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From a cultural perspective, is it unusual that Grandmother Marietta is the primary caregiver? Discuss the ways in which Lanesha, Grandma Marietta and Hannah Healthcare approach this situation from totally different perspectives. How does Lanesha’s temperament affect the situation?
What responsibilities do health care providers have in this situation?
In this case module I was asked to watch a video lecture and to review learning activity number one. I was then asked to answer and discuss four different question; from a cultural perspective, is it unusual that Grandmother Marietta is the primary caregiver? Discuss the ways in which Lanesha, Grandmother Marietta and Hannah Healthcare approach this situation from totally different perspectives. How does Lanesha’s temperament affect the situation? Finally, what responsibilities do health care providers have in this situation?
The lecture provided by Dr. Susan Horky, in the video provides an insightful answer as to why it is not unusual for Lanesha’s Grandmother, Marietta, to be her primary caregiver. The percentage of grandparents who are primary caregivers for their grandchildren is higher for African Americans than for Latino or Caucasian children. Twelve percent of African American children live with their grandparents. In contrast, 5.8 percent of Latino and 3.6 percent of Caucasian children live with their grandparents. (Horky, n.d.). This is believed to have a great deal of influence that regardless of the situation that the family should stay together at all costs. (Horky, n.d.). 12 percent is not a large number compared to the entire population. However, in comparison with specific details of ethnicity, the African American population is more than doubled in respect to grandparents being primary care givers.
Each individual in the scenario; Lanesha, a 12 year old fourth grader, her Grandmother, Marietta, and the Hannah Healthcare Group view the situation from three different perspectives, but all seem to share in one similar emotion, frustration. Lanesha is a 12 year old girl that has been having trouble with her temper and her anger in almost every aspect of her daily life. Her medicine and compliance to her treatment plan are no different. As a teenager, she does not want to continually be hassled and bothered. So to avoid this she constantly is telling the providers lies, or in her mind, “what they want to hear.” (http://support.mchtraining.net/national_ccce/case1/Flash/activity1.html). Lanesha has a sense of neglect from her grandmother because she states that she want to act like everything is fine as to appease her Grandmothers temperament. Marietta, also shares in frustration but also has a great deal of added stress as she also cares for her 10 year old grandchild and also her older ailing mother.
Marietta exudes many of the qualities spoken by Dr. Horky in her presentation; her own age is taking a toll on her ability to care for Lanesha, she is worried about Lanesha. Due to Lanesha’s age and behavior however, Marietta is experiencing depression and grief. Almost portrays a sense that she has given up, like she has done all that she can. (Horky, n.d.). Other socioeconomic issues are in Marietta’s forefront. Lanesha has clothes on her back and food on the table. Without the occasional thank you, Marietta feels neglected and unappreciated. Trips are frequent and seem pointless, like a wasted trip of gas. In addition, the majority of African American grandparent caregivers have a very limited income. One study surveying parenting African-American grandparents found 74% had incomes less than $20,000.00 per year, and nearly half of these had annual incomes less than $10,000 per year (Nunn, 2002).
With a limited income and the need to provide food could be adding to the stress and grief Marietta is experiencing. The representative from Hanna Healthcare also shares in the emotion of frustration. Her frustration is stemmed from the noncompliance of the healthcare regimen. Her point of view is that since Marietta is the guardian and Lansesha is the adolescent that the adult should be able to remind and control and adhere to the regimen. Hannah Healthcare also seems to show a genuine concern for Lanesha and the entire family, in comparison the family members seem to neglect or detflect the information and treatment regimen.
Lanesha’s anger issues are definitely having a negative effect on her taking her medications. Apart from her being 12 years old and wanting to rebel against everything and be her own person, she snaps and yells at her Grandmother when reminded to take her medications. This behavior is adding to the emotions that Marietta already has about not being able to control or influence Lanesha in a positive manner. Therefore, Marietta throws her hands in the air and decides that if Lanesha is not having problems with her breathing then this is not a battle that she wants to fight. Both Lanesha and Marietta are under the mindset that if no symptoms are present then things are fine.
As a healthcare provider, our job is to give the patient and guardians the proper education to combat the fact that the treatment regimen and medications are also apart of preventing the symptoms of an illness. The health belief model shows that patients that are shown that the benefits of following the treatment plan outweigh the barriers or inconvenience of following the plan are more likely to follow and stick to the treatment plan. (http://www.euromedinfo.eu/causes-of-non-adherence.htm).
Providers must pound home the importance of the treatment plan. As providers, we must not give into stereotypes or presumptions about how a patient will or will not act to the treatment plan. We must show empathy and genuine concern for all of our patients. Keeping in mind that other factors including environment, economics, genetics, previous and current health status, and psycho-social factors exert considerable influence on our well-being. (http://erc.msh.org/mainpage.cfm?file=1.0.htm&module=provider&language=English&ggroup=&mgroup).
The scenario at hand is a sensitive one, but our end point is the wellbeing of our patients. We are not guidance counselors, but have the urge to support our patients in any way we can.