Culturally competent care Essay Example | Topics and Well Written Essays - 2000 words

Culturally competent care - Essay Example This means that the department of veteran affairs is forced to meet with the needs of many soldiers over a prolonged time period- something which has forced it to expand in order to cater for the needs of various ex-soldiers from different ethnic backgrounds. There is a reason why army veterans require specialized care. Military service members do not face the same challenges as other members of the society. Their very job requires them to put their lives in danger constantly whenever the country is engaged in a conflict with a different nation. Many times, the challenges that soldiers face are life-threatening and require immediate specialized care. Some of these injuries include gunshot wounds, lost limbs, wounds caused by shrapnel and head injuries that affect a soldier’s daily functions or even speech and thought patterns. Military service members may also be exposed to environmental pollutants like harmful chemicals used by the opposing army, contaminated water and biolog ical weapons. There are also the mental stresses of being in a war. Being separated from one’s family and friends for an extended period of time is a difficult thing for any ordinary human being. It becomes harder for both the soldier and his or her family when both parties are aware that the soldier might never return home. Many times, the families of soldiers have sought counseling services to help them to cope with such possibilities. Another cause of mental anguish is the act of war. Killing and maiming other human beings is a difficult undertaking for even the most hard-hearted individual. Soldiers are required to do it repeatedly and automatically when ordered to do so by their commanding officers. They are also expected to ignore their fears and constantly put themselves in the way of danger. This causes mental problems such as post traumatic stress disorder and depression- which are conditions that the soldiers carry home with them even after the war is over (Jakupcak , Luterek, Hunt, Conbeare and McFall, 2008). According to (Erbes, Westermeyer, Engdahl and Johnsen (2007), more than ten war veterans commit suicide every day due to their inability to handle mental states of depressions and post traumatic stress disorder. There have also recently been reports of war veterans who took their own lives after eliminating their whole families. When they return from war situations, soldiers require healthcare benefits that will enable them to live with some measure of peace and comfort. They also usually require a lot of mental support so that they can process through the horrifying things that they may have witnessed during the war. The department of Veteran Affairs has successfully established a 24-hour suicide hot-line that helps soldiers to deal with issues they may be experiencing but feel unable to tell even family members. Standards of cultural competence that appear to be met and any that are not met The Department of Veteran Affairs defines mino rity veterans as ex-soldiers who are of Asian American, African Americans, Pacific Islander, Native American, Hispanic, Native Hawaiian, or Alaska Native origin. According to the Department of Veterans Affairs (VA), roughly 20% of the country’s 23.5 million veterans are from these ethnic backgrounds (National Alliance on Mental Illness, 2013). Similar to other racial minority populations

Prevent From Engaging In Premarital Sex Theology Religion Essay

Prevent From Engaging In Premarital Sex Theology Religion Essay In Malaysia, premarital sex is still a big NO-NO in our culture for various reasons. Sex comes with responsibility. Thus it does not matter if it is premarital sex, extra-marital sex, marriage sex or even unconsented sex. If you engage in premarital sex, be prepared to take all consequences including dealing with your God, pregnancy, the potential gossips and condemnations from the world, etc. Sexuality is not an instrument of enjoying lustful pleasure for human beings, at least. In premarital sex, many a times, immature human beings explore the sexuality, jut out of curiosity, and might be are unaware of the consequences. Society has forbid premarital sex from the very outlook that adolescence is the time to form oneself as mature and responsible human being and not at all a time to procreate. We have to start saying No! to premarital sex. We should keep in mind that engaging in premarital sex is not the best way to convey your love towards the one you loved. We should push the thought to the back of our minds and remember that we would definitely feel sorry later if we engaged in premarital sex. One of the ways to prevent premarital sex is to start from education. Sex education should begin at home and as early as possible in a childs life. The parents must have a close relationship with the child to make him feel comfortable to talk about his anxiety and concerns. From the healthy discussion between the parents and the child, the topic of premarital sex can be brought up easily. The parents may give the child piece of advice on dealing with the relationship between couples. Keep an open mind and be ready to answer any questions openly and honestly. Learning