Abby: An Ojibwa Journey

Abby: An Ojibwa Journey

Individuals are known to possess varied perceptions regarding death and the detached link between the living and the dying.  Death has a significant on every individual involved in terms of finances, psychologically and physically. Cultural and religious beliefs are important sources of assistance as they offer strength to cope with death experiences. Through such circumstances, health care experts have been challenged with diverse beliefs and practices concerning death. According to Colclough (2016), proficient health practitioners ascertain the significance of comprehending the varied cultural practices and learns ways of examining death, dying, and spiritual practices across diverse cultures. Understanding a patient’s principles may greatly assist in eliminating the adverse judgment that they are expected to pass founded on diverse personal principles. This is attributed to their opinions may have a significant impact on the patient’s predisposition and behavior. Based on the case scenario, various cultural problems have been identified. The paper seeks to provide a care plan based on Native Indian cultural practices and ways of approaching the situation.

Communication: Family and Patient

According to Colclough (2016), communication is likely to present issues pertaining to processes that should be adhered to, particularly when some members of the family possess divergent principles and perceptions regarding death. Nonetheless, a patient’s customary views, desires and undertakings should be deliberated and valued during death. The main aim for performing the rites amongst the native Indians mainly entails assisting the deceased individuals to be at ease in eternity. Moreover, various significant artifacts possessed by the deceased such as jewelry, are positioned close to the gravesites. Based on the case scenario, Abby’s household sought to prepare her body for demise, and as a result, requested for a reserved chamber within the hospital’s precincts to conduct the rites based on the Ojibwa culture.

Performing various rituals within the private room is an assurance of peace and reality of Abby’s imminent death and exhibits the significance of the family’s involvement in Abby’s final journey. Based on the presented information, it is distinctive that within the care plan, it is vital to create room for the deceased family to partake in rituals representing care and concerns for the deceased. Based on the case study, cleansing of the private room was done using sweetgrass and sage in readiness for the final journey in accordance with the Indian culture. Moreover, the patient is cleaned using cedar, and an offering of tobacco is made. In readiness for her death, the entire family is seen to accompany her, signifying the importance of the family members and rites conducted. This is important to Abby as it provides an assurance and leads to a peaceful demise. It is a timely moment that allows families to converge and partake in traditional customs. Based on the case study, some arguments are exhibited prior to arriving at the final decision. This portrays the significance of developing amicable objectives between health care practitioners, patients, and family.

Treatment Options

According to Colclough (2016), native Indian culture believes there is life in eternity, meaning that the spiritual world exists. Based on the case study, various options were accessible, for instance, feeding Abby and using other drug interventions to prolong her lifespan. Nonetheless, Abby did not require the said interventions as death is a significant and momentous journey for every human being. According to Stewart (2012), health care practitioners are responsible for adhering to patients’ spiritual needs. The family partakes in various acts such as speaking in intuitive dialects and singing as a consolation mechanism to Abby in the case study. These are considered as some of the significant cultural practices across diverse cultural groups. Abby’s cultural beliefs specify that patients comprehend their desires and rely on the world to process and obtain them. Therefore, she could not be offered modern medicine since it contravenes her cultural beliefs and practices.

Education: Family and Patient

In native cultural practices, an individual’s respectable deed is in most instances so entwined with the uprightness of the family, or in-group, whereby family members possess a significant view on healthcare pronouncements compared to the patient’s various instances. Health care practitioners should seek well-informed and divergent communication frameworks that contrast the informed consent traditions that necessitate health practitioners to have the final say. Moreover, it is deemed important to educate patients and families on the fundamental roles of healthcare practitioners during death. Initiating professional pronouncements lets patients and members of the family make informed verdicts. In addition, doctors need to carry out a comprehensive medical study on an individual’s health condition, hence, facilitating informed pronouncements. The pronouncements are vital in assisting the physicians in initiating comprehensive frameworks that are vital in preparing the family’s acceptance of a person’s demise.

Family Roles in the Process

Based on the case scenario, Abby’s death was coupled with a new outfit tailored by her children. Moreover, a haversack was positioned over her heart, complete with special pieces that they assumed could be utilized in eternity. At first, divergences were apparent pertaining to the best form of respect accorded to their mother during cremation.  Because the journey is vital, members of the family would accompany her. Mary plays a vital part as the family representative and a supporter of Abby’s desires. Throughout her experiences as a health practitioner, she integrated her intuition into the end-of-life circumstance for the family and the patient. Through this method, the family depended on her to provide care, understanding, and a sense of empathy.

