Social Implications of Medical Issues


Various cultures have different perceptions on life and death. They have different cultural practices during their life. In addition, after the death of an individual, they may perform different rituals to commemorate the death of a member of the community. Therefore, a social worker who works in a hospice should take into consideration the cultural perceptions of life and death. This would ensure that the social worker does not undertake measures that would violate the culture of the relevant families. Therefore, personalization of the social services is vital in meeting the cultural needs of various families.

Indian Americans Perceptions on Death

American Indians believe that after the death of an individual, the individual passes over into the afterlife. Here they meet the creator and other ancestors who died before them. American Indians believe that the afterlife is a place of love and beauty. Therefore, they do not fear death since it would enable them to pass over to a very good place. American Indians believe that death does not lead to the death of their spirits. Their spirits continue to exist even after the death of an individual. They believe that the spirit chooses the body as the vessel during their lives. American Indians believe that death should be a peaceful occasion. Therefore, before death, they try to make peace with other people as they prepare to take the next step into the spirit world where they would meet the creator and their ancestors.

Different American Indian tribes have different attitudes towards death. The Creeks usually accept death without anxiety or fear. On the other hand, Hopi Indians usually have high levels of fear towards death. The Navajo have a culture of death avoidance. They usually favor taking the sick to hospitals instead of allowing them to die at home. The Navajo claim that dying at home would pollute the home environment. On the other hand, certain American Indian tribes believe that taking an individual with a terminal illness to a hospice would make the individual die faster. Therefore, they usually desist from taking terminally ill members of the family in an effort to prolong their lives (Corr & Corr, 2012).


American Indians have close-knit family setups. The family consists of even members of the extended family. During illness and death, the relationships with members of the extended family are very important. Illness of a family member concerns all family members. Family members may speak on behalf of the sick individual. The sick individuals may also speak for themselves. A family may also appoint a spokesperson to speak on behalf of the sick individual. However, the decisions of the spokesperson are not final.

Application to the Case

Depending on the cultural beliefs of Ella’s tribe, they may choose to send her to a hospice to avoid her from dying at home. However, the members of the family should take part in making the decision on where she should meet her imminent death. Therefore, there may be outrage within the family if Ella is coerced into accepting mainstream medicine. According the culture and traditions of American Indians, Ella’s family expect to receive information regarding her death and dying. Therefore, it would be wrong to avoid giving them the right information in a timely manner. Ultimately, the family would have to give in to the demands of the father to follow their cultural beliefs in determining whether to put Ella into a hospice or not. This would help in avoiding tension within the family. It would ensure that the death of Ella is a peaceful occasion, which does not lead to strife within the family. This is very important in the American Indian culture.

It is evident that the Ella’s hospitalization and final diagnosis has caused several problems to members of the family.  The members of Ella’s extended family have several personal problems. Her son is an alcoholic. Her daughter has diabetes. Her grandson and granddaughter have drug related problems, with the granddaughter having severe drug problems than the grandson. On the other hand, her daughter in law is stressed out due to the medical problems of her family. Therefore, Ella’s hospitalization would increase the problems that the family members face. They may not be able to cope with the problems. Ella is stressed by the discord and discomfort among family members due to her hospitalization. Therefore, she prefers to alleviate the problems the family members are experiencing by dying in peace at home. This would make her death be a peaceful occasion and enable her to dye in peace, which is vital in the American Indian culture.

If Ella decides to leave the hospital and face palliative care at home, she would need several resources. The number of trained family members, healthcare workers, or volunteers should be sufficient to meet her healthcare needs. The healthcare workers should be able to incorporate the cultural needs of American Indians in various decisions. However, research has shown that healthcare workers are not able to meet the cultural needs of American Indians. This due to the fact that different American Indian tribes have different cultural beliefs (Purnell, 2012).

Ella is terminally ill. She requires extensive medication to relive her pain. Therefore, hospital-based palliative care would help in meeting the medical needs of the family. It would provide Ella with an interdisciplinary team of medical professionals who would be able to meet her healthcare needs. This team of medical professionals is unavailable in home-based palliative care. In addition, a hospice would make Ella’s family incur less out-of-pocket for medical expenses related to the ailment. Medicare, Medicaid or medical insurance would cover the medical costs of the healthcare in hospice. On the other hand, in home-based palliative care, the family would incur significant out-of-pocket expenses (Connor, 2009).

On the other hand, hospice care may not make the Ella feel comfortable. This is because she is not in familiar surroundings, which would be prevalent in home-based palliative care. In addition, family members may not be able to visit the hospice regularly to support Ella with support during her final days. However, in home-based palliative care, the family would be able to provide Ella with support.

It is a fact that home-based palliative care would have a negative impact on the family’s psychological well-being. Various family members already have several psychological problems. Having a prominent member of the family under home-based palliative care would imply that they would be in constant contact. Ella’s daughter in law may be the family member who would be the most severely affected family member. Therefore, the healthcare providers should discourage the use of home-based palliative care. However, in so doing, they must consider various cultural issues of the family (Forman, 2003).


It is vital for healthcare providers to ensure that they consider the cultural beliefs of patient in palliative care. This would ensure that the patients dies in perfect surroundings according to their wishes. Ella wishes to die peacefully at home. She does not want her hospitalization to increase the strife within the family.

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