the truth about sex is much better then learning false info from peers. The parents have to help their child when their child is in a relationship. The parents should not get panic and freak out when their child is in a relationship. They should help the child in avoiding temptation. For example, the child can go on supervised group dates and invite the partner over when an adult is home where premarital sex is less likely to happen. One-to-one time with the partner alone should be strongly discouraged as this may lead to unwanted accidents to happen. The child should be aware of the serious consequences of premarital sex such as unwanted pregnancy and sexually transmitted diseases like AIDS. Currently, there is no known cure for AIDS. Though most parents may know this information, keep it in mind when discussing sexual behaviours with children. Educate your children with this information. It may mean life or death. Luckily, parents are not the sole providers of sex education. Schools can lend a hand by helping parents teach children about sex. Both of them should work hand in hand in handling this problem. The children and teenagers should be taught to protect themselves from premarital sex. They must understand that nobody can force them to do anything that they feel not comfortable with. They must realise how important it is to respect themselves, not using their bodies to fulfil the sexual desires of their partner. The school and the parents should tell the children to say No! firmly. The teenagers must remember, If you dont walk away, you will be sorry. The teenagers should strictly refrain themselves from reading, listening or viewing to those unsavoury media culture such as pornography and movies with sexual scene. Instead, they should choose something which is pure and healthy. For instance, they can involve in various healthy activities and sports which can build up their self-esteem. They should draw a line wisely to set limit on the expressions of affections. The girls should never give out false signals by wearing tight and revealing clothes which may cause them to fall into sexual immorality. The boys should always refrain themselves from making any rash decisions and they should always think of the consequences they may face after involving in sexual immorality. You must lead your heart rather than letting it to lead you. The teenagers should always be careful about the uses of alcoholic beverages. They may lose their inhabitations under the influence of the alcohols. If the couples find themselves uncomfortable with the intimate situation, they must do something that breaks the mood. It is difficult to avoid premarital sex from happening, but with a bit more effort it will become easier. Never compromise to your principles and say No! firmly to premarital sex. Conclusion Is premarital sex good or bad? Well actually, that depends on us to decide it. We can tell that premarital sex is against God, and it is unsafe physically and emotionally. Although sex is pleasurable, it is designed by God to be enjoyed by two married people. Sex is a holy gift from God wherein we celebrate it after marriage. A person should think long and hard before involving in premarital sex. Premarital sex seems to be a norm in nowadays. This should not be allowed among the teenagers. They should be aware of the bad sides of premarital sex. In a pleasure of a moment, they are being blinded by the sexual desire. In the moment of lust and passion, their future is destroyed. In the moment of foolishness and self-gratification, they will fall into the dark abyss. Sexual desire is like a fire and wont stop until it burns itself. Sex is for married couples and when done out of marriage it cause a lot of harm to the doers. The effects are not immediate but later in life they are devastating. The scars of premarital sex are painful and difficult to get rid of. They will leave an indelible mark in your life and it will always follow you even in your marriage. They will shame you, degrade you and interfere with your life. Imagine meeting your previous sex partners whilst with your husband and children. How would you feel? You will wish to hide but youll have no place to do so. So, think about it before it is too late. Premarital sex should strictly be banned from teenagers life. Parents have great responsibilities in educating their children about the essence of marriage and proper sex education should be given to the children. Parents should make an endeavour in teaching their children about sex, letting them know that it can be pleasurable, but there are so many risks involved sexually transmitted diseases, AIDS and HIV, and unwanted pregnancy all which can be prevented. The teenagers will be in matured mind. As a result, the teenagers will know that marriage is not only about having sex, but having a harmonious family and a heavy responsibility as well. Teenagers should always keep in mind that, if a boy or girl truly loves you, they will want the best for you. They will not want you to suffer fear of disease, unwanted pregnancy and the psychological difficulties of premarital sex. They will want to experience love with you only in the very best place of all the love nest of marriage. So, say No! to premarital sex before it is too late.

