The basic knowledge in nursing or medical studies in itself is not enough. As Watson puts it, there is need to instill the humanistic aspect into the career or the profession. Watson believes that the nurse must establish a caring relationship with patients, display unconditional acceptance of the patient with whatever condition they are in, treat patients as holistic beings, treat patients with a positive regard, promote health through knowledge and intervention treat patients with a positive regard as well as spend uninterrupted time with patients she calls "caring moments" (Vanguard Health Systems, 2011).
In order to effectively achieve and implement the ideas in Watson's theory on culturally competent care, it is important to critically look at the cultural diversity especially among the aging American population. The cultural diversity among the old is considered to be one of the biggest challenges alongside nutrition that the elderly face. According to American Speech-language Hearing Association (ASHA) (2011), the culture shock will not only affect the lifestyle of the elder but as well affect the 'dining habit' of those affected elderly people. This can be seen to be an issue that affects both the nursing home as a comfort facility and as well the nutrition of the elderly people. There is need therefore to have a high skill and level of interpersonal communication for an effective transcultural interaction with the aging.
The elderly can be effectively considered as a vulnerable lot and with several reasons and case scenarios herein. In the 2008, there were 39 million people of 65 years and above in America, this accounted for slightly over 13%, it is estimated that by 2030, there will be around 72 million Americans in this category. This is the time when all the baby boomers shall have acquired the 65 years bracket and above. It will be a significant 20% of the entire American population. The longer life for this generation does not come easier and neither is it cheaper. The inflation, the annual health care cost keep making it harder for the senior citizens to earn a robust life style. It is estimated that in 1992 the annual healthcare cost was $9,224 and it rose to $15,081 in 2006, and this trend is meant to keep rising each year as National Institute of Aging (2008) puts it. This is a significant size of population constituting the marginalized lot and anything affecting them should therefore be addressed immediately and effectively.
The two predominant issues that affect the aging in America today are effectively poor nutrition (hence resultant conditions) and poor home care facilities and services that are not culturally sensitive. On the poor nutrition, it is noted that the heart disease is still ranked as the highest killer of the elderly and is even more serious among the very frail and old people. There could be various reasons behind this trend. However one of the major known perpetuating reasons is the type of nutrition that the elderly are subjected to. As a matter of fact, The Federal Interagency Forum on Aging-Related Statistics (2010: 17) indicate that the number of the elderly who are suffering from obesity is increasing each year since 1988 to 2000 then taken a steady trend instead of going down. On the cultural incompetence within the nursing homes and even the entire American population in general, most of the Americans are too busy to be able to spare some time for the elderly people. They are preoccupied by the pursuit of career and money. As a result, they end up looking for care homes that they take their elderly as a way of helping them to retire with dignity and live a comfortable life after the active years on earth. Unfortunately, for majority of the Americans, this turns out to be ironical since they end up not being in the comfort zone and well taken care of as initially though or intended. The elderly are more often bundled in the hands of culturally incompetent nurses within the homes and get mistreated, with little or no regard at al for their cultural backgrounds and needs. There is always the feeling that one treatment of the elderly fits all. No attention is given to the race, previous place of residence, the social background of the elderly, the psycho9logical disposition of the elderly and several other factors that constitute the cultural competence of a nurse as will be seen below.
One of the most renowned models for cultural competence is the Purnell Model for cultural competence. It is one of the most diverse models that cover the global society, the community, family and down to the person. It also goes further to explain the various cultural domains, in total 12 domains identified under this model, which noticeably do not stand alone but apply in tandem in the bid to care for the recipient of the elderly in this case. The model also covers ideas that emanate from administrative, organizational, family development and as well as communication theories. The twelve domains are heritage, Family roles and organization, communication, Workforce issues, Biocultural ecology, High-risk behaviors, Pregnancy and childbearing practices, Death rituals, Spirituality, Health care practice and Health care practitioner (Larry Purnell, 2005). Bearing the diversity that it holds, it is the best for the frail and elderly of America who need an all round care system in order to live happy lives in the care homes or even at their homes of residence. It is however worth noting here that these cultural standards do exist within economic, political as well as social systems. This means that several health organizations have varied definition of the culturally competent care for their patients across the world. However, there are some baseline characteristics or considerations that cut across most cultures and this is the point of focus here in line with the Purnel model above and those outlined by The American of Nursing Expert Panel (2009) both whom present twelve standards with interlaced qualities.
Social Justice: professional nurses are required to promote social justice for all. Leadership skills are to be developed by the nurses to advocate for socially just practices. This is a tenet of the cultural competence that has widely been met within the care homes for the elderly hence making the feeling of the patients that their rights are respected and their social well being taken care of. The wide adherence can be said to have been sparked by the legislations that have over time come alongside the establishment of such old age homes.
Critical reflection: this requires the nurses to critically reflect on their personal beliefs, values and cultures so that they can identify how these affect the culturally congruent nursing care. This is a standard that is rarely met within the old age homes. Severally the nurses therein have deeply ingrained values and beliefs that they cannot compromise within the short time that they are in the facility. This therefore impacts negatively since the elderly feel that their values are undermined because of their vulnerable condition in instances where the values of the nurses seem to override those of the patient.
Transcultural nursing knowledge: this is yet another standard that is required among nurses for cultural competence. The nurse is required to have a wide understanding of the traditions, values, practices and heritage of varying populations, societies and communities. This knowledge is geared towards provision of culturally competent care of the patients who may be from diverse backgrounds. This still remains a challenging standard among many nurses in the old age homes, leaving the elderly feeling their traditions, beliefs and even ace neglected or looked down upon.
Cross cultural practice: this standard requires the nurses to use their cross cultural knowledge to implement in order to have a culturally competent care. This is yet to be met within the old age homes since there are myriad cultural backgrounds hence a challenge to clearly know which practices are acceptable among which community. The other aspect is that the cultural practices do change as age changes hence it is hard to know all the practices that remain the same as one ages and those that change.
Healthcare systems and organization: this standard states that the organizations must provide resources as well as structures that will enable nurses to meet and evaluate those cultural needs of the patients. Within the old age homes, this is a standard that has been widely met hence making the better part of the nursing fraternity acquainted with the needs of the patients.
Patient advocacy and empowerment: this requires the nurses to advocate for the inclusion of the cultural beliefs of their patients within the healthcare. To do this, the nurses need to recognize the effects of healthcare policies. In as much as the nurses have furnished themselves with this knowledge and apply it appropriately within the care for the elderly, there is still…