Spiritual Beliefs

According to Walsh et al. (2011), Indians believe that death is a normal occurrence in life and life is a continuous thread to eternity. Besides, there exist various undertakings that mainly involve listening to the world and observing nature which is connected to imminent death. The form of care offered to patients is frequently determined by mystical beliefs.  In the case study, one of Abby’s kids, Mary, had the desire of her mother passing to the spiritual world founded on the Indian customs. She recited in the Native Indian language, seen as a move to hear the last sense leave the body in the course of end-of-life care. The family created a traveling box, and the ideal heritage outfits were founded on the traditions. Through this ritual, the family came together and collectively saw off of their mother on her final journey. The caregivers took the opportunity to have a spiritual association with the household and possess a vital understanding and empathy regarding Indian customary practices.


The health care practitioners’ restricted understanding regarding the significance of the customary undertakings commands the type of response provided when requested by the patient’s family. The guidelines directing proficient practices restrict cultural practices. As a result, this results in limitations in allowing patients and families to engage in their cultural practices. Based on the case study, blockades within the family are attributed to the misapprehensions on the appropriate method of sending off their loved one.  Therefore, this exhibits the prerequisite to create corresponding and mutually agreeable objectives between patients, families, and health practitioners.

Cultural Responses

According to Dennis and Washington (2016), culture is considered principles, worldviews, and the behavioral procedures shared by a certain group of individuals. Based on the case study, Abby’s family appears to engage in cultural practices that greatly affect the elders in society. In this case, Abby is positioned private room purified with sweetgrass and sage. Abby is later washed using cedar and offerings of tobacco given to the ancestors. Cultural practices are vital in every area they are being conducted. Care providers observe numerous practices and rites deemed to be important and symbolic to the family. Therefore, they comprehend and learn to value, provide efficient communication and empathy to the cultural practices and principles.


Health care practitioners have a duty of accepting and understanding the diversity and rites of diverse cultures. Moreover, they should recognize the rites and principles pertinent to a given culture’s end-of-life situation. Even though the cultural principles and rites do not conform to conventional medicine, comprehending the provisions offers peace to nurses and the patient’s household. Mary’s understanding regarding the cultural practices and her mother’s desires guaranteed that Abby’s wishes were fulfilled based on the Indian culture.  Moreover, she guaranteed that members of the family and the care providers comprehended the nature of care and undertakings necessary founded on the Native Indians’ customs.



Care Plan

HLT-324V: Transcultural Health Care


Patient’s Name: ____________________________________________________ Date: ____23/06/2021____________________________________

Patient’s Diagnosis: ____Alzeheimer_______________________________________________________________________________________


(Include date.)

Goals Interventions/Actions Discipline/Person Responsible Outcome/Comments

(Initial and date.)

Offering palliative care to incorporate a patient’s spiritual needs



Addressing the patient’s spiritual needs pertaining to death. Forming affiliations with patient’s household to initiate agreeable objectives. Members of the family


Establishing various undertakings and pronouncements pertinent to death that relate well with the patient’s needs, promoting smooth passage to eternity.







Establish effective communication between Abby, Mary, members of the family, and health care practitioners Establishing a viable mode of communication Health practitioners and members of the family Guaranteeing cultural competency and effective communication during the provision of services.




hourly rounds to assess the

patient’s medical condition

because of Alzheimer





Providing adequate care to guarantee the patient meets her physical and spiritual needs. Offering room for cultural practices.

Provision of essential services, for instance, skincare, feeding, and bathing.

Nursing professionals and members of the family. Preparing the journey for her final journey.

Nursing practices advance hygienic undertakings.

Partaking in rituals guarantees peace and minimizing stress.



Training patients and members of the family on the significant role of health practitioners.






Train family and patient on the significant part played by health practitioners.

Members of the family being cognizant of the presence of various services affiliated to the patient’s principles.

Nurses provide the required information pertinent to the medical condition and viable options to facilitate sound pronouncements. Counselor


Developing approaches to begin preparing members of the family to accept life without deceased members.

Members of the family being fully conscious of the health status and initiate adequate measures.


Colclough, Y. Y. (2016). Native American death taboo: Implications for health care providers. American Journal of Hospice and Palliative Medicine®, 34(6), 584-591.

Stewart, M. A. (2012). Effective physician-patient communication and health outcomes: a review. CMAJ: Canadian Medical Association Journal, 152(9), 1423.

Walsh, K., King, M., Jones, L., Tookman, A., & Blizard, R. (2011). Spiritual beliefs may affect the outcome of bereavement: a prospective study. Bmj, 324(7353), 1551. PMID:7728691

Dennis, M. K., & Washington, K. T. (2016). “Just let me go”: End-of-life planning among Ojibwe elders. The Gerontologist, 58(2), 300– 307.


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