Mama Day by Gloria Naylor :: Mama Day Gloria Naylor Literature Essays

Mama Day by Gloria Naylor The comparisons--North vs. South, city vs. country, technology vs. nature--are numerous and have been well documented in 20th century literature. Progress contrasts sharply with rooted cultural beliefs and practices. Personalities and mentalities about life, power and change differ considerably between worlds... worlds that supposed-intellectuals from the West would classify as "modern" and "backwards," respectively. When these two worlds collide, the differences--and the danger--rise significantly. This discrepancy between the old and the new is one of the principal themes of Gloria Naylor's Mama Day. The interplay between George, Ophelia and Mama Day shows the discrepancies between a "modern" style of thinking and one born of spirituality and religious beliefs. Dr. Buzzard serves as a weak bridge between these two modes of thought. In Mama Day, the Westernized characters fail to grasp the power of the Willow Springs world until it is too late. "When I was just out of school I worked with a team of engineers in redesigning a nozzle for a nuclear steam turbine generator... It was an awesome machine... And when it ran... lighting up every home in New York, a feeling radiated through the pit of my stomach as if its nerve endings were connected to each of those ten million light bulbs. That was power. But the winds coming around the corners of that house was God" (251). George's experience in the hurricane is just one example of the contrasts between technology and spirituality. George ardently believes that every problem can be solved with rational thinking, planning and plenty of hard work. His obsession with fixing the bridge after the hurricane further illustrates this point; despite assurances from Mama Day and Dr. Buzzard that the bridge would be built in its own time, George diligently pushes the townsfolk beyond their capacity to work. His behavior surrounding the bridge--not to mention the boat he tries to mend--is bas ed on his desire to save Ophelia from a strange illness. He ignores the advice and guidance of Mama Day and plunges into the crisis through rational means. Ultimately, he loses his own life when saving his beloved wife, though George never understands how or why. Dr. Buzzard had warned him that "A man would have grown enough to know that really believing in himself means that he ain't gotta be afraid to admit there's some things he can't do alone" (292).

Eurodisney Business Case Essay

1) How could the company have erred so badly in its estimates of spending patterns of European customers? * The idea was market Euro Disney as a complete holiday package and encouraging people to stay in the hotels and eat all meats in the complex. * While setting prices the Company was unable to estimate spending patterns of European consumers and competitors price alternatives. Due to the location advantage and incredible accomodation prices consumers prefer to stay in the city center. * Travel time to Paris city center from Euro Disney is only 35 minutes and cost of accomodation in Disneyland is as much expensive as a best hotel in Paris. People prefer to stay overnight in the city center instead of staying in the park. * At the end of 1992, it became clear that the numbers were not being met – there was a recession and people were bringing their own food and not staying in the hotels for many nights. Park admission prices were also very high ($42.25US for adults) * Skimming Pricing: is relatively high pricing strategy. It is tempting where product is highly differentiated. Setting prices assuming that demand will not be determined by price and therefore the price can be high with large profit margins. It assumes inelastic demad curve, which sales will not affected by prices. * Penetration Pricing: Setting prices assuming that demand will increase with lower prices and decrease with higher prices and therefore there are limitations on your profit margin. Elastic demand curve assumption. * Eurodisney saw itself in a monopoly position, and positioned itself in a relatively inelastic demand curve with attracting customers regardless of higher prices. As a result of skimming pricing policy high prices, visitors shortened their stay, avoided hotels abd brought their own food and drink. Many visitors arrived early in the morning, staying late at night or check out early in the morning. 2) Could a better reading of the impact of cultural differences on revenues have been achieved? There were a few cultural blunders made: * A no alcohol policy (wine is customary for lunch and dinner in France) and this discouraged visitors * It made mistakes with predicting the peak periods and had to lay off a number of staff when there were fewer visitors, but France has very strict labour laws so they found this to be very difficult * Disney failed to predict demand for breakfast. They told that Europeans dont take breakfast however demand for breakfast is 10 times more than capacity * Tour bus drivers were not catered for properly, so tour companies did not recommend visiting Euro Disney as much as they would have * In America there is a well-established theme park culture. In planning Euro Disney there do not seem to have been many contingency plans