Complete the following:<\/p>\n
Amish case study
\nJewish Case study #1
\nJEWISH CASE STUDY #1
\nSelecting a \u201ctypical\u201d Jewish cl
\nient is difficult. An ultra-Or
\nthodox Jew has a particular set
\nof special needs. Yet, it is more common
\nto see a Jew who is a middle-of-the-road
\nConservative.
\nSarah is an 80-year-old woman who is
\n a first-generation American. She was
\nraised in a traditional Conservative home. Her husband died after 50 years of a strong
\nmarriage. She has three children. Although her home is not kosher, she practices a
\nvariation of kosher-style eating, avoiding por
\nk and not making dishes that combine
\nmeat and milk.
\nTwo months ago, she was diagnosed w
\nith pancreatic cancer. Surgery was
\nattempted, but the cancer was already in an advanced stage. Chemotherapy was started,
\nbut the cancer has progressed and is not re
\nsponding to the medications. She is having
\ndifficulty eating because of the pressure of
\n the tumor on the gastrointestinal tract.
\nDiscussions are being held to determine
\nwhether or not treatme
\nnts should be stopped
\nand whether hospice care should be initiated.
\nHer hospital room is always filled with visitors.
\nStudy Questions
\n 1. \u00a0\u00a0\u00a0What must you anticipate in discussi
\nng with Sarah her wi
\nshes regarding the
\ncontinuation of medical care?
\n 2. \u00a0\u00a0\u00a0How would you respond to
\n her initial decision to ha
\nve surgery and initiate
\nchemotherapy? <\/p>\n
3. \u00a0\u00a0\u00a0What questions do you need to ask in
\nthe initial patient interview to assess her
\ndegree of religious practice? How will
\nyou determine her spirituality needs?
\n 4. \u00a0\u00a0\u00a0What is your understanding of the reas
\non she has so many visitors in her room?
\n 5. \u00a0\u00a0\u00a0Is hospice care appropriate for this patient?
\n 6.
\n \u00a0\u00a0Sarah dies with her family at her bedsid
\ne. What interventions can you take at the
\ntime of death to demonstrate religious sens
\nitivity to the family? What questions do
\nyou need to ask the family?
\n 7. \u00a0\u00a0\u00a0Describe three genetic or heredita
\nry diseases common with Ashkenazi Jews.
\n 8. \u00a0\u00a0\u00a0Describe Jewish burial
\nrituals and grieving process.
\n 9. \u00a0\u00a0\u00a0Discuss the laws of Kashrut in regard to
\n food practices for observant Jewish clients.
\n10.
\nWhat should the health-care provider keep
\nin mind when entering a Jewish home to
\nprovide care?
\n11. \u00a0\u00a0Distinguish between the terms
\nSephardic
\n and
\nAshkenazi
\n.
\n12. \u00a0\u00a0How might a non-Jewish and a Jewish cowo
\nrker share holidays in the workforce?
\n13. \u00a0\u00a0What is the official language
\nthe Jewish people use for prayer?\u00a0<\/p>\n
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\nAMISH CASE STUDY
\nElmer and Mary Miller, both 35 years old, liv
\ne with their five children in the main
\nhouse on the family farmstead in one of th
\ne largest Amish settlements in Indiana.
\nAaron and Annie Schlabach, aged 68 and 70, live in the attached grandparents\u2019
\ncottage. Mary is the youngest of their ei
\nght children, and when she married, she and
\nElmer moved into the grandparents\u2019 cottage
\nwith the intention that Elmer would take
\nover the farm when Aaron wanted to retire.
\nEight years ago, they traded living space.
\n Now, Aaron continues to help with
\nthe farm work, despite increasing pain in hi
\ns hip, which the doctor advises should be
\nreplaced. Most of Mary\u2019s and Elmer\u2019s sibli
\nngs live in the area, though not in the same
\nchurch district or settlement. Two of Elmer\u2019s brothers and their families recently
\nmoved to Tennessee, where farms are less expensive and where they are helping to
\nstart a new church district.
\nMary and Elmer\u2019s fifth child, Melvin,
\nwas born 6 weeks prematurely and is 1
\nmonth old. Sarah, aged 13, Martin, aged
\n12, and Wayne, aged 8, attend the Amish
\nelementary school located 1 mile from thei
\nr home. Lucille, aged 4, is staying with
\nMary\u2019s sister and her family for a w
\neek because baby Melvin has been having
\nrespiratory problems and their physician told
\nthe family he will need to be hospitalized
\nif he does not get better within 2 days.
\nAt the doctor\u2019s office, Mary suggested
\nto one nurse, who often talks with Mary
\nabout \u201cAmish ways,\u201d that Menno Martin, an
\n Amish man who \u201cgives treatments,\u201d may
\nbe able to help. He uses \u201cwarm hands\u201d to
\n treat people and is
\nespecially good with <\/p>\n
babies because he can feel what is wrong. Th
\ne nurse noticed that Mary carefully placed
\nthe baby on a pillow as she prepared to leave.
\nElmer and Mary do not carry any hea
\nlth insurance and are concerned about
\npaying the doctor and hospital bills associat
\ned with this complicated pregnancy. In
\naddition, they have an appointment for Wayne
\nto be seen at Rile
\ny Children\u2019s Hospital,
\n3 hours away at the University Medical Cent
\ner in Indianapolis, for a recurring cyst
\nlocated behind his left ear. Plans are being
\nmade for a driver to take Mary, Elmer,
\nWayne, Aaron, Annie, and two of Mary\u2019s sist
\ners to Indianapolis
\nfor the appointment.
