Management of their health and illness issues is also discussed. Cultural assessment theory and an assessment tool are used for he study, and their usefulness, strengths, and weaknesses analyzed. Demographics This cultural assessment is focused on elderly Chinese Americans in Flushing, New York where according to the revised 2010 census reported 56,355 Asians resided, comprising 70. 35% of the total population. Although the census reported on all Asian subgroups combined, it has been determined that most of the population consists of Chinese and Korean immigrants.
Studies have also shown that the elderly portion of the population often faces more disparate treatment in relation to health care and that is why this population was chosen for the assessment. Ethnic and Cultural Health Practices Illness and death are usually viewed by elderly Chinese Americans as a natural part of life. Health is equated to finding harmony between the complementary forces of yin and yang. Special foods and herbs are used to restore balance between yin and yang and promote healing.
Other common practices include massage, acupuncture, conferring with a medium or spiritualist, and institution, which is a traditional Chinese technique that involves burning an herb called Muggers to facilitate healing. Otherwise, Chinese Americans do not generally have conflict with Western health practices but when an illness is considered shameful, they often will not seek treatment. Bad news regarding diagnosis or prognosis is shielded from the patient by family members because they believe it will make the patient worse medically.
With family having such a significant role in decision-making processes, it is imperative to explain and encourage durable power of attorney or other tool used to give power to the person making medical decisions. Religious Belief System Religious practices the Chinese may follow are Confucianism (a philosophy), Taoism, ancestor worship, Buddhism, and Christianity. At one time, atheism was encouraged in mainland China so some patients will say they do not have a religion. Generally, Chinese religion is dualistic and emphasizes yin and yang which are considered the makeup of the Tao.
Tao is their ‘eternal cosmic principal’. Health and Illness Needs Common illnesses in the Chinese community include diabetes, stroke, hepatitis B, hypertension, tuberculosis, and cancers of the upper GIG tract, lung, liver, and misanthropy, and G-6-PDP deficiency, a condition in which the lack of an enzyme results in anemia. ” Chinese men also have a large tendency to smoke. As noted by Eng, et al (2005-2006), “Up to 65% of men from China smoke. Although there is no true conflict with Western medicine, Chinese Americans often institute traditional remedies before trying Western treatments.
That is why they may initially present to the facility in an advanced stage of illness. Management of Health and Illness When managing the health and illness of elderly Chinese immigrants several factors are involved. Availing health care to those in need is essential to managing the health of Chinese immigrants. Understanding familial roles and relationships is another one of the most important factors because “culture emphasizes loyalty to Emily and devotion to traditions and puts less emphasis on individual feelings” (University of Washington Medical Center, 2007).
Another factor is whether the patient understands their medications and the importance of following a regimen. Explaining medications fully and not Judging traditional Chinese remedies involving herbs will help build a bridge between traditional medicine and Western medicine. If the patient is not comfortable with the dosages or uses of their medication, they will most likely be noncompliance. Learning and understanding nonverbal cues will also help because out of respect, Chinese clients will not tell a actor no.
Respect is shown by avoiding eye contact or giving small bows when authority figures are present. It is also believed emotions must be maintained in stressful times so they may appear stoic. Lastly, be aware that women are modest about being examined by a male and should be asked up front if it is alright for the practitioner to examine them. Language Language has been the crux of many of the problems elderly Chinese Americans encounter on a regular basis. The fact that many of the immigrants do not speak English and there are several dialects spoken, interpretation becomes more difficult.
Mandarin is the official spoken language in China but Cantonese, Taiwanese, Taiwanese, and Fussiness are some of the other dialects to name a few. Chinese characters used in writing are the same for all the dialects, characters are used to express words, thoughts and principles. Nutrition An old Chinese saying is that “Medicine and food share the same source”. Chinese Americans tend to believe food provides certain energies for different parts of the body and grains, fruit, meat, and vegetables must be eaten to maintain a healthy balance. Pork is the preferred meat and rice is the most important food.
Hot and old fluids also are considered necessary for healing based on the individual’s situation. As noted by University of Washington Medical Center (2007), mirror patient may only prefer to drink only hot liquids (water or tea) when sick or postpartum”. Hot and cold energies are thought to balance yin and yang Just as light and dark energies do. Herbs are a common part of traditional Chinese diets so it is very important to question clients about their diet in the initial interview for purposes of learning interactions with possible interventions.
Literacy and Education For Chinese Americans, education is the leading determinant of health status. Many elderly Chinese, especially the earlier immigrants, did not have formal education and most of them did not speak English (Pariah, et al 2009, p. 7). Compounded with language barriers, this group became socially isolated and lacked access to health care. They also participated less in leisure activities other than family planned functions, and had more difficulty finding employment.
Thus, most live in poverty and that has harmed them drastically both in mental and physical health. Fortunately, the younger generations of Chinese Americans have been afforded more educational opportunities and help the elders understand and receive treatments otherwise unattainable to them. The Friedman Family Assessment Model The Friedman family assessment model was used in this cultural assessment. It assisted in the collection of identifying data, developmental stage and history of the family, environmental data, family structure, and family functions.
Information on family stress, coping, and adaptation was also collected. Overall, the process of the family assessment using Friedman Assessment Tool was a great experience. Knowing the family and building rapport with them while assessing them in various aspects is very helpful regardless of setting. This type of assessment and involvement encourages holistic care of the individual, their family as a group, and the community. The strengths of this assessment model are the in-depth questions and large amount of areas covered.
The weakness is that if all parts are not completed, it is difficult to develop an accurate assessment. The lack off good rapport with the family could render the tool understanding of the culture and family functions are key to attaining desired outcomes. Conclusion This cultural assessment was developed through the use of the Friedman family assessment model. It successfully identified data on the family’s development, history, environment, health and illness beliefs and practices, religion, cultural beliefs, language, literacy and education issues, and a host of other information.
Although it was found that most Chinese Americans still prefer to try traditional remedies first, it was also found that Western medicine is an option they are open to when available and all else fails. Familial influences and education are the major factors governing health status. Those who are more educated, have better overall health. Elderly Chinese Americans in Flushing, NY will probably always encounter issues with health care because most of them still do not speak English and were never formally educated.
Educating this population on their medications and available interventions will improve their quality of life and possibly extend their life ps. It is time stop allowing elderly Chinese Americans to be lost in poverty and suffering needlessly. References 2010 census interactive population search.