Peer Response 1: Please respond to following discussion post. According to Mille

Peer Response 1: Please respond to following discussion post.
According to Miller (2019), African Americans consider their elder family members to be a “source of wisdom and deserve respect” (p. 121). Unfortunately, Mr. McKay is not only suffering from the cumulative effects of health disparities related to his race, he is also suffering because of a possible conflict his daughter may have between what is deemed normal in her culture versus what is the best course of action for her father. When approaching this situation, the nurse must be culturally competent to understand that Mr. McKay’s family feels they are doing the right thing by taking care of him at home and reserve any bias she may have because of the obvious deterioration in his condition to properly advocate for a transition in care.
Neglect and abuse can easily go undetected, so it is important for the nurse to be assessing for certain behaviors such as fear and secrecy in the presence of a caregiver. Mr. McKay shows several concerning risks or indicators of neglect. The albumin test results could be a possible indication of malnutrition, especially when coupled with there being cold food present in the room and water not within reach. The patient is clearly not having his needs met by those charged to take care of him, as evidenced by the primary caregiver not being there and the secondary caregiver not knowing answers to the patient’s status nor fulfilling activities of daily living, such as cleaning, toileting, and medication administration, in the absence of the primary caregiver. The pressure ulcer that is developing, though not a sure sign of neglect, is going to be a threat to the patient’s safety related to risk of infection due to incontinence and inability to ask for help when he has a bowel movement. The fact that Mr. McKay seems to be afraid of his daughter would also suggest the nurse do a more than thorough assessment for bruises since they could be hidden by his skin color.
Reference
Miller, C. A. (2019). Nursing for wellness in older adults (8th ed.). Lippincott Williams and Wilkins.
Peer response 2: Please respond to following discussion post.
A nurse’s assessment is very important in identifying the risk for actual or potential elderly abuse or neglect. Risk assessments should include cultural considerations because what is considered a normal act in one culture may be considered abuse or disrespectful to an elderly in another culture. To assess the risks, the nurse should keep the following questions in mind when the nurse is doing the home visits. “What conduct is considered abusive in the family? Who within the family is expected to care for Mr. McKay and what happens if they fail to do so? Is it culturally acceptable to employ paid caregivers? Do family members differ in their perceptions of caregiving responsibilities? How might cultural perspectives influence the roles of family related to expectations for caregiving? Who makes the decisions about how family resources are expended? Who, within the family, is expected to provide financial support for older members? Does the family consider it appropriate to use the older member’s resources for the benefit of other family members?” (Miller, 2018, p. 169)
References Miller, C. A. (2019). Nursing for wellness in older adults. 8th ed. Philadelphia: Wolters Kluwer.
Lachs, M., & Pillemer, K. (2004). Elder abuse. The Lancet, 364(9441), 1263-1272. https://doi.org/10.1016/S0140-6736(04)17144-4