established. The attitude towards customer habits was very complacent, assuming that there would be so many customers every day, each staying an average number of nights spending an average amount of money (for America that might be the case). * Leftist demonstrators against to American culture. They called the Park an American cultural abomination. * Disney management failed to research the culture thoroughly enough 3) What suggestions do you have for fostering a climate of sensitivity and goodwill in corporate dealings with the French? * Cultural differences need to be addressed and not just assume that the foreign country will adopt domestic views. The way Europeans took holidays, bought souvenirs, took transport and ate, all affected Euro Disney’s performance * Disney did not understand the differences in the United States compared to European Labor Laws. This resulted in a waste of funding because labor costs in Europe were significantly higher than in the United States 4) How do you account for the great success of Tokyo Disneyland and the problems of Euro Disney? What are the key contributory differences? Euro Disney contrasted Tokyo in a number of ways. * Disney invested heavily in the Euro initiative while it never invested any funds in the Tokyo Park since the Tokyo Disneyland was owned and operated by the Oriental Land Company. * Tokyo Disneyland was a major success with a turnover of over 16 million in 1991 as compared to the low turnover in the Euro Disney. * An increasing trend in Japan towards leisure along with increasing appetite for the American food as opposed to the French who never valued the American foods contributed a lot to the success of Disney land in Tokyo. 5) Do you believe that Euro Disney might have done better if located elsewhere in Europe rather than just outside Paris? Why or why not? * With change of location to be somewhere else in Europe other than Paris, Euro Disney could have not done any better. This is because people in the Europe follow relatively similar cultural norms. It was not only the French who had problems with them, but also others. In Spain where they thought of at first had no adequate space for the establishment of the facility. The master spirit on the sides of the Americans could also not allow them to work in any environment. Moreover a general wave of recession and economic downturn all over the Europe, did not allow such capital intensive project. 6) â€Å"Mickey Mouse and the Disney Park are an American cultural abonimination†. Evaluate this critical statement. * Although European public acceptance of the theme park itself has not been a problem for Euro Disneyland there has been a different type of cultural clash. Most Europeans believe there is cultural imperialism * â€Å"Mickey Mouse and the Disney Park are an American cultural abomination† This is a statement connected to the hard line taken by the French Leftist who never accepted the American people to erode their culture. They claimed the pollution on their country’s cultural ambience was due to the arrival of Mickey Mouse and the company. They wanted to see more European culture in the park than the American culture. 7) Consider how a strong marketing approach might be made to both European consumers and middlemen, such as travel agents, tour guides, even bus drivers. * The strategy was very greedy in buying all the surrounding land so no one else could benefit from the project. This is not going to promote any local support and isolates the project from and other business support. The scale of the investment also isolated them more in the case of a failure. * The idea was to market the Disney as a complete holiday encouraging people to stay in the hotels and eat all meals in the park. * The travel time to Paris was 35 minutes from Euro disney and the hotel Disney cost as much as the best hotel in Paris, many people may prefer to stay overnight in the city center. * High competition in tourism industry. People passing through the area may decide to take the more traditional visit to Paris instead. * Marketing approach is very strong local partnership is important. In planning, Disney were more interested in the moneymaking ventures than the fundamental details such as providing enough restrooms for coach drivers. Inpatient drivers resulted a decrease in the number of visitors. * Tour guides have direct communication with customers. 8) Discuss the desirability of raising admission prices at the very time when attendance is static, profits are nonexistent, and new attractions are months and several years in the future.   * Skimming Pricing: is relatively high pricing strategy. It is tempting where product is highly differentiated. Setting prices assuming that demand will not be determined by price and therefore the price can be high with large profit margins. It assumes inelastic demad curve, which sales will not affected by prices. * Eurodisney saw itself in a monopoly position, and positioned itself in a relatively inelastic demand curve with attracting customers regardless of higher prices. As a result of skimming pricing policy high prices, visitors shortened their stay, avoided hotels abd brought their own food and drink. Many visitors arrived early in the morning, staying late at night or check out early in the morning.

