Cultural Competence

     Comprehension of the importance of practicing in a culturally competent manner is crucial in today's diverse society.  As medical professionals, we must understand the effects of a patient’s culture and integrate that into their care.  The needs of older people differ greatly than do younger people because their ability to understand and perform task may be hindered due to age.  According to the Center on Aging Society, cultural competency is "The ability of providers and organizations to effectively deliver health services that meet the social, cultural, and linguistic needs of patients" (Ihara, 2004).    

     In delivering nursing care to the elderly, the nurse must take in consideration the specific activities or procedures needed for the client’s welfare and promotion of health all while performing in a way that is respectful to the elderly client’s values and traditions (de Chesnay and Anderson, 2012,p.29). By applying Watson’s theory that considers “culture and care” into care of the elderly who are diagnosed with COPD, “the nurse and the patient become more human through their interaction” (de Chesnay et al., 2012, p.31). Many times the elderly are proud and do not like to complain. A diagnosis of COPD can leave many elders unable to perform many tasks like cooking, bathing and housekeeping that maintained their independence.  Activity intolerance due to shortness of breath can leave elders with an experience of great loss.  Many of the elderly with COPD are in denial of the disease and conceal their decreased abilities from healthcare providers fearing loss independence. The nurse must gain the trust of the elderly and inform them that correctly reporting exacerbations of their COPD symptoms will only mean faster intervention, better treatment measures and outcomes with pulmonary rehabilitation. In order the teaching to be effective, it must be catered to fit the needs and lifestyle of the older patient.  Goals must be realistic, and mutually agreed upon by patient and healthcare professional. The older patient must be involved in choosing expected goals. Meis, Bosma, Spruit, Franssen, Janseen and others stress that unrealistic goal setting can lead to feelings of failure if a goals are not met. “Healthcare professionals need to guide patients in formulating specific measureable and achievable goals as well as stimulating patients to evaluate their goals frequently” (2013, p.503). Altering these goals may be needed to ensure the patient is reaching realistic goals.

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