Mainpost Case study: JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father's health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter." Discussion: Diversity and Health Assessments Introduction             Health care providers should exhibit knowledge of population diversity and treat all patients with respect regardless of their culture and belief system. This is essential in understanding patient’s lifestyle, and behavior which may affect their health care. Accepting patient’s culture in a nonjudgmental manner creates a unique relationship between the patient and the healthcare provider. Therefore, APRN’s should be cognizant of patient’s culture, beliefs, lifestyle, and socioeconomic status as it relates to healthcare. A culturally competent healthcare provider accustoms his/herself to the exclusive needs of patients with cultures that are different from his or her own. Being accustomed to the belief’s and values of a patient lays the foundation for a trusting patient-provider relationship (Ball et al., 2019). Socioeconomic, Spiritual, Lifestyle, and Cultural Factors Associated with the Patient             The case study presents an 86-year-old Asian male that is physically and financially dependent on his daughter who is a single mother with little money to care for the patient’s healthcare needs.  Understanding the Asian culture is relevant to providing care to this elderly patient.  I will verify patient’s preferred language, ask about patient’s preference with a healthcare provider regarding race or ethnicity, gender, and age. Ensuring respect for this patient despite his financial and physical dependency will encourage a trusting relationship between the patient and the health care provider. Asian culture is known to teach respect for parents and family is a priority over self. Additionally, in Asian culture adult children are required to make financial, physical, and social sacrifices for their parents that are aging (Miyawaki, 2015). As a healthcare provider, I will welcome this patient, show respect by avoiding eye contact as some Asian countries consider making eye contact as rude. Maintaining eye contact is not done with individuals of East Asian cultural backgrounds. Also, the Japanese culture, teaches against maintaining   eye contact with others as it is believed to disrespectful (Uono & Hietanen, 2015).             I will make the patient understand that I am familiar with culture of adult children caring for their aged parents. I will explain to the patient that he should not consider himself a burden to his daughter as .

1. Mainpost
Case study:
JC, an at-risk 86-year-old Asian male is physically and
financially dependent on his daughter, a single mother who has
little time or money for her father's health needs. He has a hx of
hypertension (HTN), gastroesophageal reflux disease (GERD),
b12 deficiency, and chronic prostatitis. He currently takes
Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections
monthly, and Cipro 100mg QD. He comes to you for an annual
exam and states “I came for my annual physical exam, but do
not want to be a burden to my daughter."
Discussion: Diversity and Health Assessments
Introduction
Health care providers should exhibit knowledge of
population diversity and treat all patients with respect
regardless of their culture and belief system. This is essential in
understanding patient’s lifestyle, and behavior which may affect
their health care. Accepting patient’s culture in a nonjudgmental
manner creates a unique relationship between the patient and
the healthcare provider. Therefore, APRN’s should be cognizant
of patient’s culture, beliefs, lifestyle, and socioeconomic status
as it relates to healthcare. A culturally competent healthcare
provider accustoms his/herself to the exclusive needs of patients
with cultures that are different from his or her own. Being
accustomed to the belief’s and values of a patient lays the
foundation for a trusting patient-provider relationship (Ball et
al., 2019).

2. Socioeconomic, Spiritual, Lifestyle, and Cultural Factors
Associated with the Patient
The case study presents an 86-year-old Asian male that
is physically and financially dependent on his daughter who is a
single mother with little money to care for the patient’s
healthcare needs. Understanding the Asian culture is relevant
to providing care to this elderly patient. I will verify patient’s
preferred language, ask about patient’s preference with a
healthcare provider regarding race or ethnicity, gender, and age.
Ensuring respect for this patient despite his financial and
physical dependency will encourage a trusting relationship
between the patient and the health care provider. Asian culture
is known to teach respect for parents and family is a priority
over self. Additionally, in Asian culture adult children are
required to make financial, physical, and social sacrifices for
their parents that are aging (Miyawaki, 2015). As a healthcare
provider, I will welcome this patient, show respect by avoiding
eye contact as some Asian countries consider making eye
contact as rude. Maintaining eye contact is not done with
individuals of East Asian cultural backgrounds. Also, the
Japanese culture, teaches against maintaining eye contact with
others as it is believed to disrespectful (Uono & Hietanen,
2015).
I will make the patient understand that I am familiar
with culture of adult children caring for their aged parents. I
will explain to the patient that he should not consider himself a
burden to his daughter as the daughter is maintaining the
requirement of their culture. This will encourage a relaxing
environment that will enable the patient to feel accepted and
ready to relate with the health care provider. Respect for the
patient’s spiritual and religious belief is also vital. The patient
should be asked about any spiritual belief that may affect his
healthcare when sick or dying. Also, the APRN should inquire
about spiritual or religious groups that the patient may belong

