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Geriatrics

Geriatrics

Ethnogeriatrics

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Case Study 2: Mrs. P

Case Study 2: Mrs. P

Mrs. P, a 65-year-old African American wife and mother of five, had a stroke that resulted in residual right sided paralysis. After the acute phase, Mrs. P returned home. Her geriatric nurse practitioner (GNP) understood that this was probably going to be a chronic condition.
Mrs. P’s oldest child, Dee, aged 26, was married and had two children. She wanted her mom to help with parenting skills, but Dee knew that such help might not be possible because repeated strokes are common.

After much prayer and many teary days and nights, Dee asked Mrs. P’s GNP for help. Without a doubt, Dee was going through her own anticipatory grief work. Dee believed the GNP might help her mom and family, especially her dad, through some role changes. Mr. P had only been the wage earner. He did not know how to pay the bills, cook, clean, or do laundry.

Possible Questions to ask Mrs. P: The LEARN Model

The LEARN Model encourages Geriatric Nurse Practitioners (GNPs) to use open-ended questions in a conversational approach.

As one builds a culturally appropriate exchange between ethnic older adults and families, a direct “complete the questionnaire” style communication would be ill advised. The following are a few questions one might want to ask in a conversational style interview.

  • What do you think led to the change in your condition?
  • How have you managed the condition or illness so far?
  • How can we work together to deal with this condition or illness?
  • What traditional cultural approaches have you used thus far?
  • What should we aim for in our new action plan?
  • What is the best time to begin a new action plan?

Adopted from Anticipatory Grief and Chronicity, Lewis et al., 2004

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African American

  • Description
  • Learning Objectives
  • Introduction & Overview
    • Population Growth and Distribution
    • Characteristics
  • Patterns of Health Risk
    • Life Expectancy
    • Mortality
    • Morbidity
    • Self-Rated Health and Functional Status

CULTURALLY APPROPRIATE CARE

  • Fund of Knowledge
    • Health History
      • Up from slavery
      • Health and Longevity Since the Mid-19th Century
      • Significant Dates and Periods
      • Cohort Experiences
    • Health Beliefs
    • Illness Causes & Interventions
  • Assesment
    • Cultural Biases and Misdiagnoses
    • Showing Respect
    • Use of Assesment Instruments
  • Delivery of Care
    • Cardiovascular Disease
    • Stroke
    • Breast Cancer
    • Mental Health
    • End-of-life Care
  • Cancer Care

Access and Utilization

  • Disparities
    • 1. Patient-Based Factors
    • 2. Physician-Based Factors
      • Maltreatment and Segregated Training
      • Discriminatory Patterns
      • Social and Kinship Networks
      • Informal Caregiving
      • Caregiver Burden
      • Long-Term Care
    • 3. End-of-Life Care Issues
      • Palliative and Hospice Care
      • Advance Directives
      • Role of Church and Religion
  • Health Promotion
    • Improving Health Care

Learning Resources

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