Lucia Cordova, a 32-year-old Hispanic granddaughter and caretaker for her grandmother, Elena Cordova, has been facing challenges related to potential memory issues in her grandmother. Elena, who moved in with Lucia and her husband Martin five years ago after her husband’s death, has shown signs of memory impairment, including getting lost on her walks home from the park. Lucia and Martin became concerned when the police found Elena after one such incident. Lucia shared her worries about Alzheimer’s disease with her friend Hannah Kennard, a school counselor at Cargill Academy. Hannah referred Lucia and her grandmother to Dr. Bhandari, a specialist in memory and aging.

However, the visit to Dr. Bhandari’s office highlighted a lack of cultural competency in the healthcare system. Elena, who did not understand English well, faced challenges during the visit. Dr. Bhandari, recognizing the language barrier, turned to address Lucia instead. Unfortunately, Lucia had difficulty understanding the doctor’s thick accent and did not effectively communicate the doctor’s recommendations to her grandmother. This lack of communication resulted in Elena feeling outraged and potentially negatively impacted her overall treatment experience.

Addressing Cultural Difference and Competency

The case study exemplifies a lack of cultural competency in both Hannah, the school counselor, and Dr. Bhandari, the medical professional. The concept of crossroads identity is evident in Lucia, the granddaughter, who navigates between her Hispanic culture and the dominant American culture. On the other hand, Elena, the grandmother, may exhibit characteristics related to racial identity development, showing resistance to interactions outside her ethnic group. Familism, a Hispanic concept, is present in the strong family bond between Elena and Lucia, emphasizing interdependence throughout life stages.

Hannah and Dr. Bhandari lack thoughtful cultural analysis and contextual understanding, leading to a failure in providing culturally competent care. The absence of necessary knowledge, skills, and attitudes for cultural competency in healthcare professionals can have detrimental effects on patient outcomes.

Analysis of the Issues

Hannah and Dr. Bhandari demonstrated a lack of cultural competence in their interactions with Lucia and Elena. The cultural differences became evident, affecting the ethical considerations and care provided. The failure to consider age, gender, ethnicity, socioeconomic status, religion, and potential diagnosis contributed to a biased approach and lack of cultural competency.

Theoretical Issues

Cultural identity development theories, such as multiculturalism and familism, help explain the cultural issues present in the case study. Lucia’s potential cross-cultural identity reflects a flexible adaptation between Hispanic and American cultures, while Elena’s resistance may align with racial identity development. The lack of cultural competence from professionals like Hannah and Dr. Bhandari exacerbates these issues.

Cultural Competency Approach

Cultural competency in healthcare is essential, and professionals like Dr. Bhandari and Hannah must undergo training to effectively work within the multicultural context of the United States. The age, potential diagnosis, ethnicity, socioeconomic status, religion, and gender of patients should be considered to provide culturally competent care. The analysis focuses on addressing cultural differences through assessment and theory.

An Analysis of the Issues

The case study reveals a lack of cultural competence in Hannah and Dr. Bhandari, affecting their interactions with Lucia and Elena. Cultural differences become evident, influencing ethical dilemmas and potentially impacting other Hispanic Americans or ethnic populations. Failure to address cultural issues may lead to biased practices and a lack of competence in addressing diverse patient needs.

Research Findings

Research studies by Ostir et al. (2004) and Monserud (2019) provide insights into potential solutions for cultural issues affecting Hispanic populations. Positive psychology interventions, social support, and religious involvement can impact the mental and physical health of elderly Hispanic individuals. The findings align with the case study’s context, suggesting potential interventions for Elena and Lucia.

Conclusion Statement on Culture

The importance of cultural sensitivity is acknowledged, and ongoing efforts are made to enhance cultural awareness. Continued education, professional growth, and self-assessment are crucial in maintaining cultural competency. The proposed guidelines and competencies aim to address cultural issues effectively, promoting a client-oriented model for cultural competence in healthcare.

Personal Plan of Cultural Sensitivity

The commitment to cultural sensitivity involves ongoing education, self-assessment, and engagement in cultural practices. Emphasizing the importance of trade-like apprenticeships, where professionals learn from diverse mentors, can contribute to a deeper understanding of cultural competence. Acknowledging the limitations of existing guidelines and proposing additional considerations can enhance cultural competency.

References

American Medical Association. (2018). AMA annual house delegates meeting: Board report 33, A-18, a “Plan for continued progress toward health equity D-180.981.” [PDF]. https://www.ama-assn.org/about/leadership/ama-s-strategic-plan-embed-racial-justice-and-advance-health-equity

American Psychological Association. (2016). Ethical principles of psychologists and code of conduct. http://www.apa.org/ethics/code/index.aspx

PSYC FPX 4900 Assessment 1 A Cultural Crisis with a Lack of Professional Competency

American Psychological Association. (2017). Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality. Retrieved from: http://www.apa.org/about/policy/multicultural-guidelines.pdf

Balbim, G. M., Marques, I. G., Cortez, C., Magallanes, M., Rocha, J., & Marquez, D. X. (2019). Coping strategies utilized by middle-aged and older Latino caregivers of loved ones with Alzheimer’s disease and related dementia. Journal of Cross-Cultural Gerontology, 34(4), 355-371. https://doi.org/10.1007/s10823-019-09390-8

Bertram, C. (2017). Jean Jacques Rousseau. Stanford Encyclopedia of Philosophy. Retrieved from https://plato.stanford.edu/entries/rousseau/

Capella University. (n. d.) Introduction to Hays’s addressing model. A. Gilston. https://courserooma.capella.edu/bbcswebdav/institution/PSYC-FPX/PSYCFPX4900/210100/Course_Files/cf_hays_addressing_model.pdf

Comas-Díaz, L. (2012a). Cultural analysis: Looking through a multicultural lens. In Multicultural care: A clinician’s guide to cultural competence. (pp. 89–120). American Psychological Association. https://doi.org/10.1037/13491-004

Di Stefano, C., Gino, F., Pisano, G. P., & Staats, B. R. (2019). Learning by thinking: Overcoming the bias for action through reflection. Harvard Business School Working Paper, 16-058.

Flynn, L., Newton, C., & Walker, K. (2020). A systematic review of diversity training in health care organizations. Journal of Health Care Organization, Provision, and Financing, 57, 1–17. https://doi.org/10.1177/0046958020968123

Hays, P. A. (2016). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy (3rd ed.). American Psychological Association.

Iribarren, S., Montoro, R., & Fraile, M. (2019). A psychoeducational intervention to improve mental health and physical activity in Spanish breast cancer survivors. International Journal of Environmental Research and Public Health

PSYC FPX 4900 Assessment 1 A Cultural Crisis with a Lack of Professional Competency