Mr. Paul james is a 88-year-old widow who lives on

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Mr. Paul james is a 88-year-old widow who lives on the Sheguiandah First Nation Reserve among the tribe of the Anishinaabe people. He worked as a custodian for 18yrs and retired when he was 64yrs old. He is widowed and has 3 children. James lives with his younger son, daughter-in law and their 2 small children: 3yr old Kane and 18month old Jon plus three dogs. James and his family share a small home with poor ventilation and often the roof leaks during the winter months. Presently no one in the family is working and they rely on government financial assistance and his pension. He often helps entertain the children and helps with household chores. His 2 other children, grandchildren, and great grandchildren all live in his community. They speak only Ojibwe at home and all struggle with the English language.
He has a history of diabetes, COPD, and hearing loss. He considers himself to be healthy, describing his breathing condition as ‘not that bad, and his diabetes as ‘manageable’. He becomes short of breath doing daily activities which take him longer now. He still smokes occasionally and understands he should quit but feels he is ‘too old to try’
James had 3 toes from his left foot amputated 5 weeks ago, secondary to a wound that didn’t heal due to diabetes. Wound care is provided in an outpatient clinic on the reserve. He understands the severity of his situation and is concerned that the wound is not healing as expected. He states “I don’t want to have my leg amputated just below the knee”. James does his own dressing changes and explains to the nurse that he does not want to bother his family and states ‘I can take care of myself’. The wound care nurse assessed James, noting that he was not wearing his hearing aids, and suspected he could not hear the wound care instructions.
James seeks care from the Medicine Person and plans to participate in smudging ceremonies. The Medicine Person recommends James drink herbal teas made of willow bark, black tea leaves, licorice root and choke cherry to help with his wound. As well, he advises Jimmy to chew yarrow leaves to improve his breathing.
The following are James’s prescribed medications form the health clinic physician:
· Albuterol 90mcg 1-2 puffs q4h prn SOB/wheezing,
· Lisinopril 20mg once daily,
· Omeprazole 40mg once daily,
· Metformin 500mg one tablet daily
Question
1. Identify the challenges in Mr. Redcoat’s environment that largely defines the Aboriginal situation.
2. How would you share this information with Mr. James and his family
3. How can you incorporate traditional healing practices into Mr James care.
4.How can nurses and health care practitioners work together to optimize health care to the community?

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