CULTURAL SENSITIVITY AND MEDICATION MANAGEMENT: RECONCILING PERSONAL BELIEFS WITH CARE PLANS

This article was written by Douglas Castellanos, an RN with Caregiver Homes.

In Spanish we have a funny joke, which I think is universal: There’s a girl who is always praying to God to win the lottery. “I’m a good person,” she cried. “I really need this. Help me win the lottery, please.” One day, she got really upset about it and asked God why she hadn’t won yet, since she prayed every day. All of a sudden, she hears the voice of God say, “Maria, buy a ticket.”

In my work as an RN, I care for people of all cultures, heritages and religions, and sometimes I’ve seen prayer replace medication adherence. Personal beliefs sometimes feel in conflict with care plans for some consumers. By listening, educating, and creating an ongoing dialogue, care teams can be sensitive to different cultures and respect consumers’ faiths, while also giving them the best care possible.

Listen and learn.

In order to build a truly person-centered care plan, it is helpful to start by asking questions. Ask them about their food preferences and traditional meals. “What do you like to cook?” “What are your favorite foods?” “Why are these meals special to you?”

As you build an understanding of an individual’s culture, it’s important to ask questions about their medication and health management. In addition to taking prescribed medications, many individuals self –medicate with vitamins, over-the-counter drugs, herbal and nutritional supplements. A lot of times, consumers will tell me about what is used in their culture or country to treat different ailments. While some of their herbal supplements may actually help their symptoms, many consumers don’t know how that supplement may interact with their prescribed medications. For example, if you are taking gingko biloba and Coumadin at the same time, you are double-dosing. Both are blood thinners. If you take both, your blood will be even thinner, and it can be dangerous. I always encourage people to tell their doctors about supplements.

Asking consumers and caregivers about their culture is critical to understanding their care. What do they do when they become ill? How do they maintain their health? The answers might surprise you, and they will help guide the direction of your conversations about medication management.

Educate; don’t patronize.

Demonstrate the benefits of changes to their health regiment. If you can show examples and point out the improved results, that can be very helpful. Show examples; demonstrate the improved results. I once worked with a consumer whose blood sugar was very high. When I asked her if she was taking her medication as prescribed, she would answer, “I’m leaving it in the hands of God, and He is going to cure me.” I approached this situation by having her become even more involved in her care. When she took her medication regularly, I had her test her blood sugar, and she saw how it made a difference. By involving consumers in their own care, they are able to make connections: “I took my medication today, and yes, my blood sugar is good.” I put some power back in her hands to see the effects of her choices, and it made a difference in her care.

Create open, ongoing dialogue.

Be sure to have these conversations often. Revisit their use of medications and supplements. People may forget or overlook the fact that a new herb supplement might conflict with their other medications in their regiment.

Caregiver Homes serves families of all religions and cultures. As part of a care team, it is important to know about families’ religion and the things they believe in. If you are dismissive of their culture, heritage or religion, caregivers and individuals receiving care might not want to share with you. If they don’t trust you, they aren’t going to follow your advice. They may think you are not really listening or caring about their life. Let them know you understand and do your best to relate to them.

I often tell consumers, “It’s a good thing that you pray and you believe. There are many benefits to that. God has probably given you many blessings and opportunities. There are doctors and nurses and teams of people to care for you. Not everyone has that. Your religion is important. Your cultural beliefs are important. And now you have all of these opportunities to get better and stay healthy—a team of care professionals, a loving caregiver, treatments. You can pray to God, and also take your Doctor’s advice, too. You can still have faith and take ownership over your care.”