Social Implications of Medical Issues - Desklib

This article discusses the social implications of medical issues, including the impact of terminal illness on patients and their families, the role of cultural diversity in care delivery, and coping strategies for patients and families. It explores the concept of palliative care, including traditional and complementary medicine techniques, and the advantages and disadvantages of home-based care. The article also discusses the psychological and social issues associated with chronic illness and the importance of culturally appropriate care.

Running head: SOCIAL IMPLICATIONS OF MEDICAL ISSUES
Social Implications of Medical Issues
Name of the student:
Name of the university:
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SOCIAL IMPLICATIONS OF MEDICAL ISSUES
Table of Contents
Question 1:.......................................................................................................................................2
Question 2:.......................................................................................................................................3
Question 3:.......................................................................................................................................4
Question 4:.......................................................................................................................................6
Question 5:.......................................................................................................................................7
Question 6:.......................................................................................................................................8
Question 7:.......................................................................................................................................9
References:....................................................................................................................................10

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Question 1:
End stage cancer has been reported to have a deleterious and disengaging impact of the
living conditions and the will to live among the patients with terminal disease. The impact of
impending death and the perceived distress of the family members of patients after the death is
known to give rise a varied number of challenges and restrictions in success of the palliative care
that has been planned for the patient (Harvey, 2016). The will to live among the patients for
these terminal diseases is often very less, hence, the nature of the palliative care can have a
significant impact on the last few days or months for a terminally ill patient. The palliative care
practice in USA has changed drastically in the last couple of decades, it has evolved significantly
from the singular focus on the end of life care which is based entirely on the comfort of the
patients to a completely broad and multifaceted interdisciplinary specialty approach which can
potentially address the each and every holistic care needs of the terminally patient and their
family members as well (Littlewood, 2014).
The practice scenario of the palliative care in the USA is now conceptualized as patient
centered and family oriented care. The present western medicine technique of palliative care
especially in the USA attempts to optimize the quality of life of the terminally ill patients by the
means of anticipating, managing and preventing sufferings encountered. The primary focus of
the palliative care practice is on pain management and the related distressing symptoms through
pharmacological and non-pharmacological treatment methods. Along with the traditional means
of medical aid, complementary or alternative medication (CAM) technique is also increasingly
being used for terminally ill patients, especially for pain management. The beneficial impact of
CAM has been very successful in improving the living experience of the patients along with

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providing much needed relief from the exhaustive pharmacological treatment procedure
(Morrison, 2013). On a more elaborative note, for the young adults that are suffering from cancer
or similar terminal illness, providing quality comprehensive care is often very difficult. In such
cases, the implementation of CAM in conjunction with traditional therapies have been reported
to be more effective in enhancing the quality of life and experience of the patients. For the
elderly populations as well, the impact of the using both conventional westernized treatment
methods in conjecture with the holistic alternative treatment methods is expected to yield better
results in both patient satisfaction levels and in care outcome (Wilson et al., 2014).
Question 2:
Culturally diverse communities often experience various cultural and traditional
restrictions when receiving curative care delivery with respect to palliative care given to the
patients. There are various struggles such as communication around death and dying, anger
regarding the impending death, family conflict, family centered care giving during the end of life
stage, cultural differences, the concept of informed consent, and time flexibility. While the
traditional treatment measures are exhaustive and pain inducing, the complementary or
alternative medication techniques are also often associated with extensive activities such as
acupuncture, yoga, and meditation, which might lead to cultural complications (Corin, 2017).
In this case, if Ella decided to continue with CAM mode of treatment, the reaction in her
family is expected to be content and supportive of the decisions taken as the CAM treatment
modes are more acquainted with the traditional healing techniques. However, if Ella is coerced
into the mainstream medicine techniques, the family members might feel extremely agitated and
angry for their cultural safety being violated and their loved family member being forced into a
particular treatment method. Next, If Ella’s husband insisted his family traditions to be followed,

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it might interfere with the caring approach that is needed for the patient under consideration. Ella
is a cancer patient and she might need a curative and individualized care plan involving the aid
of both mainstream medication and CAM medication as well in order to be able to address each
of the care needs that she is exhibiting. Hence, her family will have mixed reaction to this,
whereas the elderly might feel content with Ella being treated with only traditional treatment
methods; and on the other hand, the young generation of the family might disagree, concerned
about her safety and wellbeing (Muriel & Brent, 2017).
The biological basis of care illustrates the impact of the illness along with the treatment
procedure on the overall living experience of the patient and the family members as well. In this
case, the care approach taken for Ella will have a significant impact on her state which will
indirectly impact her son, daughter, grandson, granddaughter and daughter-in-law. Her son is
alcoholic which can contribute to challenging behavior, hence in case the care approach is not
optimal and effective for Ella, her son might be angered and agitated. Similarly her daughter is
also diabetic which might lead accelerate the anxiety with underlying cardiac problems. Both her
grandchildren are drug addict and the condition of their grandmother might affect them dearly
and aggravate any psychotic issue. Lastly, her daughter in law is suffering from stress and
anxiety, and the trouble, pain or struggles during the last few months of Ella’s life might enhance
the stress on her daughter in law as well (Burke et al., 2015).
Question 3:
Terminal illness diagnosis and the impending death is an event which can have a life
altering impact on the family as well. The impending future where a family will have to bid
adieu to their loved one devastates each of the family members, and the coping strategy of each
of the members will differ along with their reactions to the prognosis of a terminal illness. These

