Care Study: Stories of Abby: An Ojibwa Journey

Allied health professionals are confronted with different death and dying practices. An effective allied health professional recognizes the importance of understanding different cultural practices, and learns how to evaluate the death, dying, and spiritual beliefs and practices across the cultures.

Read the two specified case histories and choose one for this assignment.

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Chapter 4, “Stories of Abby: An Ojibwa Journey” and Chapter 14, “Stories of Shanti: Culture and Karma,” by Gelfland, Raspa, and Sherylyn, from End-of-Life Stories: Crossing Disciplinary Boundaries (2005), from the GCU Library.

Identify your role as a health care professional in supporting Abby’s or Shanti’s dying rituals, and in creating strategies for displaying respect while still providing quality care. Identify communication strategies necessary in caring for your select person. Integrate your strategies as you develop a care plan describing how you would approach the situation and care for the patient. Review the “Care Plan” template prior to beginning.

Include the following in your care plan:

Communication: family and patient
Treatment options that align with the specific culture
Education: family and patient
Family roles in the process
Spiritual beliefs
Cultural responses
Any additional components that you feel would need to be addressed (from your perspective as a health care professional)
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.


Sample Answer


                                                                      Care Plan

HLT-324V: Transcultural Health Care


Patient’s Name: Abby Ojibwa            Date: 28th May 2020

Patient’s Diagnosis: Alzheimer Disease



(Include the date.)

Goals Interventions/Actions Discipline/Person Responsible Outcome/Comments

(Initial and date.)

1.Communication, 2nd June 2020.





1. Explore and inspire the broadcasting of cultural diversity in the nursing profession.

2. To initialize a communication strategy that enhances the physician-patient relationship through trust.

3. Strategize on using communication to break cultural barriers in the nursing profession.

4. Build a communication strategy that transmits necessary information to patients/families (Gol, Dorosti & Montazer, 2019).

1. Empower family intervention for a dying patient. Non-verbal cues are the most reliable instruments in the advancement of native cultures. Mary claims to embrace “nonverbal, subtle communication” from “the dying person” (p. 62). Mary asserts that the feeling helped her to accompany her dying mother into “that” world (p. 63).

2.Avail vital information regarding the care and treatment of a dying patient. Such information should be held in a dialogue to accumulate views on cultural and practiced viewpoints. Mary seemed to have a different perspective in the treatment plan of Abby, one that contrasted with the view of the physicians and her family members. Physicians’ perspective of consulting with a sector of the family of a dying patient shows resistance to cultural inclusivity in the institution.

3. Models of cultural actualization should not be intercepted if the profession validates the inclusion of cultural diversity. For instance, everyone in the room was moved by the cultural transition of Abby’s death (p. 58), which shows that embracing the beauty of culture is a good thing.

1. Family- recognize, embrace, and trait cultural fortes irrespective of pending cultural barriers. Mary was able to facet her cultural beliefs even though her family and colleagues contested them.

2.Physicians- If they had provided a dialogue with the family on treatment plans, then the conflict that was overheard by Abby between the family members would have been avoided.

1. The communication strategies overcome cultural barriers in the institution.

2. The profession embraces the importance of cultural diversity.

3. The nurse-patient relationship is enhanced through confidence.

4.The profession benefits from enhanced research on native cultures in diverse societies.

2.Treatment Options, 3rd June 2020. 1. Care and treatment for patients are critical; provide necessary treatment to dying patients.

2. Treatment options should align with the cultural preference of the patient’s family.

3. To allow for aesthetic treatment for culturally-sensitive patients.

1. The physician is given mandate to initialize treatment of dying patient in the absence of their family. Mary was a family member and not a physician upon the dying period of Abby.

2. Allow for family consciousness on preferred treatment plans for a dying patient. The physicians would have allowed a dialogue with the family members on whether medical or aesthetic care and treatment were ideal for Abby (Kaihlanen, Hietapakka & Heponiemi, 2019).

1. Physicians- treat culturally sensitive patients according to the morality view of their family members.

2. Family- communicate following aesthetic or medical options of treating an acute patient.

3. Patient- should be treated according to his/her will; according to the text, Mary and Abby had the same will on the approved treatment plan.

1. The patient receives the required treatment option.

2. Cultural alignment of treatment options is achieved in the profession; the nurses approved the aesthetic view of treating Mary’s mother.

3. The chosen treatment option is initiated; Mary is provided with a separate room to prepare for the cultural rituals of her dying mother.

3.Education, 4th June 2020. 1. To educate the family on the patient’s condition.

2. To educate the family on the need for a specified treatment option.

3. To educate family members on the nature of interaction with the patient.

1. Physicians should provide the health outcome of the patient if a decision on a treatment plan is to be made. The physicians made it known to the family that Abby was in pain and suffering (p.62).

2. Physicians should provide accurate details on why the preferred treatment plan was chosen. According to the physicians, initiating IV feeding and oxygen would relive Abby’s pain (52).

3. The physicians should have educated the family that the hearing conscience of a dying patient is strong. In that, the family arguments would have been controlled, and Abby would have continued with her regular feeding and medication program.


1.Physician- educate the family on the patient’s condition, the preferred treatment option, and why the treatment option is needed (Oikarainen et al., 2019).

2.Family- propose on the culturally interceptive treatment plan of their dying patient.

1. The family becomes aware of the fate of the patient. Abby’s children were prepared for her imminent death.

2. Mary’s siblings considered the use of IV feeding to relieve their mothers’ pain. However, cultural inclusivity allowed for the more comfortable passing of Abby as dictated by Mary in the text.

3. The family avoids holding opinions in front of the patient, which helps in maintaining the designated treatment schedule of patients.

