Question

Elmer and Mary Miller, both 35 years old, liv

e with their five children in the main

house on the family farmstead in one of th

e largest Amish settlements in Indiana.

Aaron and Annie Schlabach, aged 68 and 70, live in the attached grandparents’

cottage. Mary is the youngest of their ei

ght children, and when she married, she and

Elmer moved into the grandparents’ cottage

with the intention that Elmer would take

over the farm when Aaron wanted to retire.

Eight years ago, they traded living space.

Now, Aaron continues to help with

the farm work, despite increasing pain in hi

s hip, which the doctor advises should be

replaced. Most of Mary’s and Elmer’s sibli

ngs live in the area, though not in the same

church district or settlement. Two of Elmer’s brothers and their families recently

moved to Tennessee, where farms are less expensive and where they are helping to

start a new church district.

Mary and Elmer’s fifth child, Melvin,

was born 6 weeks prematurely and is 1

month old. Sarah, aged 13, Martin, aged

12, and Wayne, aged 8, attend the Amish

elementary school located 1 mile from thei

r home. Lucille, aged 4, is staying with

Mary’s sister and her family for a w

eek because baby Melvin has been having

respiratory problems and their physician told

the family he will need to be hospitalized

if he does not get better within 2 days.

At the doctor’s office, Mary suggested

to one nurse, who often talks with Mary

about “Amish ways,” that Menno Martin, an

Amish man who “gives treatments,” may

be able to help. He uses “warm hands” to

treat people and is

especially good with

babies because he can feel what is wrong. Th

e nurse noticed that Mary carefully placed

the baby on a pillow as she prepared to leave.

Elmer and Mary do not carry any hea

lth insurance and are concerned about

paying the doctor and hospital bills associat

ed with this complicated pregnancy. In

addition, they have an appointment for Wayne

to be seen at Rile

y Children’s Hospital,

3 hours away at the University Medical Cent

er in Indianapolis, for a recurring cyst

located behind his left ear. Plans are being

made for a driver to take Mary, Elmer,

Wayne, Aaron, Annie, and two of Mary’s sist

ers to Indianapolis

for the appointment.

Because it is on the way, they plan to stop in

Fort Wayne to see an Amish healer who

gives nutritional advice and does “treatment

s.” Aaron, Annie, and Elmer have been

there before, and the other women are considering having treatments, too. Many

Amish and non-Amish go there and tell others

how much better they feel after the

treatments.

They know their medical expenses seem minor in comparison to the family

who last week lost their barn in a fire

and to the young couple whose 10-year-old child

had brain surgery after a fall from the hayl

oft. Elmer gave mone

y to help with the

expenses of the child and will go to the barn raising to help rebuild the barn. Mary’s

sisters will help to cook for the barn raisi

ng, but Mary will not help this time because

of the need to care for her newborn.

The state health department is concer

ned about the low immunization rates in

the Amish communities. One community-health nurse, who works in the area where

Elmer and Mary live, has volunteered to talk

with Elmer, who is on the Amish school

board. The nurse wants to learn how the health

department can work more closely with

the Amish and also learn more about what

the people know about immunizations. The

county health commissioner thinks this is a wast

e of time and that what they need to do

is let the Amish know that they are creating

a health hazard by ne

glecting or refusing

to have their children immunized.

1.Develop three open-ended questions or statements to guide you in your understanding of Mary and Elmer and what health and caring mean to them and to the Amish culture. 2. List four or five areas of perinatal care that you would want to discuss with Mary. 3. Why do you think Mary placed the baby on a pillow as she was leaving the doctor’s office? 4. If you were the nurse to whom Mrs. Miller confided her interest in taking the baby to the folk healer, what would you do to learn more about their simultaneous use of folk and professional health services? 5. List three items to discuss with the Millers to prepare them for their consultation at the medical center. 6. If you were preparing the reference for consultation, what would you mention about the Millers that would help to promote culturally congruent care at the medical center? 7. Imagine yourself participating in a meeting with state and local health department officials and several local physicians and nurses to develop a plan to increase the immunization rates in the counties with large Amish populations. What would you suggest as ways to accomplish this goal? 8. Discuss two reasons why many Old Order Amish choose not to carry health insurance. 9. Name three health problems with genetic links that are prevalent in some Amish communities. 10.How might health-care providers use the Amish values of the three-generational family and their visiting patterns in promoting health in the Amish community? 11. List three Amish values to consider in prenatal education classes. 12.Develop a nutritional guide for Amish women who are interested in losing weight. Consider Amish values, daily lifestyle, and food production and preparation patterns. 13. List three ways in which Amish express caring.

Answer 1

Q. No. 2. Answer :

Peri natal care means total care during pregnancy and during delivery and after delivery.

I want to discuss with Mary regarding perinatal care is she had premature baby by delivery.

* during pregnancy adequate nutrition and, psychological good ness, and emotional well-being is important.

* immunization is needed.

* if mother takes good nutritious diet and the baby also will grow normal.

* and pressure and tension should not be their during pregnancy, if it is there there is a chance to premature labour.

* after delivery also she need to take adequate nutritious diet and she, must be psychologically well, not in depression mood, then only she will get adequate milk production and she can take care of her child.

So that early recovery of newborn.

* adequate warmth ness should be provided to baby.

* only breast milk has to be given.

Q. No. 3. Answer :

* Because she had premature baby and the baby is sick, and also the are not having any insurance benefits to pay for bills and amount to the care which is provided to the baby.

* so that she thought that to leave the baby, because of frustration and depression.

Q. No. 8. Answer :

Two reasons for old older Amish choose not to carry health insurance :

1. Because self employed people exempt from the pay ment of tax. And they will get some benefits during in the old age.

2. And they pay income and property directly to the public sectors not to private sectors , so they are excempted to pay and receiving social security.

Q. No. 11. Answer :

* three Amish values consider in pre natal educational classes:

1. They thought the pregnancy due to the gods gift.

2. They are prefer to sit along with their husbands to the prenatal educational classes. Because they will reject so many vedios.

3. They will prefer the home deliveries.