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factors influence the patient and the family members considerably, these influences can be
categorized into micro-, meso-, and macro- categories. First and foremost, discussing the micro-
influence, the effect of her prognosis in the pertinent and likely family members will be affected
by the prognosis and progress of Ella, and hence it might lead to certain conflicts and differences
complicating the stay or experience Ella has. First and foremost, the type of care approach taken
and whether or not it adheres to traditional beliefs of healing can be a major reason for conflict.
Along with that who would be the direct point of contact or carer for Ella can also be a reason for
conflict among her husband and children. The responsibility of funding Ella’s care can also be a
major reason for conflict in her family so as who will be taking care of the funding and if all of
them are going to fund alternately (Davis, Deane & Lyons, 2015).
The impact of a terminal such as cancer will also affect the extended family and even the
neighborhood. Whereas going through the hardship of going through the terminal illness can
strengthen relationships within the immediate family members, the impact of the pain and
struggle of cancer can lead to impacting the psyche of the extended family and the neighborhood
as well. Similarly, sympathy and acceptance from the meso-environment can help Ella and her
family feel empowered and encouraged to go through the hard times and build resilience.
Similarly, in case the extended family and neighborhood extends social isolation and withdrawal
for Ella and herv family it will add to their woes (Israel, Baruiz & Solis, 2016).
Two local Australian institutes that can provide assistance to Ella and her family in her
care includes Palliative Care Australia which is a person and family oriented care service
providing assistance and support for the patients with a terminal illness with no prospect of care
(Palliativecare.org.au, 2018). For this organization, the main focus of the organization is to
enhance the quality of life of such patient and provide them a comfortable experience while

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living the last months of their life. Another considerable organization that can help Ella and her
family is Palliative Care nurses Australia or PCNA that provides palliative care nursing service
to the terminally ill and dying patients, providing care and assistance to the patients and the
families to cope with the changes Ella’s life as well as her family members’ (Pcna.org.au, 2018).
Question 4:
A patient with a terminal disease is associated with various different complications and
complexities and hence when the prospect of cure is also missing from the care scenario, the
only care need that the terminally ill patient awaiting the time of death exhibit comfort and
enhancement of the quality of life. In this case the hospice stay, whether it is in a hospital or if it
is in the cozy environment of their own house, facilitates a huge difference in the outcome of the
quality of life. On a more exploratory note, as mentioned by Lustbader et al. (2017), there are
various comfort related issues and complexities associated with palliative stay in a hospital and
as a result most of the terminally ill patients prefer to stay in their home and receive whatever
care they can ion the home setting to be able to spend the last few days or months of time in the
familiar and comfortable ambience of their own homes.
On a more elaborative note, most of the terminally ill patients that have no prospect of
cure prefer the known, familiar ambience of their homes with which they have an emotional
attachment; hence, before inevitable death, the patients often crave one last encounter with the
home environment among their loved ones. As discussed by Ventura et al. (2014), in case of
culturally diverse patients, the traditional beliefs and spiritual connections also drives the patients
to want to live the last of their days and then die in their own house and among their family and
loved ones. Considering the advantage of home stay for terminally ill patient, the comfort, peace
and contentment of being surrounded by their loved ones in a house with emotional and spiritual

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attachments has to be discussed. However, there are considerable disadvantages of home based
palliative care as well. First and foremost, terminally ill patient patients often require the aid of
mechanical ventilation and monitoring in the severe stage which is difficult to provide in a home
based setting (Hopp et al., 2016). Maintaining proper hygiene and sterile environment along with
medication administration, most importantly IV medication of the hospital based setting is
difficult to be replicated in the home setting as well. Managing any emergency deterioration in
the patient condition which is a common occurrence such as cardiac deterioration, respiratory
distress and even organ failure becomes difficult to manage in home setting (Hua et al., 2018).
Question 5:
The terminal illness is intricately linked with pain, struggle and suffering, hence the
concept of coping with these stressors develops significant impact on the psychological and
social issues. First and foremost, a terminal illness and the impending death alters the
perspectives and even the behavior of the patient suffering from the terminal illness is modified,
and as a result the family members of the patients are also subjected to the stress as well.
Considering the psychological issues that are prominent in this condition, the grief, anxiety and
helplessness among the patient and the family. Most importantly, the inability of the family
members to save Ella or even reduce her suffering along with the wish to prolong her inevitable
death as far as possible will be a detrimental impact on the psyche of the patients and their family
members (Doka, 2016). Considering the social issue, the financial burden of continuing the care
for her might lead to considerable burden on the family. Along with that, unequal treatment from
the community or extended family, cultural restrictions and discouragement from them can also
affect their resilience and affect Ella and her experience as well. The chronic illness that has
persisted or has been ongoing for a long period of time can result in many psychological issues

