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Modules:

  • Introduction
  • 1. Advance Care Planning
  • 2. Communicating Bad News
  • 3. Whole Patient Assessment
  • 4. Pain Management
  • 5. Assisted Suicide Debate
  • 6. Anxiety, Delirium
  • 7. Goals of Care
  • 8. Sudden Illness
  • 9. Medical Futility
  • 10. Common Symptoms
  • 11. Withholding Treatment
  • 12. Last Hours of Living
  • 13. Cultural Issues
  • 14. Religion, Spirituality
  • 15. Legal Issues
  • 16. Social and Psychological
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    Back to Module 13: Cultural Issues
    Tools for Identifying Cultural Resources in Your Community

    Community Based Organizations (CBOs) as Cultural Resources The Telephone Book as a Cultural Resource
    The World Wide Web as a Cultural Resource

    Community Based Organizations (CBOs) as Cultural Resources

    Identifying Community Based Organizations

    • Consider the cultural diversity of your patient population and of your cachement area
    • Enlist the support of your social services department
    • One place to start is by informally surveying your own employees about key leaders and organizations within their communities. If at all possible, work within your organization to practice diversity in hiring. Your own employees are your best liaisons to the communities
    • Churches, community service organizations, and cultural centers serve immigrant communities
    • In small communities there are only a few organizations
    • In urban areas the plethora of organizations makes it difficult to identify the stable, professional agencies

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    What Can CBOs Do For My Patients?

    • Most states and large cities have immigrant-refugee programs that directly or through CBOs provide public aid, Medicaid, vocational and educational services
    • Going through the CBOs may or may not link you to traditional healers and spiritual resources. Your patients already have the information
    • Linking the patient to CBOs will help them to obtain other services such as homemakers and childcare

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    Establishing Relationships with CBOs

    • One of your key resources is to add the names of CBOs and key personnel to your Rolodex
    • If you deal primarily with one or two language communities check that your telephone answering tapes give the option of hearing instructions in that (those) languages
    • Invite the executive directors and key staff of important CBOs to meet you and tour your facility. One agency at a time. Everybody at once in a multiethnic community really means not enough time for anyone. One size does not fit all, unless your purpose is to give the Exec’s an opportunity to network among themselves
    • Offer to give workshops for their staff on palliative care
    • Keep your associations professional, however. Encapsulated communities can be fractious and you do not want to be distracted from your principal objective of providing care

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    The Telephone Book as a Cultural Resource

    • Other sources of information include (really) the telephone book. Let your fingers do the walking
    • If you are in smaller town near (within 100 miles of) a big city, your local immigrant group probably goes in to shop and participate in cultural events. Check that phone book for listings of service agencies
    • There are as well umbrella agencies such as Traveler’s Immigrant Aid (Heartland Alliance) that can network you to specific CBOs
    • Refugees have U.S. sponsors, frequently churches, even if for example the family is Buddhist or Muslim. The church is connected to other resources

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    The World Wide Web as a Cultural Resource

    • With this website you receive an inventory of other palliative care pages (See Additional Links). To our knowledge, few other palliative care sites address diversity. But the web is an excellent place to search for cultural information
    • As we have more time to review them, this page will be updated with sites to check
    • At present, know that many sites are commercial, offering the services of diversity trainers. We do not make endorsements for these services
    • You will also find sites by ethnicity. This will link you to advocacy organizations and cultural interest sites that will not give you direct information about cultural practices but may identify organizations and individuals that may be of assistance to you
    • Native American tribes support several excellent sites and Indian Health Service affiliates
    • There are federal government sites through the NCI, Office of Minority Health DHHS NIH and AHSCPR specializing in low literacy materials, some available in translation
    • AHA, ACS, Y-ME, Susan G. Komen and other special interest groups maintain sites where you can review their material for quality and appropriateness
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