This post is from Kristine Keough Forte taking the our Cultural Competence in Health Care class. She discusses an opportunity to promote cultural competence.
July 2nd – “I had the opportunity to nudge my fellow team members from thinking of a patient with multiple admits for DKA (last time he was rte-admitted within four hours) as “non-compliant” to digging a bit deeper to see if it actually was non-volitional – I suggested that OT evaluate the patients cognitive skills, especially for the math necessary to calculate sliding scale doses of insulin. (one of the most common reasons for diabetics being “non-compliant” are numeracy issues – they can’t do the math; and we in healthcare don’t always check). The Doc and team thought it was a great idea. The patient was resistant at first but the therapist was able to convey that she cared and wanted to help, no one was judging him. He was not able to do the math necessary for calculating sliding scale insulin, he had other cognitive issues as well which led her to recommend assisted living, which the patient is willing to try. He is only 44 y.o., the teams attitude about getting his coverage for assisted living, working with his state case worker to see why this would be of benefit, helping the patient to see how we wanted to help him be successful – all this changed because he was no longer seen as “non-compliant” but rather as a person with a learning disability that effected his health literacy. Yeah cultural competency!”
Update from this morning; the pt. hasn’t been into the hospital in 10 days, he showed up for his appt. at the FQHC and met w/ his caseworker as well, and they’re working on getting his Medicaid approval for assisted living. He is participating in his care and every one is pretty excited; I think it’s wonderful!