PMY 503 Fundamentals of Pharmacology

An 84-year-old Hispanic-American woman is in good health, lives alone, and remains active in the community. She volunteers at the local hospital. Lately, she has started talking to family members about "when I die", reminiscing of meaningful past events, and sharing what accomplishments she has fulfilled in her life.

Answer the following questions:

1. Based on Maslow's Hierarchy of Human Needs, which level of wellness has this woman reached?
2. Describe Maslow's Hierarchy of Human Needs and its levels of wellness
3. How can the Gerontological nurse assist older adults to achieve the highest level of wellness in relation to whatever situation exists?
4. What could be some cultural influences for this individual?
5. How does the National Library of Medicine National Institute of Health explain Transcultural Nursing?

Introduction

The paper deals with the case study of an 84-year-old Hispanic-American woman. She lives alone and participates actively in community. She volunteers at the local hospital and is recently talking about her death to her family members.

1.Based on Maslow's Hierarchy of Human Needs, the woman has reached the level where she needs self actualisation. It means that she has already met her physiological or survival needs. She has also met her safety needs. She also has good connection with her family members. She is nostalgic about her achievements but fears death. It means she has also met the needs of esteem (Cao et al., 2013).

2.The theory of needs put forward by Maslow includes five levels. The five levels are arranged in the form of pyramid where the lower level needs must be fulfilled to satisfy the higher level needs. In psychology, this model is known as motivational theory. The theory of needs state that motivation drives an individual to fulfil the desired needs. Once a particular need is fulfilled, an individual moves a level up which is a new motivation. Once, the needs are satisfied the motivation ceases to exist (Karnatovskaia et al., 2014).

Starting from the bottom the lowest level in the Maslow's hierarchy of needs represents physiological needs and is the holistic model of care that are shelter, warmth, sleep, food and drink. The next level represents safety needs that are she is protected in her community and law and order. The third level of needs belongingness and love needs. These needs are also called psychological needs. Since she is the volunteer at the local hospital, she receives support and love of people. She also receives love and belongingness from her family members.  The fourth level marks the esteem needs. It refers to feeling of accomplishment and prestige. The American woman has already met these needs. She has high sense of achievement from her profession. The last level of need that is on the tip of the pyramid refers to self-actualisation. Needs at this level indicates that a person desires to achieve one’s full potential including creative activities. At this level, one has need of growth and being (Cao et al., 2013).  

3.Gerontological nurse can assist older adults by demonstrating exquisite sensitivity towards their needs, feelings and moods (Crist et al., 2015). Since, Hispanic-American woman are highly represented in death due to colorectal and liver cancer, the client in the case study is fearing death (Siegel et al., 2015).  Moreover, health literacy is very low among this ethnic minority, which adversely impacts the quality of life as they fail to understand the disease prevention and treatment. Therefore, nurses must increase the client’s awareness, build trust and establish rapport with her. The nurse must possess communication skills to assess and responds to her concerns and value her personhood. Providing person-centered care will give the client the love, emotional support and sense of belongings (Hirst & Lane, 2016). Once his need is fulfilled, the nurse can work to improve client’s self-esteem. This is the fourth level of Maslow’s hierarchy of needs. This stage is partially achieved by the client as she has the feeling of achievement, accomplishments and independence. The Gerontological nurse must help the client overcome her fears of death and improve her confidence.  Once this need is met the client will achieve the highest level of wellness.

4.The cultural influences among these individual is the belief system of this ethnic group that health is a God’s gift and illness is the punishment of the God due to wrongdoings. Therefore, the client may have guilt feelings from her past life due to which she fears death. Other potential causes of illness in Hispanic culture are the supernatural triggers, imbalances between hot (illnesses such as diarrhea, rashes) and cold (remedies).  People in this culture, prefer folk system of medicine and delay the health care. Psychiatric disorders in this culture are thought to be due to evil spirits (Lee et al., 2014). Such cultural responses to health may have adverse impact on the client in the case study

5.Transcultural nursing is vital in dealing with clients from different cultural backgrounds particularly in US where there is rise of multicultural population. Transcultural nursing refers to gaining culturally competent skills to ensure patient satisfaction and outcomes. The nurses must exhibit cultural sensitivity towards clients.  The nurses need to understand and appreciate the cultural differences in healthcare beliefs, values, and customs. Eventually, it will help to meet the health care needs of cultural and linguistically diverse patients (Maier-Lorentz, 2008).

References

Cao, H., Jiang, J., Oh, L. B., Li, H., Liao, X., & Chen, Z. (2013). A Maslow's hierarchy of needs analysis of social networking services continuance. Journal of Service Management, 24(2), 170-190.

Crist, J. D., Koerner, K. M., Hepworth, J. T., Pasvogel, A., Marshall, C. A., Cruz, T. P., & Effken, J. A. (2015). Differences in Transitional Care Provided to Mexican American and Non-Hispanic White Older Adults. Journal of Transcultural Nursing, 1043659615613420.

Hirst, S. P., & Lane, A. M. (2016). How do nursing students perceive the needs of older clients? Addressing a knowledge gap. Journal of Geriatrics, 2016.

Karnatovskaia, L. V., Gajic, O., Bienvenu, O. J., Stevenson, J. E., & Needham, D. M. (2015). A holistic approach to the critically ill and Maslow's hierarchy. Journal of critical care, 30(1), 210.

Lee, S., Schwarz, N., & Goldstein, L. S. (2014). Culture-sensitive question order effects of self-rated health between older Hispanic and non-Hispanic adults in the United States. Journal of aging and health, 26(5), 860-883.

Maier-Lorentz, M. M. (2008). Transcultural nursing: Its importance in nursing practice. Journal of cultural diversity, 15(1), 37. https://www.ncbi.nlm.nih.gov/pubmed/19172978

Siegel, R. L., Fedewa, S. A., Miller, K. D., Goding?Sauer, A., Pinheiro, P. S., Martinez?Tyson, D., & Jemal, A. (2015). Cancer statistics for Hispanics/Latinos, 2015. CA: a cancer journal for clinicians, 65(6), 457-480.