Patients usually go through a lot and in most instances; other people influence their decisions in all aspects. They are forced to follow certain aspects even though they themselves are against them. This is because they are sick and as thus depend on the help of others in order to regain their healthy.


The scenario


Ella has been sick and as thus has been requiring medical help. She wishes to stick to the alternative and complementary medical practices but is coerced to follow the mainstream medical advice. Her husband, who insists to make decision on her behalf, as he is the head of the family, opts for traditional practices.


There are alternatives for her care as she may be discharged home to receive treatment and care from there.However; the family members at home also have individual problems. The son is an alcoholic while the daughter has diabetis.The grandson has drugs problems while the grand daughter is bipolar and also has drug problems. The daughter in law is also stressed because of the medical issues in the family which include nephew with leukemia, brother who has HIV and her father’s view that they are all crazy.


Ella is expected by the doctor to go home and receive care from there. The family members are thus expected to provide her with all the care needed in order to enhance her recovery. The question is, keeping in mind the current situation with family members; will she be able to recover adequately?


Cultural Aspects and alternative treatments


Ella’s husband wants the family traditions to be followed in her medications. Assessment of therapy process and its outcome usually vary across cultures. A cure in a system may be regarded as a failure in another system. This makes assessment of success or failure a daunting task.


The biomedical perspective of traditional systems is that they usually lack models necessary for chronic disorders. In a scenario, a medicine man may say that their therapy works as their patients never come back. A physician may say that their therapy works as their patients do come back. Physicians view this as success to an ongoing process while the medicine mans` cure does not appear to need any further therapy. These thoughts reflect the different expectations of people on illnesses and therapy. These methods are based on various expectations of patients and their families. (Jennifer Christine Mills Niemeyer, 2010)


The current scenario is complicated further as the husband opts for traditional mechanisms. He wants a therapy that will adequately provide a permanent cure and relief. The husband challenging the use of biomedical to traditional poses a great task to physicians and healers of any tradition. This makes the patients to struggle and reject with the chronic illness. The physician should thus recognize the psychosocial problems and try to analyze the complexities of the cross-cultural settings of caring for the patient. This is to ensure positive progress of the patient’s health.






In dealing with this Ella’s husband, the physician may apply the following guidelines:-


  • Negotiate with the patient, Ella’s husband and the family at large on all issues that are related to the biomedical illness processes and Ella’s experience and views on the illness.

  • Create awareness to the family of their importance in involving themselves to therapy. This should be emphasized at all levels of care and physicians should empower and support the patient and the family in the whole care process.    

  • Physicians should also encourage actions in the family that will enhance the peoples needs in participating to help and neutralize the fears that are linked between the traditional beliefs and the biomedical aspects.

  • Physician should also compare the various explanations given by the patient and the patient’s husband. From this, they should mould a therapeutic plan that will accommodate the special perceptions and beliefs held by the patient’s husband.

  • The physician should analyze the discrepancies between the patient-family goals and the biomedical goals. All the difficulties that may relate to miscommunication or communication style should be addressed that cut across cultural boundaries.


Complementary medicine and beliefs


Ella wishes for the use of a complementary system in her treatment. These treatments are used in addition to the conventional medicine. She wants to integrate both the scientific proven therapy with the traditional herbal formulas. Complementary medicines unite the best practices of both worlds. (Helen E Sheehan; Barrett P Brento, 2002)


Some of the reasons patients opt for complementary medicine and therapy include: some patients emphasize on the value of treating the whole person; some believe that the complementary medicine will be effective on the specific problem than mainstream therapy; the believe that the complementary therapy will enable them to take an active role in maintaining their health; while others believe that the mainstream treatment was not adequately effective on the specific problem.


As Ella has been chronically sick for a long time, the above factors are the basis for her choice of opting for a complementary therapy.


Mainstream medicine


Mainstream medicine is the system applied by medical doctors in diagnosing and treating diseases. (Helen E Sheehan; Barrett P Brento, 2002)  This is the doctor’s choice for Ella’s therapy. The doctor will provide guidelines and procedures to be followed in the whole therapy process. As both the Ella and her husband are against this system, the doctor may be unable to effectively provide the medical care during therapy.


In conclusion, the different aspects of traditional, complementary and mainstream systems of treatments are incompatible and will only make the patient’s situation even harder to manage. The three parties should agree on which system is most effective in order to enhance medical care of the patient.