3. that could be supportive in providing some assistance to his
healthcare. Spirituality and faith help Asian-Americans manage
the turmoil of adapting to a new country, by providing a safe
environment where immigrants can socialize and be of
assistance to one another (Lee & Eun-Kyoung, 2017).
Sensitive Issues
I will inquire if the patient is compliant with taking his
medications as prescribed and access for the use of over the
counter, herbal, or traditional medications. This is especially
important as the patient takes lisinopril 10mg QD, prilosec
20mg QD, B12 injections monthly, and cipro 100mg QD. To
avoid drug interactions, it is important to ask about additional
medications that the patient may be taking. Examples of
Chinese herbal medicine include astragalus, ginger, licorice,
panax ginseng, and schizandra. Traditional medicine is used
across Asian societies for daily health maintenance, and
treatment of certain medical conditions. Also, in China, Japan,
and Korea, traditional medicine has become almost or
equivalent to conventional medicine (Mu et al., 2020).
Furthermore, the functionality of the patient will be
accessed to determine the level of dependency on the daughter.
Activities of daily living like feeding, bathing, wearing clothes,
grooming will be accessed. Asking about financial assistance
with purchasing medications, proper feeding and housing is
vital to ensure the overall needs of the patient are catered for.
Due to socioeconomic status and financial constraint of the
patient and his caregiver (daughter), I will recommend the help
of a social worker to provide the services of a home health
nurse and home health nursing assistant. This will ensure that
patients’ needs are met, and the patient takes his medications in
a timely manner thereby relieving the responsibility on the
patient’s daughter. In addition, the services of physical and
occupational therapy will be sorted to help strengthen any weak

4. muscles or extremities to ensure some dependence with physical
activities. I will explain to the patient that my recommendation
for a social worker is to help him meet his daily needs and not
to disrespect him. This will maintain patients pride and ego.
Targeted questions to assess health risks
Do you have health insurance, or do you pay out of pocket for
your medications?
Do you take your medications as prescribed?
Do you check your blood pressure at home?
Would you want to receive help with feeding, clothing, bathing,
or moving around your home?
Do you experience any pain or difficulty in urinating?
In the las two weeks have you experienced sleep disturbances,
decreased appetite, feeling of sadness, hopelessness, or guilt,
thoughts of committing suicide and poor concentration.
In what way do you think you are a burden to your daughter?
How often do you eat and what type of food do you eat?
Do you take any herbal, traditional or over the counter
medications?
The questions above are used to access the patient’s
access to his medications and if he is compliant with taking his
medications. The need to access for patient’s knowledge about
checking his blood pressure due to his history of hypertension.

5. Accessing patient’s willingness to receive outside resources like
home health assistance is essential to providing the needed
healthcare. Question about urinating accesses the history of
prostatitis. Accessing for depression in the elderly is crucial to
determine the patient’s mental state. Elderly Asian immigrants
in the US are at risk of depression (Seungah & Eun-Kyoung,
2017). Evaluating the patients feeding habits and if the patient
takes any medication outside his prescribed medications
determines the patient’s health risk.
References
Ball, J., Dains, J., Flynn, J., Solomon, B., Stewart, R. (2019).
Seidel's guide to physical examination: An interprofessional
approach
(9th ed.). St. Louis, MO: Elsevier Mosby.
Lee, R., Eun-Kyoung, O. (2017). Faith, spirituality, and values
among Asian-American older adults: An exploratory factor
analysis of the multidimensional measures of religion and
spirituality.
Mental Health, Religion & Culture, 19
(8), 920–931. doi:10.1080/13674676.2017.1290593
Miyawaki, C. (2015). A review of ethnicity, culture, and
acculturation among Asian caregivers of older adults.
SAGE Journals
. https://doi.org/10.1177/2158244014566365
https://journals.sagepub.com/doi/full/10.1177/21582440145663
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Ryu, S., & Lee, O. E.-K. (2016). Faith, spirituality, and values
among Asian-American older adults: An exploratory factor
analysis of the multidimensional measures of religion and
spirituality.

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Uono, S., Hietanen, J. (2015). Eye contact perception in the
West and East: A cross-cultural study.
Plus One
. https://doi.org/10.1371/journal.pone.0118094
Xin, B., Mu, S., Tan, T., Yeung, A., Gu, D., Feng, Q. (2020).
Belief in and use of traditional Chinese medicine in Shanghai
older adults: A cross-sectional study.
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