Negotiating outcome criteria with older adults/family members. Western biomedical linear model may be in conflict with circular model, more common in most Indian cosmology.
For example, Mr. B. was always known in the Indian community as an elder who “talked and talked”. Mr. B. was admitted to a nursing home, after having had a serious stroke , with a tracheotomy tube. The first month he pulled out his tracheotomy tube several times, much to the alarm of the staff, and was labeled as “non-compliant”.
The second month after closure of the tracheotomy, his friends asked why he had pulled out his breathing tube. He told them that he needed to be able to talk to the spirits that were visiting him after he had had a healing ceremony performed in his room.
The health care staff expected Mr. B. to understand that the breathing tube was necessary for his survival. For Mr. B. it was more important for him to be able to talk to the spirit world to aid in his healing.