INDH2490: Foundations of Aboriginal and Torres Strait Islander Health Assessment

Assessment 2 - Written Assignment Case Study - 30%

This assessment is designed to develop critical thinking and responsiveness to decolonise the experience of health care for Aboriginal and Torres Strait Islander people. The case study will allow students to reflect on the knowledge of Aboriginal and Torres Strait Islander history, cultural identity and beliefs and suggest improvements of care to improve the burden of disease and life expectancy.

Weighting: 30% of total mark

Length: 2000 words (+/-10%). Note: only the first 2200 words will be marked, this includes in-text references but excludes the headings and reference list.

Due Date: Friday?17th of September by 11.59pm

Case study

Aunty Letti is a 60-year-old Dunghutti women, she is an elder in her community. She lives with her eldest daughter Marli, who works fulltime at the local school as an Aboriginal Educational Officer and has three children (ages 4,6 and 9). Aunty Letti has recently retired from her role at the same school where she taught art for many years. She now spends most of her time reading to her grandchildren, leading art sessions in the community and growing local food. Aunty Letti has four other children who all live close by.

Aunty Letti has a history of Type 2 Diabetes (insulin controlled) and was diagnosed with chronic kidney disease 3 years ago. Her care has been managed at their local hospital, which is a small remote 10 bed hospital with one permanent doctor. At Aunty Letti’s most recent check-up the doctor raised some concerns with her health. The doctor has organised a referral to the specialist endocrinology and renal teams in the neighbouring metropolitan hospital, which is 3hrs away. An initial appointment with the renal team was organised for 4pm one afternoon. Marli would be the one driving her mum. So this meant she had to organise care for her children and accommodation for the night. The day they were leaving Aunty Letti expressed that she was feeling quite overwhelmed as she “has never been to a big city hospital and the stories her grandmother shared weren’t very good”, she also hasn’t been off country in more than 10 years.

Once arriving to the hospital Marli and Aunty Letti aren’t quite sure where to go, the directions on the appointment letter aren’t very clear, so they ask someone who looks like they work in the hospital for help. The wardsman looked at them and said, “well I guess you aren’t from here are you” but pointed them in the general direction. Marli and Aunty Letti felt ashamed for not knowing where to go but took this small amount of information and found the room they needed, this led to them arriving at the initial appointment 10minutes late. While they were checking in, Aunty Letti and Marli overhead a comment from the administration staff “these people out bush are never on time”. The renal team conducted their review and concluded that Aunty Letti was in renal failure, and she would need to start dialysis right away. Dialysis will be undertaken 3 times a week initially to see how she responds. So that would mean multi trips per week to the hospital or choosing to stay in hospital accommodation for the duration of her intensive treatment. When Marli suggested

that this is a difficult situation for her family, the doctor cut her off and stated they would like to start the treatment the next day and that they should speak to the administration staff to help organise the process.

Please answer the following questions and consider what you have learnt from weekly learning materials:

*DON’T FORGET:

In your answers you must consider:

· Aboriginal and Torres Strait Islander peoples, history, cultural identity, beliefs and values with a particular focus on the burden of disease.

· Present health care inequalities and strategies/promotion/frameworks that are current in today’s health care system.

· Strategies that hold the potential to improve the burden of illness and life expectancy for Aboriginal and Torres Strait Islander people.

· Explore potential biases towards Aboriginal and Torres Strait Islander peoples.

Your work must be supported by relevant, contemporary literature (from within the last 10 years) and a minimum of 8 references, 2 of these references must be from Aboriginal and/or Torres Strait Islander authors.

THIS IS NOT TO BE ANSWERED WITH CLINICAL TREATMENTS OR CLINICAL DIAGNOSISES THIS IS ABOUT CULTURAL AND CULTURAL APPROPIATE CETNRED CARE.

Questions

1. Briefly identify any barriers and cultural considerations that the family may face when accessing Aunty Letti’s treatment (300 words)

2. Briefly describe the determinants of health, and inequalities that Aunty Letti and her family are facing to receive adequate health care? (300 words)

3. Identify what health services and resources that could be accessed to help support the care of Aunty Letti in the admission and treatment process? And why it is important to use culturally appropriate resources? (400 words)

4. Identify and describe how a culturally safe environment could be ensured for Aunty Letti through her hospital admission and treatments? (500 words)

5. Reflect on the actions and conversations from hospital staff and how you felt about the situation. (500 words)