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on the family. The inability to cope with the stress of watching a loved one go through extreme
hardship towards an inevitable death and the helplessness of not being able to help her could
have led her son to alcohol addiction and aggravated the stress and anxiety of her daughter in
law. The torture Ella had been going through and the stressful and depressing home ambience
due to her ongoing illness could have propelled her grandchildren to substance abuse as well
(Bowen, 2018).
Question 6:
Cultural diversity has a profound role in care delivery scenario, when providing care to a
culturally diverse patient the care provider must ensure that the he care provided is culturally
appropriate and adheres to cultural safety standards. Although diversity has a strong impact on
how patients and the pertinent family reacts to illness as well, especially for chronic or palliative
illness. It has to be acknowledged that Ella, the patient in the care scenario belonged to a family
that was not just culturally diverse but had a diverse mindset and ways of coping with the stress
of having to watch a member die due to terminal illness (Doka, 2016). The psychosocial struggle
was evident in the family when the rest the family chose alternative medicine and her husband
John insisted she continue with mainstream cancer treatment. Such conflict of interest can affect
the care decision making and complicate the condition of the patient as well and in order to avoid
it affecting the care for the patient, the care decision making should prioritize the choices of the
patients. Considering the impact of the stress of her cancer prognosis, both financial and
psychological has led her son to alcohol addiction and her grandchildren to substance abuse, and
there is need for care planning that will focus on patient and family behavior modification and
coping skills (Bowen, 2018).

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Question 7:
Death is a catastrophic event for a family and it can never be easy for a family to cope
with the loss of a loved one with whom they have shared a lifespan. Although, when faced with
such a saddening prognosis it also helps to bring the whole family together and decide on
optimally comforting and best solution for their loved one. In this case, different members of her
family decided on different care approaches for her to be taken and the lifespan development for
them has had a significant impact on their choices. John is a Native American who had lived in a
city and was more acquainted with the westernized culture and ways of living. Hence, his insight
and judgment were also influenced by the western culture which led him to choose mainstream
medication for Ella. Although, Ella grew up in a farm where she was more acquainted with home
remedies and traditional approaches to care which had been her and her extended family’s choice
as well. The conflict of choices has resulted due to different upbringing, lifestyle, socio-
demographic ambience and judgment of the both groups (Israel, Baruiz & Solis, 2016).
Although, considering the impact of intellect and cognitive ability, her son was an
alcoholic with considerably altered judgment and cognitive abilities, which has a huge impact on
his decision making for Ella. Her grandchildren were also dealing with drug addiction which
alters cognitive thinking and judgment as well. In this case, these socio-cultural factors have
undoubtedly given rise to care decision making issues. However, in this the family must
prioritize the wishes and preferences of Ella as she transcends to her impending death and
support her through this journey providing her comfort, love and care (Perkins, 2016).

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References:
Bowen, M. (2018). Family reaction to death. In Death and Chronic Illness in the Family (pp. 33-
50). Routledge.
Burke, L. A., Clark, K. A., Ali, K. S., Gibson, B. W., Smigelsky, M. A., & Neimeyer, R. A.
(2015). Risk factors for anticipatory grief in family members of terminally ill veterans
receiving palliative care services. Journal of social work in end-of-life & palliative
care, 11(3-4), 244-266.
Corin, E. (2017). The social and cultural matrix of health and disease. In Why are some people
healthy and others not? (pp. 93-132). Routledge.
Davis, E. L., Deane, F. P., & Lyons, G. C. (2015). Acceptance and valued living as critical
appraisal and coping strengths for caregivers dealing with terminal illness and
bereavement. Palliative & supportive care, 13(2), 359-368.
Doka, K. J. (2016). Living with Grief: When illness is prolonged. Taylor & Francis.
Harvey, J. H. (2016). Give sorrow words: Perspectives on loss and trauma. Routledge.
Home - Palliative Care. (2018). Retrieved from http://palliativecare.org.au/
Hopp, F. P., Zalenski, R. J., Waselewsky, D., Burn, J., Camp, J., Welch, R. D., & Levy, P.
(2016). Results of a hospital-based palliative care intervention for patients with an acute
exacerbation of chronic heart failure. Journal of cardiac failure, 22(12), 1033-1036.
Hua, M., Ma, X., Morrison, R. S., Li, G., & Wunsch, H. (2018). Association between the
Availability of Hospital-Based Palliative Care and Treatment Intensity for Critically Ill
Patients. Annals of the American Thoracic Society, (ja).

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Israel, K., Baruiz, C. P., & Solis, S. (2016). Psychosocial needs and their determinants among
patients with cancer. SPMC Journal of Health Care Services, 2(1).
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Ventura, A. D., Burney, S., Brooker, J., Fletcher, J., & Ricciardelli, L. (2014). Home-based
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Zaider, T. I., Salley, C. G., Terry, R., & Davidovits, M. (2015). Parenting challenges in the
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