Jewish case study. Complete the following:
- Amish case study
- Jewish Case study #1
- JEWISH CASE STUDY #1
Selecting a “typical” Jewish cl
isn’t is difficult. An ultra-Or
orthodox Jew has a particular set
of special needs. Yet, it is more common
to see a Jew who is a middle-of-the-road
Conservative.
Sarah is an 80-year-old woman who is
a first-generation American. She was
raised in a traditional Conservative home. Her husband died after 50 years of a strong marriage. She has three children. Although her home is not kosher, she practices a
variation of kosher-style eating, avoiding pork and not making dishes that combine meat and milk.
Two months ago, she has diagnosed with pancreatic cancer. Surgery was attempted, but the cancer was already in an advanced stage. Chemotherapy was started,
but cancer has progressed and is not responding to the medications. She is having difficulty eating because of the pressure of
the tumor on the gastrointestinal tract.
Discussions are being held to determine whether or not treatments should be stopped and whether hospice care should be initiated.
Her hospital room is always filled with visitors.
Study Questions
1. What must you anticipate in discussing with Sarah her wishes regarding the continuation of medical care?
2. How would you respond to
her initial decision to have surgery and initiate chemotherapy?3. What questions do you need to ask in the initial patient interview to assess her degree of religious practice? How will you determine her spirituality needs?
4. What is your understanding of the reason she has so many visitors in her room?
5. Is hospice care appropriate for this patient?
6.
Sarah dies with her family at her bedside. What interventions can you take at the time of death to demonstrate religious sensitivity to the family? What questions do you need to ask the family?
7. Describe three genetic or hereditary diseases common with Ashkenazi Jews.
8. Describe Jewish burial rituals and the grieving process.
9. Discuss the laws of Kashrut regarding
food practices for observant Jewish clients.
10.
What should the health-care provider keep in mind when entering a Jewish home to provide care?
11. Distinguish between the terms
Sephardic
and
Ashkenazi
.
12. How might a non-Jewish and a Jewish coworker share holidays in the workforce?
13. What is the official language the Jewish people use for prayer?
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AMISH CASE STUDY
Elmer and Mary Miller, both 35 years old, liv
e with their five children in the main
house on the family farmstead in one of th
e largest Amish settlements in Indiana.
Aaron and Annie Schlabach, aged 68 and 70, live in the attached grandparents’
cottage. Mary is the youngest of their eight children, and when she married, she and
Elmer moved into the grandparents’ cottage with the intention that Elmer would take over the farm when Aaron wanted to retire.
Eight years ago, they traded living space.
Now, Aaron continues to help with the farm work, despite increasing pain in his
ship, which the doctor advises should be replaced. Most of Mary’s and Elmer’s siblings live in the area, though not in the same church district or settlement. Two of Elmer’s brothers and their families recently moved to Tennessee, where farms are less expensive and where they are helping to start a new church district.
Mary and Elmer’s fifth child, Melvin,
was born 6 weeks prematurely and is 1
month old. Sarah, aged 13, Martin, aged
12, and Wayne, aged 8, attend the Amish
elementary school located 1 mile from they
r home. Lucille, aged 4, is staying with
Mary’s sister and her family for a w
eek because baby Melvin has been having
respiratory problems and their physician told
the family he will need to be hospitalized
if he does not get better within 2 days.
At the doctor’s office, Mary suggested
to one nurse, who often talks with Mary
about “Amish ways,” that Menno Martin, an
Amish man who “gives treatments,” may
be able to help. He uses “warm hands” to
treat people and is
especially good with
babies because he can feel what is wrong. The nurse noticed that Mary carefully placed the baby on a pillow as she prepared to leave.
Elmer and Mary do not carry any health insurance and are concerned about
paying the doctor and hospital bills associated
ed with this complicated pregnancy. In
addition, they have an appointment for Wayne
to be seen at Rile
y Children’s Hospital,
3 hours away at the University Medical Cent
er in Indianapolis, for a recurring cyst
located behind his left ear. Plans are being
made for a driver to take Mary, Elmer,
Wayne, Aaron, Annie, and two of Mary’s sist
ers to Indianapolis
for the appointment.