End of Life & Dementia Care Essay

1.1 Dementia is a progressive disease where an individual’s brain functions deteriorate and affects their mental capabilities. This disease is incurable which is similar to another terminal illness such as cancer. Symptoms of dementia will affect an individual’s memory leading to loss and confusing, language/ communication, understanding and judgement. Medication can be prescribed to help slow down the progression of symptoms. Within the more advanced stages the individual will commonly suffer from incontinence, limited mobility and limited communication usually the individual will not be able to use sentences just limited words. Other symptoms that worsen similar to those with a terminal illness are: aspiration, difficulty with breathing, pressure sores from lack of mobility, unrecognisable symptoms of pain (may not be able to communicate) this could lead to the individual not being treated for pain. 1.2 The end of life experience may differentiate between those who have to dementia to those who individuals without. An individual may lack understanding surrounding the diagnosis being made, they may have had symptoms for a longer period of time before a diagnosis had been made. This can lead to confusion as to why they are having symptoms and the way they are feeling. An individual’s communication may be limited, so they may not be able to express their feelings, changes in symptoms and pain. This can lead to depression/ anxiety which impacts on the individual’s behaviour I.e. verbally aggressive, changes in appetite. Lack of communication regarding pain could impact on the quality of care and medical treatment, as care givers are the primary source of recognising an individual’s pain through sounds rather than speech and non verbal communication. Whereas someone who doesn’t have dementia may be able understand a diagnosis and engage fully on how this c an affect their health through an illness progressing. 1.3 Person centred care has come under Health and social care act which states â€Å"that people should make choices about their lives and they should be at the centre of all planning†. Is it important having the person at the centre of all care throughout the time of caring for someone and when end of  life is approaching. The care provided to an individual within this should be based around their choices, beliefs, values and decisions which may have been made in advance. Working as a carer these should be respected. For example knowing the individual’s likes/ dislikes surrounding food, drinks, clothing, to have permission to give medication when the individual is unable to verbally consent. 1.4 In the earlier stages of dementia it is important that the carer works alongside and includes the individual and their family to make plans to reflect the individual’s wishes to be cared for at the end of life, before the dementia progresses and leaves the individual unable to communicate their wishes. Otherwise an appointed person would need to make decisions for the individual which could leave them feel distressed and unhappy. Planning and assessing allows time to plan for the care over the few days of life including after death. These advanced care plans reflect the individual’s values, beliefs and choices I.e. lifestyle, finances, medication, DNAR’s, funeral plans, after death care, appointed person for as/when the individual lacks capacity under the Mental health act to make â€Å"best interest† decisions on their behalf. 2.1 Pain in individuals with dementia is poorly recognised and undertreated can be due to lack of communication. This is dependent on what stage the individual is at within their dementia and how well the care givers know the individual. Some people maybe able to verbally communicate to carers if they are in pain by using single words and using non verbal methods I.e. pointing to what hurts but as this diseases progresses the individual’s ability to express themselves will worsen. If pain is going unrecognised, then there would be no medical intervention, which could cause more pain and will impact on the individual’s health and behaviours. 2.2 In the earlier stages individual’s may be able to express pain through verbal and non verbal communication, together the carer could recognise that they are in pain and a rough area of where this is coming from. This will enable carers to be able to provide medical intervention if needed I.e. Administering PRN paracetamol or seeking medical attention from a nurse/doctor when required. Care givers should use clear questions when speaking to someone with dementia as it may take them a little longer to process what is being asked. As the dementia progresses the individual could be unable to communicate, but they may be able to express pain through noise I.e. screams, but these could be easily misinterpreted by care providers as a â€Å"normal† behaviour if these are regular occurrences. 2.3 When pain has been recognised by care providers, communication with the individual is important where possible dependant of their ability to be verbal and how much capacity the individual has to understand their pain. Care givers will continuously monitor and observe the individual for changes in needs and record these within the daily care notes within the care plan. Dependant on the type of pain will depend on what medical intervention will be best for the individual through advice from other health professionals. Health professionals offer support to care providers to work as a multi-disciplinary team to promote the well-being of the individual to observe, monitor symptoms as well as the care staff. Care staff can give over the counter medications as per care plan, or the doctor/ nurses can prescribe stronger pain relief and controlled drugs. As end of life gets nearer palliative nurse would be visiting to monitor the individual and advise staff on how