Running Head: CRITIQUE 1
Case scenario: JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a history of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter”
Explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient.
JC is an 86-year-old Asian male. He is physically and financially dependent on his daughter for his health needs. The patient’s ethnic background classifies him as a minority, struggling with socioeconomic disparities such as the lack of family and financial support sufficient to meet his needs. The patient stated he is worried about being a burden to his daughter.
There is a lot of diversity within the Asian-American culture. Their religious practices include Islam, Buddhism, Animism, Christianity, or no religion. Overall, Asian Americans commonly have a strong sense of community and unity within their cultures. According to (Geetha, 2022), up to 29% of Asian-Americans live in multi-generational homes. This might explain why JC may be a burden on his daughter.
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
Due to JC’s Asian-American background, there are a few cultural norms to pay close attention to. Prior to my assessment I would refer to my cultural assessment guide to be familiar with his cultural beliefs, spiritual influences, environment, diet, health beliefs, and family support. Based on JC’s cultural norms, I would avoid prolonged eye contact during my assessment to show him respect (Geetha, 2022). I would make a point to emphasize his feelings and assess his ability to speak and understand English.
I would also review his medication history for compliance. Due to his financial state, he may have gone without refills on his medications. JC is prescribed Prilosec, which is known to cause depression and anxiety in some patients (Mammoser, 2018) . Therefore, I would assess his mental health to rule out these side effects. His B12 injections may also be an issue of accessibility due to his inability to access and finance care on his own.
In Asian culture, adult children are usually loyal and obedient caregivers to their aging parents (“Improving health and healthcare of Asian Americans,” 2021). The daughter in this case may desire the ability to care for her father but cannot due to having to support herself and child with a lack of financial income. Therefore, I would seek services that can provide them financial assistance.
Five target questions
Older adults require additional care that goes beyond medication management. Their health history should include an evaluation of physical, financial, and environmental issues that impact their health.
What do you usually eat and drink each day?
How do you take medications each day?
Do you have financial difficulty affording your medications?
Do you feel safe at home?
Do you feel sad or anxious?
Cultural competence in health and human services | NPIN. (2021, September 10). Retrieved from https://npin.cdc.gov/pages/cultural-competence
Geetha, J. (2022). Working with Asian-American patients. Retrieved from https://psychiatry.org/psychiatrists/diversity/education/best-practice-highlights/working-with-asian-american-patients
Like, R. (n.d.). A Physician’s Practical Guide to Culturally Competent Care. Retrieved from https://cccm.thinkculturalhealth.hhs.gov/
Improving health and healthcare of Asian Americans. (2021, October 26). Retrieved from https://geiselmed.dartmouth.edu/news/2021/improving-health-and-healthcare-of-asian-americans/
David E. Coleman (2019) Evidence Based Nursing Practice: The Challenges of Health Care and Cultural Diversity, Journal of Hospital Librarianship, 19:4, 330-338, DOI: 10.1080/15323269.2019.1661734
Mammoser, G. (2018, July 16). Medications with depression risk. Retrieved from https://www.healthline.com/health-news/commonly-prescribed-medications-have-highest-depression-risk