\nBecause it is on the way, they plan to stop in
\n Fort Wayne to see an Amish healer who
\ngives nutritional advice and does \u201ctreatment
\ns.\u201d Aaron, Annie, and Elmer have been
\nthere before, and the other women are considering having treatments, too. Many
\nAmish and non-Amish go there and tell others
\n how much better they feel after the
\ntreatments.
\nThey know their medical expenses seem minor in comparison to the family
\nwho last week lost their barn in a fire
\nand to the young couple whose 10-year-old child
\nhad brain surgery after a fall from the hayl
\noft. Elmer gave mone
\ny to help with the
\nexpenses of the child and will go to the barn raising to help rebuild the barn. Mary\u2019s
\nsisters will help to cook for the barn raisi
\nng, but Mary will not help this time because
\nof the need to care for her newborn.
\nThe state health department is concer
\nned about the low immunization rates in
\nthe Amish communities. One community-health nurse, who works in the area where
\nElmer and Mary live, has volunteered to talk
\n with Elmer, who is on the Amish school
\nboard. The nurse wants to learn how the health
\n department can work more closely with <\/p>\n
the Amish and also learn more about what
\n the people know about immunizations. The
\ncounty health commissioner thinks this is a wast
\ne of time and that what they need to do
\nis let the Amish know that they are creating
\na health hazard by ne
\nglecting or refusing
\nto have their children immunized.
\nStudy Questions
\n 1.
\nDevelop three open-ended questions or
\n statements to guide you in your
\nunderstanding of Mary and Elmer and what
\nhealth and caring mean
\n to them and to
\nthe Amish culture.
\n 2. \u00a0\u00a0\u00a0List four or five areas of perinatal
\ncare that you would want to discuss with Mary.
\n 3. \u00a0\u00a0\u00a0Why do you think Mary placed the baby
\non a pillow as she was leaving the doctor\u2019s
\noffice?
\n 4. \u00a0\u00a0\u00a0\u00a0If you were the nurse to whom Mrs. Mill
\ner confided her interest in taking the baby
\nto the folk healer, what would you do to le
\narn more about their simultaneous use of
\nfolk and professiona
\nl health services?
\n 5. \u00a0\u00a0\u00a0\u00a0List three items to discuss with the M
\nillers to prepare them fo
\nr their consultation at
\nthe medical center.
\n 6. \u00a0\u00a0\u00a0If you were preparing the reference fo
\nr consultation, what would you mention about
\nthe Millers that would help to promote cu
\nlturally congruent ca
\nre at the medical
\ncenter?
\n 7. \u00a0\u00a0\u00a0Imagine yourself participa
\nting in a meeting with state
\nand local health department
\nofficials and several local physicians and nur
\nses to develop a plan to increase the <\/p>\n
immunization rates in the
\ncounties with large Amish
\npopulations. What would you
\nsuggest as ways to accomplish this goal?
\n 8.
\nDiscuss two reasons why many Old Orde
\nr Amish choose not to carry health
\ninsurance.
\n 9.
\nName three health problems with genetic
\nlinks that are prevalent in some Amish
\ncommunities.
\n10.
\nHow might health-care providers use the
\nAmish values of the three-generational
\nfamily and their visiting patterns in pr
\nomoting health in the Amish community?
\n11. \u00a0\u00a0List three Amish values to consid
\ner in prenatal education classes.
\n12.
\nDevelop a nutritional guide for Amish wome
\nn who are interested in losing weight.
\nConsider Amish values, daily lifestyl
\ne, and food production and preparation
\npatterns.
\n13. \u00a0\u00a0List three ways in which Amish express caring. <\/p>\n
APPALACHIAN CASE STUDY #1
\nWilliam Kapp, aged 55 years, and his wife, Gloria, aged 37, have recently moved from an
\nisolated rural area of northern Appalachia
\nto Denver, Colorado, because of Gloria\u2019s
\nfailing health. Mrs. Kapp has had pulmonary t
\nuberculosis for several years. They decided
\nto move to New Mexico because they heard that the climate was better for Mrs. Kapp\u2019s
\npulmonary condition. For an unknown reason, they stayed in Denver, where William
\nobtained employment making machine parts.
\nThe Kapp\u2019s oldest daughter, Ruth, ag
\ned 20, Ruth\u2019s husband, Roy, aged 24, and
\ntheir daughter, Rebecca, aged 17 months, moved with them so Ruth could help care for
\nher ailing mother. After 2 months, Roy return
\ned to northern Appalachia because he was
\nunable to find work in Denver. Ruth is 3 months\u2019 pregnant.
\nBecause Mrs. Kapp has been feeling \u201cmor
\ne poorly\u201d in the last few days, she has
\ncome to the clinic and is accompanied by her husband, William, her daughter Ruth, and
\nher granddaughter, Rebecca. On admission, Glor
\nia is expectorating greenish sputum,
\nwhich her husband estimates to be about a teac
\nupful each day. Gloria is 5 ft 5 in. tall and
\nweighs 92 pounds. Her temperature is 101.4\u00b0F,
\nher pulse is regular at 96 beats per
\nminute, and her respirations are 30 per minute
\nand labored. Her skin is dry and scaly with
\npoor turgor.
\nWhile the physician is examining Mrs. Kapp, the nurse is taking additional
\nhistorical and demographic da
\nta from Mr. Kapp and Ruth. Th
\ne nurse finds that Ruth has
\nhad no prenatal care and that her first chil
\nd, Rebecca, was delivered at home with the
\nHelpance of a neighbor. Rebecca is pale and
\nsuffers from frequent bouts of diarrhea and
\n paper needs to be written in a paper format-not just a list of the questions and replies.<\/p>\n
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