In this journal activity, you will review a case study focused on the later stages of life. You will explore perspectives on death and dying through the research of Elisabeth Kübler-Ross and address the role of cultural competence across the life span. You will have the opportunity to explore these topics and how they apply to you.
After 20 empowering years of working with geriatric patients as a caseworker, Jamie has decided to transfer her extensive knowledge and expertise in working with this population to the hospice care setting. Beginning this week, Jamie will be working in an urban center with a demographically diverse mix of individuals from various ethnic, social, and cultural backgrounds. Jamie’s reason for making this change is simple: She believes that we each have so much to learn from a person’s unique attitudes, beliefs, values, and wisdom—especially from those in the final years of their lives. Jamie also believes that our cultural values have a direct impact on our notion of death; some customs frame death as a transition into another existence, whereas others believe that we continue to have a spiritual relationship with our deceased loved ones long after they are gone. In other cultures, death is viewed as an event that is, in no uncertain terms, final.
In her first assignment, Jamie is grateful to meet Jackie, a 75-year-old Thai female who has recently been diagnosed with terminal (stage 4) breast cancer. Jackie is divorced and lives with her 50-year old daughter. Jackie’s daughter has been very supportive throughout her cancer diagnosis, transporting Jackie to her medical appointments and helping with her personal care needs. Since her divorce, Jackie has not been in an intimate relationship because she did not feel confident that she would ever find a suitable partner. As a practicing Buddhist, Jackie believes that her divorce was necessary in order for her to live her remaining years in peace, a decision that she feels has significantly improved her sense of life satisfaction.
Up until her diagnosis, Jackie worked part-time as a teacher’s aide in her granddaughters’ elementary school; however, she stopped working six months ago due to feeling exhausted by her chemotherapy. As she prepares to enter hospice care with only months to live, Jackie feels full of despair about her lack of mobility and independence. As she reflects on her life, Jackie is proud that she raised a good daughter and that she left a dysfunctional marriage; however, she feels some degree of regret for not having given back to society in a meaningful way. Lastly, although she practices Buddhism, Jackie is now questioning the idea that death leads to rebirth. As Jackie increasingly believes in the finality of death, she views life as short, fleeting, precious, and something that no one should ever take for granted.
As a valued member of the multidisciplinary health care team, Jamie is on a mission to apply the following theories, models, and concepts to support Jackie and her daughter throughout Jackie’s end-of-life experience: Kübler-Ross’s stages of grief, Erik Erikson’s stages of psychosocial development, and the Model of Transcultural Health and Cultural Competence (Papadopoulos, Tilki, & Taylor, 1998).
Papadopoulos, I., Tilki, M., & Taylor, G. (1998). Transcultural care: A guide for health care professionals. Wiltshire, UK: Quay Books.
The following resource supports your work on the activity:
Module Four Activity Template
For this journal activity, in order to better understand perspectives of death and dying, you will read the case study presented in the scenario and thoughtfully apply theory to complete the Module Four Activity Template. In the template, you must address each of the following rubric criteria with a minimum of 2 to 5 sentences.
Describe which of Kubler-Ross’s stages of grief are most applicable to Jackie’s situation. Explain your response.
Explain how a person experiences Kübler-Ross’s stages of grief. Address the following in your response:
Does a person move through the stages in a linear fashion?
What have you read or experienced about grief to support your answer?
Explain why having a sense of cultural competence (empathy, respect, self-awareness, cultural awareness, communication) could help Jamie be a more effective caregiver.
Given your unique needs, desires, and aspirations, describe some things that you feel will provide you with a sense of life satisfaction as you enter the later stages of the life span
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