Because it is on the way, they plan to stop in
Fort Wayne to see an Amish healer who
gives nutritional advice and does “treatment
s.” Aaron, Annie, and Elmer have been there before, and the other women are considering having treatments, too. Many
Amish and non-Amish go there and tell others
how much better they feel after the treatments.
They know their medical expenses seem minor in comparison to the family who last week lost their barn in a fire and to the young couple whose 10-year-old child had brain surgery after a fall from the hayloft. Elmer gave me money to help with the expenses of the child and will go to the barn-raising to help rebuild the barn. Mary’s sisters will help to cook for the barn raising, but Mary will not help this time because of the need to care for her newborn.
The state health department is concerned about the low immunization rates in the Amish communities. One community-health nurse, who works in the area where
Elmer and Mary live, have volunteered to talk
with Elmer, who is on the Amish school board. The nurse wants to learn how the health
department can work more closely with
the Amish and also learn more about what
the people know about immunizations. The
county health commissioner thinks this is a wast
e of time and that what they need to do
is let the Amish know that they are creating
a health hazard by neglecting or refusing
to have their children immunized.
Study Questions
1.
Develop three open-ended questions or
statements to guide you in your understanding of Mary and Elmer and what health and caring mean
to them and the Amish culture.
2. List four or five areas of perinatal care that you would want to discuss with Mary.
3. Why do you think Mary placed the baby on a pillow as she was leaving the doctor’s office?
4. If you were the nurse to whom Mrs. Mill
er confided her interest in taking the baby to the folk healer, what would you do to learn more about their simultaneous use of folk and professional health services?
5. List three items to discuss with the Millers to prepare them for their consultation at the medical center.
6. If you were preparing the reference for consultation, what would you mention about the Millers that would help to promote culturally congruent care at the medical center?
7. Imagine yourself participating in a meeting with state
and local health department
officials and several local physicians and nurses to develop a plan to increase the
immunization rates in the counties with large Amish populations. What would you suggest as a way to accomplish this goal?
8.
Discuss two reasons why many Old Orde
r Amish choose not to carry health insurance.
9.
Name three health problems with genetic links that are prevalent in some Amish communities.
10.
How might health-care providers use the
Amish values of the three-generational
family and their visiting patterns in promoting health in the Amish community?
11. List three Amish values to consider in prenatal education classes.
12.
Develop a nutritional guide for Amish women who are interested in losing weight.
Consider Amish values, daily lifestyle, and food production and preparation patterns.
13. List three ways in which Amish express caring.
APPALACHIAN CASE STUDY #1
William Kapp, aged 55 years, and his wife, Gloria, aged 37, have recently moved from an isolated rural area of northern Appalachia to Denver, Colorado, because of Gloria’s failing health. Mrs. Kapp has had pulmonary tuberculosis for several years. They decided to move to New Mexico because they heard that the climate was better for Mrs. Kapp’s pulmonary condition. For an unknown reason, they stayed in Denver, where William obtained employment making machine parts.
The Kapp’s oldest daughter, Ruth, aged 20, Ruth’s husband, Roy, aged 24, and their daughter, Rebecca, aged 17 months, moved with them so Ruth could help care for her ailing mother. After 2 months, Roy returns
ed to northern Appalachia because he was unable to find work in Denver. Ruth is 3 months pregnant.
Because Mrs. Kapp has been feeling “more poorly” in the last few days, she has come to the clinic and is accompanied by her husband, William, her daughter Ruth, and her granddaughter, Rebecca. On admission, Glor
is expectorating greenish sputum,
which her husband estimates to be about a teacupful each day. Gloria is 5 ft 5 in. tall and weighs 92 pounds. Her temperature is 101.4°F,
her pulse is regular at 96 beats per minute, and her respirations are 30 per minute and labored. Her skin is dry and scaly with poor turgor.
While the physician is examining Mrs. Kapp, the nurse is taking additional
historical and demographic da
ta from Mr. Kapp and Ruth. Th
e nurse finds that Ruth has
had no prenatal care and that her first child
d, Rebecca, was delivered at home with the
the assistance of a neighbor. Rebecca is pale and
suffers from frequent bouts of diarrhea and
the paper needs to be written in a paper format-not just a list of the questions and replies.
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