DISCHARGE PLANNING
As a care coordinator in a local hospital, you have been asked to meet with a 90-year-old female patient who was recently admitted to the hospital with shortness of breath and frequent falls. During your initial visit with the patient, you meet her 50-year-old daughter. There is a significant language barrier with both the patient and the daughter, as well as low health literacy. There does not appear to be any additional family to contact. You have been able to determine they are from South America and have been in the United States for less than a year. They are currently homeless, with no source of income, and living in a rural area with minimal resources.
You are tasked with maintaining a therapeutic alliance and getting your client the services she needs.
A. Discuss the patient’s immediate needs and referrals for services in preparation for discharge.
B. Describe how the patient’s understanding of her medical condition and her available options to care will be assessed.
C. Explain how the patient’s location, background, and life circumstances will affect outcomes.
D. Describe methods that you could use to understand this family’s communication style and culture better to enhance your professional relationship.
E. Describe the effect social determinants of health have on this patient’s health by doing the following:
1. Identify the barriers this patient faces related to social determinants of health.
2. Identify the gaps between clinical care for the patient and community resources.
F. Explain strategies to engage community relationships with stakeholders to support the patient in the scenario.
G. Analyze two national standards of Culturally and Linguistically Appropriate Services (CLAS) applicable to the patient’s health disparities in the scenario.
H. Recommend an evidence-based intervention that includes the following:
• Community involvement
• Cultural considerations
• Improves an identified health disparity.
I. Describe community resources to support patient adherence to potential lifestyle changes after discharge, with consideration of the patient’s cultural norms.
J. Discuss information that could be provided to the hospital that would decrease the cultural misunderstandings regarding the immigrant population and help the hospital understand the needs of this population.
1. Describe the community resources that might be accessed to support and sustain the hospital’s cultural intelligence development.
2. Describe two accreditation standards, laws, professional standards, or funding requirements that relate to cultural intelligence.
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K. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
L. Demonstrate professional communication in the content and presentation of your submission.