best to care for the individual and what symptoms to look for in the last few days of life I.e. changes in skin colour, increase of secretions. Medications maybe increased I.e. syringe drivers, which will help ease the pain and to make the individual more comfortable. Advice from colleagues and other health professionals will support care givers about non medicated techniques, these can be how best to position the individual, how often they should be repositioned to prevent pressure sores, skin care – keep the skin clear of sores, trying to keep the mouth clean as there would be increased secretions from the mouth, advice on fluid intake, methods how to try and encourage fluid intake i.e. spooning drinks, changes in food I.e soft. The individual should have an advanced care plan which care givers would be using to meet the individuals needs and wishes for example if they have a DNAR in place, then CPR would not be given. 3.1 Carers may feel guilt and stress and the end of life of an individual with dementia because they may have felt negative emotions towards the individual throughout the stages of dementia. At diagnosis the carer may not have accepted the diagnosis and treated the individual normally which could have caused frustration between the individual/ carer or they could have been in denial of the diagnosis and treated the individual â€Å"normally†, so the needs of the individual may not have been met fully. This could of impacted on the behaviour of the individual to become agitated or withdrawn if they feel they are a burden. The carer may not fully understand the symptoms of dementia especially challenging behaviour I.e. shouting out/ aggression. The carer may have felt negative emotions such as embarrassment and may have lost their temper or felt like hurting the individual and they are frustrated with the constant needs of support the individual has. When dementia has progressed and the carer may have been stressed from taking on the responsibility of caring if they have not had regular breaks. But on the other hand the carer may feel guilty for taking breaks and leaving them for other services to look after them. The carer may have had to make difficult decisions regarding accommodation for the individual such as going into residential care as they feel they can no longer cope with the responsibility of looking after them. After death the carer may feel they have let the individual down and not cared for them well enough based on their own expectations of themselves, they may also regret certain decis ions I.e. residential care. 3.2 Carers can be supported by other professionals to understand how the end of life process may differ for individuals with dementia. Any health professional involved with the individual’s care can provide support and advice I.e. GP’s, nurses, palliative nurses and social workers. They can also suggest informative services offered to carers as support where they can go and discuss the process with trained professionals and other carers. Communication between family, carers, health professionals is vital with end of life care as this can provide reassurance that the individual is being cared for is comfortable as possible, also to keep informed of any changes in the individual’s health I.e. refusal/ lack of ability to drink. A family  member may have been chosen to be the individual’s power of attorney in the advanced care plan once capacity has been lost. This would have been documented under the Mental Health Act. This chosen person would need to be involved in decisions alongside doctors. All the people involved with the care of the individual will support each other, answer any questions, and work alongside any advanced plans which should have been put in place. As towards end of life the individual won’t be able to make their own decisions so someone else will have to do this in the best interest of the individual. 3.3 Anyone supporting an individual with dementia will feel loss and grief at the end of his or her life. Some people may experience loss and grief at the time of diagnosis or once the dementia has progressed further as there will be a lack of recognition between family and the individual as they may feel the dementia has taken over. People may feel all different kinds of emotions through loss and grief. Some may have accepted the diagnosis/ changes of the individual and feel sadness. Others may find this a relief that the individual has passed and no longer having to carry on with progressing symptoms causing them pain and a poor quality of life. 3.4 Carers can have support from health professionals to make decisions and some of these decisions have to be made with health professionals, for example for a Do Not Attempt Resuscitation decision has to be made by a GP has to sign this document off in order to meet their best interests. Other decisions may need to be made if an advanced plan hasn’t been made such as where the individual will reside at home or within a residential placement. 3.5 At the final stages of end of life it is important to have good communication between all relevant parties (carers, family and colleagues). This is important so relatives are kept informed about how the individual’s health is, any changes in medications as towards end of life as it is common to be prescribed a higher dosage of pain relief I.e. morphine syringe drivers, as changes as in the final stages changes can happen quickly. Relatives may also want to know about the individual’s health as they may want to visit to say their last words or even be present at the time of death. Good communication is also important between carers as in  residential placements there will be staff change overs which they will need to know the individuals health state, information about medication, to read end of life care plans, if anyone relatives need calling, any other info I.e. visits from nurses/ GP’s.