety of cultural backgrounds, and in order to deliver high quality primary care that is meaningful, effective, and cost effective, these providers must develop a greater understanding and appreciation of the social-cultural background of clients, their families, and the environment in which they live” (Elminowski, N., 2015).

Reference:

Howard, B. S., Beitman, C. L., Walker, B. A., & Moore, E. S. (2016). Cross-cultural Educational Intervention and
Fall Risk Awareness. Physical & Occupational Therapy in Geriatrics, 34(1), 1–20.
https://doi.org/10.3109/02703181.2015.1105344

Mareno, N., & Hart, P. L. (2014). Cultural Competency Among Nurses with Undergraduate and Graduate
Degrees: Implications for Nursing Education. Nursing Education Perspectives (National League for
Nursing), 35(2), 83–88. https://doi.org/10.5480/12-834.1

O’Donoghue, C. E., A. D. H. Botha, and G. H. Van Rensburg. 2014. “Culturally Diverse Care for Older Persons:
What Do We Expect of Caregivers?” Professional Nursing Today 18 (1): 3–6.
https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=103751477&site=ehost-live.

Sanchez Elminowski, N. (2015). Developing and Implementing a Cultural Awareness Workshop for Nurse
Practitioners. Journal of Cultural Diversity, 22(3), 105–113. Retrieved from
https://search.ebscohost.com/login.aspx?direct=tru…