Family conflicts and differences likely to be encountered in the family


Everyone in the family have their own individual problems. They range from drug addiction, illnesses such as diabetes, leukemia and HIV to stress. These are the family members that are supposed to take care of Ella. In case of therapy, the family members are assigned responsibilities as too how each is supposed to play a role in the therapy.


In view of this, everyone in the family feels that even them they require special care. This is because everyone is undergoing difficult situations in their lives that affect them physically, socially and emotionally.


From the scenario, one can truly say that each member of the family does whatever they think is best for them without considering the repercussions or other family members. It seems like all the family members are irresponsible and there is no one to guide them into doing what is right. With Ella coming home and requiring special care from all family members, this will indeed be a hard task. The other family members will too feel that they also need the special care as they too are undergoing difficult situations in their lives.


All the above factors will cause conflicts and differences among the family members and make everyone’s situation even worse. All these aspects will derail Ella’s progress in her therapy. They will indeed have an impact on their social and psychological perspective on their basis of life.






Reaction and role of the community in meeting the diverse family circumstances


The extended family plays an important role in the whole therapy process of Ella. They are the immediate people to offer therapy care to her and in view of this, their action on the situation will indeed have an impact on the situation. The neighborhood is also like part of her family as they live in the same surroundings.


High chances are that the extended family and the neighbors may not feel it as right to have Ella be taken care of at home. This is because of the circumstances surrounding her family members who are supposed to take care of her. Their view would be that the family members might have a negative impact on the treatments of Ella and thus derail her recovery.


As all the family members are in need of therapy because of their various situations, the communities has resources and programs to deal with the circumstances. This include –


  •  The alcohol anonymous program that is run in the community helps alcoholics who are in need of changing their situations. They usually meet, share their experiences on how alcohol has ruined their lives and they are given therapy on how to change. Also those that have successfully finished their therapy encourage others of the impact of such therapy on their lives. This program will indeed help her son Sam, grandson Josh and granddaughter Lucy.

  • There is also a social agency in the community that offers counseling services to people. The various counselors at the station are trained with vast experience to help in mitigating some problems people encounter in their lives. This counseling service will best suit all the family members including Ella’s husband. After successful completion of the counseling process, the family will now be joined together in helping Ella.


The above community services will adequately help in meeting the needs of the diverse family circumstances.


 Hospital care and home care


A home based care is usually affordable and cost effective than a hospital based care especially for chronic conditions. However, the cost of caregivers remains at a higher rate as compared to their incomes.


Palliative care is the best option for Ella as its most suitable for people experiencing stress, pain or other conditions caused by a serious illness. This care is appropriate at any of the stages of serious illness and patients usually are given together with the treatment prescribed to cure the patient. (John Arras, 1995)


Importance of Palliative care


  • The palliative care team helps in identifying the sources of discomfort and pain and thus provides the necessary treatments that offer relief.

  • The team comprises of good communicators and as thus, they apply their communication and coordination skills in ensuring that the family needs are met. This will indeed be most essential to Ella’s family as there lacks communication and coordination.

  • The palliative team offers emotional support focusing on the person as a whole rather than just the illness. The team addresses the psychological, social or emotional needs of the family.

  • This team also offers support to the family members as they also go through a lot of stress. They help to ease their stress and tension and also help in decision-making.


In view of the above, a home care enables one to have a more control of their lives and care and provides a supportive and comfortable atmosphere that helps to reduce stress and anxiety. The home care also with palliative team enables one to go on with their daily lives while at the same time improving their ability to continue their therapy. It helps one to better understand their conditions and the treatment choices available.


Impact of the situation and each person perspectives on their lifespan development


The situation has indeed changed the whole family’s perspective of life. There are many problems to be solved and with a patient at home requiring care, this will make things even worse. Each member of the family minds about their affairs without being responsible for others in relation to the actions they show. This will indeed hinder a positive development of their lives’. As everyone in the family requires the same care, their position on the situation may shift. They may understand what Ella is going through but may not be able to help her appropriately.


However, with the necessary social agencies around the community, the situation may change and have a positive impact.








Helen E Sheehan; Barrett P Brento (2002) Global perspectives on complementary and alternative medicine


John Arras (1995) Bringing the hospital home : ethical and social implications of high-tech home care

Jennifer Christine Mills Niemeyer (2010) The impact of a coordinated care program on chronically ill patients

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