Teaching Module on Culturally Sensitive End-of-Life Care

Instructor: Becky Ellis, MN, BSN, RN

Clinical Instructor 6^th quarter

Clark Community College

Clients who do not speak English and come from diverse cultures are at a greater risk of not having their physical, emotional, and spiritual needs met at the end of their life. This module is designed to assist you, the student nurse, as well as the seasoned practitioner in identifying and understanding your own values and beliefs about life, death and the dying process. Only by recognizing our own beliefs can we then assist those from other cultures during this final stage of living, dying.

Module Objectives

After completing this module, you will:

1. Understand and be able to verbalize your personal beliefs and cultural values about life, death, and dying.

2. Identify different cultures beliefs about death and dying.

3. Be able to describe the rituals that patients from differing cultures practice as death nears.

4. Recognize stereotyping behavior and will know how to avoid using it when caring for their clients.

5. Demonstrate cultural sensitivity when communicating with the dying and their family members.

Methods of Teaching

1. You will write an essay describing your own cultural beliefs about life, death and the dying process.

2. Independent research and self-study of the following web sites that contain information about differing cultural and religious practices:

http://www.health.qld.gov.au/multicultural/default.asp

As you peruse this site, pay special attention to the Guide for Health Professionals caring for diverse populations. Look at religious practices and patient interactions for the various cultures listed. What are some differences between our Western culture and other cultures? Next, go to Guidelines for Practice, what are some of the communication techniques suggestions?

http://offices.colgate.edu/alana-cultural-center/communityservice/utica/default.htm

Pay special attention to cultural beliefs about death, dying and health care. How is grief expressed differently in different cultures?

http://www.diversityinhealth.com/welcome/index.htm

At this site click on the identity issues bar in the box on the left of the screen. Look at each religion listed and note differences in beliefs concerning illness and practices at the time of death.

http://ethnomed.org/

This site is a good reference for our use in this area of the Pacific Northwest. This was developed by the University Of Washington and discusses many cultures located within our area.

http://www.ggalanti.com/cultural_profiles.html

This site has a wealth of information about many different countries, including spiritual and cultural beliefs

http://pedspain.nursing.uiowa.edu/GenePain/Cultutt.htm

This site addresses the cultural aspects of pain.

http://www.settlement.org/cp/english/index.html

Cultural profiles of many different countries

3. Blackboard discussion of the cultural differences pertaining to beliefs of death and dying.

4. Multiple-choice posttest

Evaluation of Learning

1. Using small group activities within Blackboard, case study scenarios will be used to assist you in identifying differing cultural beliefs about death and the grieving process and identifying stereotypical behaviors. A culturally sensitive end-of-life care plan will be developed by online collaboration within each small group and presented to the class. 20 %

Click here for Case Scenario for discussion and care plan development

2. Role playing will also be used. You will be paired with another student and each pair will be given a card with a cultural or religious belief listed and a scenario to be role-played with one being the client and the other the nurse, demonstrating cultural awareness, and sensitivity appropriate to the culture and/or religious beliefs named. Each presentation will be evaluated and critiqued by the other members of the class. 20%

Click here for Case Scenario for Role-Playing Assignment

3. Essay on own beliefs of death and dying 40 %

4. Post test 20%. The test consists of 4 multiple-choice questions each worth 5 points. Click here for Post-test

Important! Please copy and paste the test into a word document first, then take the test and mail the entire test to me at bellis@clark.edu.

Study Materials

Cultural Competence Article

Guideline for Multicultural Practice

End-of-Life Care and Practices in the Russian Culture

Course Information

Completion of this module should take no longer than 6 hours

I’m available by phone and e-mail if you have any problems or questions about any of the material.

To One in Sorrow

Let me come in where you are weeping, friend,
and let me take your hand.
I, who have known a sorrow such as yours, can understand.
Let me come in--I would be very still beside you in your grief;
I would not bid you cease your weeping, friend,
Tears bring relief. Let me come in--and hold your hand,
for I have known a sorrow such as yours, and understand.

-Grace Noll Crowell