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Taking care of the terminally ill patients involves providing holistic care to the patients, regardless their values, culture, and religion. The existing health care system meets the needs of the dominant groups. The system does not consider that most people in the United States are of diverse culture. Healthcare providers, however, cannot assume that people share common values. It would be necessary for the health care providers to examine religious backgrounds of their patients. Islamic culture should be considered most, since it has several religious and cultural beliefs, different from other faiths. The terminally ill Muslims can only get comfort from their religious and spiritual faith. It is advisable that health care providers and nurses learn to deal with the challenges of caring with terminally ill people from all cultures.

Understanding peoples’ culture is necessary, when caring for the terminally ill, impending death. Over the years, people think of care as the role of a nurse or a health care provider. However, the care provider must consider the cultural values of a patient, his family or community. This would result into care, which is culturally congruent. This includes acts, knowledge, and decisions, made to meet the cultural beliefs and values of clients in order to promote their health (Enck 2002).

Health care providers face several problems, while offering their services. The reason here is that the health care system has not been designed to meet different cultural groups’ needs. There is also a shortage of health care providers due to employment reasons. Therefore, it becomes hard to find health care providers and nurses who come from different cultural backgrounds. This has significantly influenced care delivery. It has now been acknowledged that the patient cultural background ought to be respected. Health care providers face a challenge, when their patient’s culture conflicts their own culture and practices. This may eventually lead to stress and frustration among the nurses or those providing care to the terminally ill patients.

The healthcare providers should learn and adjust to other people’s cultural practices. This helps to understand the patient’s culture and its effect on his health practice. During the first days of hospitalization, the patient should be asked to give details, regarding their culture, education background, religion, values, gender role, knowledge of English language, and their exposure to the large cultural community. Such information would help the health care provider to understand the cultural values of the patient. This understanding would, in turn, help the nurse to attend to the patient with little or no judgment on why they want to practice their practices, while still in the hospital.

Some terminally ill patients will insist on having a health care provider, who is of their sex. This becomes yet another challenge to the health care provider or to the nurse because the available care providers could be of the opposite sex. It becomes crucial to have a family member of the same sex, accompanying the patient as the health care attends him. The health care should minimize physical exposure as much as possible. For example, when dealing with a Muslim lady, their privacy including the wearing of jihab must be respected. This is their culture and must be respected, especially if the family insists so. Adult men should not expose their bodies during the examination by the physician. Health care providers should keep in mind that Muslims discourage eye contact between people of the opposite sex as a sign of respect and modest (Poor & Poirier 2001).

There is also a challenge, when it comes to diet of the terminally ill. The doctor may recommend some food, but according to the patient’s beliefs, he should not take such food. It becomes important for the health care provider to consult with the family members in order to know the alternative food that can be taken by the patient. The patient should also be notified whether their medication contains the prohibited products, in their faith, such as pork and alcohol. Adult Muslims are required to fast during Ramadan so long as they are physically fit. Some patients are found to insist that they must fast and they go ahead to refuse treatment. This becomes a serious challenge. The health care providers should consult a Muslim leader to come and intervene. The Imam will explain to the patient the dangers of fasting when one is ill. The patient is likely to understand his religion more than the physician.

Another challenge arises, when the patient insists that he wants to pray five times a day. According to Islam, prayers will help an individual to meet his spiritual needs. The health care provider should help the patient perform the physical cleansing before the prayers. Some patients, however, refuse bed bath and insist that they must shower at least ones in a day. Special care must, therefore, be given to clean the body from blood, faeces and urine. Direction must also be sought from Mecca, to provide direction on the clean place to do the prayers. Doctors and nurses should not interfere with that prayer session. Therefore, medical procedures cannot be performed at that moment. The physician ought to be patient enough to consider such occasions (Taylor & Field 2007).

Terminally ill patients pose a challenge to the health care providers, when their family and relatives keep on visiting them. Many communities believe that they should visit a sick person. This may interfere with the doctor’s programme of administering drugs to the patient because of the large crowd, surrounding the patient, in the name of praying and comforting their loved one. The visitors may end up bringing foods, which the doctor does not recommend to the patient. This will interfere with the treatment process without the knowledge of the doctor or nurse. It would, therefore, be beneficial to make a schedule for the visiting hours to avoid overcrowding around the patient. This overcrowding may also lead to lack of fresh air for the patient; hence, delayed treatment.

Some cultures have a poor perception of health care professionals. This affects the nursing care, given to the patient. A problem also comes when deciding on whether to disclose the health condition of a patient. Some families prefer that the patient remains in darkness of his illness in order to protect him from bad news. In some cultures, the final decision comes from the family, but in some other cultures, the decision comes from the physician. Some other cultures do not believe in hospital medication. They believe that God brings healing and, therefore, there is no need to follow doctor’s instructions. All these are challenges, which must be addressed, even if it means put in place laws, dealing with people who ignore medication in the name of religion. Many people have lost their lives because of ignoring doctor’s advice. This is, therefore, a major challenge that the health providers must be aware of.

In religions, a person should die at home near their family. For example, Muslims believes that a person who dies at a non-Islamic area should be treated differently from a person who dies in a Muslim institution. Some rituals are performed before an individual dies, which cannot be perform when one is still in the hospital. Healthcare providers might be forced to respect such beliefs to avoid challenges, when the patient dies. Terminally ill people should be encouraged to face death without fear. All of us are religious, and most of us believe in life after death. When dealing with the sick, it would be important to use encouraging, religious words such as “those who would love to meet God, God would love to meet them”. Therefore, the medical care provider should allow religious people to come and talk to the patient. In case the patient does not have a family, the nurse should call the nearest religious leader to come and help the terminally ill person to repent his sins.

A challenge also comes, when a patient belongs to a culture, where they do not believe in putting a patient in a life saving machine for long. The health care needs to understand that some cultures and religions do not support mercy killing, assisted suicide, and euthanasia. Families from such cultural backgrounds can sue a physician for attempting to perform the above mentioned acts. Organ transplant is also an issue to many communities under different cultures and religion. Some support it, while others do not. This poses a challenge to the healthcare providers in deciding what to do to a patient. Some patients may require blood transfusion but their culture does not allow that. Their argument is that the human body belongs to God and not to an individual. It is, therefore, advisable that the doctors understand the religious and cultural backgrounds of their terminally ill patients (Abbey 2008).

CONCLUSION

Religion, faith and spirituality should not be isolated in the culture context. Health care providers need to understand the significance of culture and faith. When these two are viewed together, they help to form a cultural understanding of the patient, his family and his community, as regards health care of the terminally ill patients. It is, therefore, paramount for the health care providers to understand the role of religion in taking care of the terminally ill. These patients require care physically, spiritually and psychologically.

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