4. Family is linked to a shared belief, achieving cultural sensitivity in the institution.

4.Family Roles 5th June 2020. 1. To differentiate the professional and family roles of physicians.

2.Family to discuss the outcome of their dying patient.

3. To provide an accord on the fate of the dying patient.

4. To discuss cultural needs and implications of death rituals to be performed if the ending of a dying patient finally comes.

1. Allow for the separation of professional and family roles when it comes to a patient. The institution allowed Mary to serve the role of a daughter upon Abby’s imminent death.

2. Family members should discuss and accord treatment and care plans of their patients to the physicians. Mary and her siblings finally agreed on a cultural way of transitioning their dying mother.

3. The family discusses and accords the cultural effects of their dying patient.

4. Prepare the cultural aesthetics and rituals of the dying patient. Mary cleansed the room with sweetgrass and sage to prepare for the peaceful transition of her mother.

1. Family- reference their cultural beliefs and the required dying rituals to be performed for their dying patients.

2. Physicians- enhance the ritual exercise of family members. The institution provided the family with a separate room and aesthetic materials for them to prepare dying rituals for Abby.

1. Professional and personal attributes are advanced; Mary was able to act as a daughter and not a physician. As well, Mary was able to advance cultural and not professional accords at the death of her mother.

2. Family perceives the fate of their dying patient; family members prepare for the final journey of their loved one.

3. Dying rituals of the family are performed upon the death of the patient.

5.Spiritual Beliefs 5th June 2020. 1. To assess the inherent spiritual belief of a physician/patient.

2. To understand the assessment of death in native cultures.

3. To assess the religious view of a dying body in native cultures.

1. Explore the dying rituals of a patient/family. Mary idealized death as a transition “into the spirit world” (p. 54).

2. Provide a setting in which the family of the deceased can caress cultural and spiritual rituals. Mary was undistracted in her spiritual embodiment. As a result, she was able to observe the essence of the Milky Way that traveled her mother’s spirit to the spiritual world.

1. Family- caress spiritual rituals regarding the essence of death in cultural practice.

2. Physicians- provide a setting in which families can exercise dying rituals for their loved ones. For example, Mary was not distracted by her spiritual embodiment that accompanied her mother’s death.

1. The family recognizes inherent dying rituals.

2. Family exercises inherent dying rituals.

3. With a spiritual accord to death rituals, the pain of losing a loved one is neutralized as death is seen as a passage of life as it is the case in the Ojibwa culture.

6.Barriers, 5th June 2020. 1.To separate cultural barriers in the nursing profession.

2. To initiate treatment plans that accord o cultural strings.

3. To eliminate policies that bar the exercise of cultural diversity in the nursing profession.

1. Exercise a culture of diversity in the profession. The Canadian medical profession barred cultural diversity to native cultures, which unresolved cultural eminence of cultures such as the Ojibwa’s.

2.Initiate policies that promote cultural diversity and refute suppression of inherent beliefs in physicians, patients, and family. Initially, the nurses thought Abby as “just another Indian dying” (p. 52), without observing the cultural essence of Mary; not forgetting that Abby was their colleague’s mother.

1. The nursing profession- should exercise culture of diversity.

2. Nurses- should provide social support to those mourning a loved one.

3.Patient/Family-welcome positive anomalies meant to support the cultural view of a dying patient in an inherent culture.

1. Cultural diversity is practiced in the profession.

2. Barriers to cultural diversity are controlled or eradicated.

3. The nursing profession creates policies that promote cultural diversity in the profession.

4. Nurses execute inherent rituals without the fear of violating trained accords.

7.Cultural Responses, 7th June 2020. 1. To advocate for cultural inclusivity in the nursing profession.

2. To balance cultural diversity with a professional ethos.

3. To bar the exemption of ritual practice in the profession.

1. Create independence between professional and cultural accords so that professionals can exercise either of the two rites as situations allow. Mary was both a nurse and a daughter at Abby’s death.

2. Develop policies that support cultural diversity in the profession. Even though Canada barred the exertion of traditions in the nursing profession, Mary was firm to stand against these vicious rites.

3. Create a culture of diversity in the profession.

1. Nursing profession- create policies of cultural diversity.

2. Nurses- exercise inherent beliefs in the profession.

3.Family- appreciate the inclusion of cultural exercise in the nursing profession.

1. Cultural diversity is achieved in the profession.

2.Culture of diversity balances cultural and professional accords in the institution.

3. The nursing profession creates policies that bar the suppression of inherent practice in the profession.

8.Additional Components, 7th June 2020. 1. To initiate cultural sustenance in the profession. 1. Nurses should join family members to mourn for the loss of a loved one. As can be seen in the text, the nurses and Mary’s siblings enjoyed the transition upon Abby’s death. It shows that they did not fully enhance emotional support to the family. 1. Nurses- emotionally support family/patient on trying times such as death.

2. Family- provide emotional support to a dying patient. As well, members should embrace emotional appreciation in the eyes of dying patients.

1. Cultural support becomes a culture for supporting patients and families in the nursing profession. Nurses are expected to exercise care for both the patients and the family.



Gol, M. K., Dorosti, A., & Montazer, M. (2019). Design and psychometrics cultural competence questionnaire for health promotion of Iranian nurses. Journal of education and health promotion, 8.

Kaihlanen, A. M., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC nursing, 18(1), 1-9.

Oikarainen, A., Mikkonen, K., Kenny, A., Tomietto, M., Tuomikoski, A. M., Meriläinen, M., … & Kääriäinen, M. (2019). Educational interventions designed to develop nurses’ cultural competence: A systematic review. International Journal of nursing studies, 98, 75-86.

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