This excerpt from the third edition of Hospice & Palliative Care Handbook, published by Sigma, focuses on the role of cultural competency in providing individualized care for hospice patients.
Hospice care is individualized by the interdisciplinary group (IDG) for each patient and the patient's family. Needs are assessed through an initial and comprehensive assessment process, and the IDG develops a plan of care (POC) to meet those needs.
This part discusses the comprehensive assessment and the POC as it relates to planning, management, and coordination of care for the hospice patient and the family.
Care planning and IDG cultural competency
The end-of-life process is a momentous experience for a patient and family, and it can be challenging for the IDG to individualize care related to the cultural and religious beliefs of today’s diverse population. A hospice team member’s challenges can be further influenced by the amount of training and experience in cultural diversity and his or her comfort level in discussing the topic.
Cultural competency can be characterized as continual active engagement through the process of cultural awareness, cultural knowledge, cultural skills, cultural collaboration, and cultural encounters. Cultural awareness and competency of the IDG ensures the provision of individualized hospice care within the cultural context of the patient (Coolen, 2012).
The IDG must have sufficient knowledge, understanding, and recognition of the specific influences that culture has on a patient’s and family’s behavior, attitudes, preferences, and decisions related to end-of-life care. One cannot make assumptions about a patient’s/family’s beliefs; it is important to determine through assessment and conversation what their beliefs are and how they will affect the POC.
Cultural and religious beliefs could affect symptom management, communication, and the disposition of the patient’s body at the time of death. Assessment of cultural and religious beliefs should be part of the comprehensive assessment for the IDG and guide the collaborative care planning process between the IDG, the patient, and the family (Coolen, 2012).
Click here to read a case study and other content from Part 3 of Hospice & Palliative Care Handbook (3rd ed.) in the Virginia Henderson Global Nursing e-Repository of Sigma Theta Tau International Honor Society of Nursing (Sigma).
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(3rd ed.) at the Sigma Marketplace.
Tina M. Marrelli, MSN, MA, RN, FAAN, is an international healthcare consultant specializing in home care and models of care provided in the community to people at home.