AMISH CASE STUDY
Elmer and Mary Miller, both 35 years old, live with their five children in the main
house on the family farmstead in one of the 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 eight 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 his hip, which the doctor advises should be
replaced. Most of Mary’s and Elmer’s siblings 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 their home. Lucille, aged 4, is staying with
Mary’s sister and her family for a week 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. The nurse noticed that Mary carefully placed
the baby on a pillow as she prepared to leave.
Elmer and Mary do not carry any health insurance and are concerned about
paying the doctor and hospital bills associated with this complicated pregnancy. In
addition, they have an appointment for Wayne to be seen at Riley Children’s Hospital,
3 hours away at the University Medical Center 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 sisters 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 “treatments.” 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
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 hayloft. Elmer gave money 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 raising, but Mary will not help this time because
of the need to care for her newborn.
The state health department is concerned 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 waste of time and that what they need to do
is let the Amish know that they are creating a health hazard by neglecting 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
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
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
9. Name three health problems with genetic links that are prevalent in some Amish
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
13. List three ways in which Amish express caring.
JEWISH CASE STUDY
Selecting a “typical” Jewish client is difficult. An ultra-Orthodox Jew has a particular set
of special needs. Yet, it is more common to see a Jew who is a middle-of-the-road
Sarah is an 80-year-old woman who is a first-generation American. She was
raised in a traditional Conservative home. Her husband died after 50 years of a strong
marriage. She has three children. Although her home is not kosher, she practices a
variation of kosher-style eating, avoiding pork and not making dishes that combine
meat and milk.
Two months ago, she was diagnosed with pancreatic cancer. Surgery was
attempted, but the cancer was already in an advanced stage. Chemotherapy was started,
but the cancer has progressed and is not responding to the medications. She is having
difficulty eating because of the pressure of the tumor on the gastrointestinal tract.
Discussions are being held to determine whether or not treatments should be stopped
and whether hospice care should be initiated.
Her hospital room is always filled with visitors.
1. What must you anticipate in discussing with Sarah her wishes regarding the
continuation of medical care?
2. How would you respond to her initial decision to have surgery and initiate
3. What questions do you need to ask in the initial patient interview to assess her
degree of religious practice? How will you determine her spirituality needs?
4. What is your understanding of the reason she has so many visitors in her room?
5. Is hospice care appropriate for this patient?
6. Sarah dies with her family at her bedside. What interventions can you take at the
time of death to demonstrate religious sensitivity to the family? What questions do
you need to ask the family?
7. Describe three genetic or hereditary diseases common with Ashkenazi Jews.
8. Describe Jewish burial rituals and grieving process.
9. Discuss the laws of Kashrut in regard to food practices for observant Jewish clients.
10. What should the health-care provider keep in mind when entering a Jewish home to
11. Distinguish between the terms Sephardic and Ashkenazi.
12. How might a non-Jewish and a Jewish coworker share holidays in the workforce?
13. What is the official language the Jewish people use for prayer?
Presentation The years 1450 to 1700 were a period of incredible change and inconsistency in Europe. The learned person, logical, and social illumination of the Renaissance was sprouting tremendously, yet the predominant societal power was perpetually religion, especially Roman Catholicism, whose sole control offered path to an uneasy –, best case scenario – control imparting relationship to its alleged unwanted youngster, Protestantism, whose birth was around 1517. In spite of the fact that Protestantism was an only response to the fraudulent debasement and oppression of the enlarged Catholic administration, whose raison d'etre had progressed toward becoming as much about the propagation of its own control over Western human advancement than about most profound sense of being and illumination, the two strains of Christianity in any case were seriously male centric, various leveled, and organized, and thusly depended intensely on an assortment of conventions and customs to sustain social and religious coherence and strength amid a period of turmoil. It was a two-way unique, additionally – it is hard to overestimate how much average folks in the Early Modern time frame surrounded their reality and its significance through Christianity: The example of the universe, the history and fate of the world, and the requesting of social, political and local relations were altogether clarified in scriptural and religious terms. … Faith and custom influenced individuals at a wide range of levels, making profound, scholarly, enthusiastic and instinctive interests. Open and private issues alike were profoundly mixed by religion. Given that the idea of detachment of chapel and state was unfamiliar to everyday citizens and even most instructed individuals of the time, the line between the Church and governments was foggy or nonexistent, and along these lines the Church possessed the otherworldly and mental persona and space of The Great Father Figure, with whom communication was represented by, and who kept up arrange and allotted favors and disciplines through an assortment of customs: recommended rituals, functions, and ceremonies. These ran from the ordinary to the wonderful; the indecent to the honorable and were intertwined into the texture of regular daily existence for a huge number of individuals amid the previously mentioned 250 years. While certainly there was much truthfulness of aim from the Church (Catholic or Protestant in assortment) as far as endeavoring to convey profound enlightenment to its supporters, the Church additionally had what appeared to be a hereditarily encoded need to apply and sustain its energy. Customs were a key segment these continuous endeavors, in light of the fact that all things considered, "ritualization is above all else a methodology for the development of specific kinds of energy connections viable inside specific social organizations," for this situation power and connections that were both kindhearted and reformatory in both nature and propensity. In spite of the fact that the normal national was still faithfully religious and discovered much comfort in religious practices and ceremonies, the Catholic Church's fortunes had ebbed to some degree by 1450 in contrast with the for all intents and purposes unhindered influence it had delighted in for a few centuries earlier. The staggering human cost of the bubonic torment, a.k.a. The Black Death, had not just seriously undermined the regular monetary structures that held Europe together, however had additionally extremely undermined the populaces' confidence in the energy of Catholic Church. The Church, regardless of unsurprising confirmations and dicta announcing their control over infection and passing as the living illustrative of Christ on earth, was completely weak to shorten the stunning and inevitably tremendous catastrophe of the Black Plague. In the vicinity of 1347 and 1351, it is assessed that the Plague murdered between a third and half of Europe's whole populace – countless individuals. The Church guaranteed they could cure the debilitated and oust the infection, yet they obviously proved unable, as their dug in antagonistic vibe to science had abandoned them with a blind side as for solution, to state nothing of their complicity in sustaining the financial structures which encouraged unsanitary living conditions endured by most everyday citizens – the main purpose behind the spread of the Plague. Incidentally, in any case, the dismal and serious zeitgeist that was dominating in Europe after the Black Plague, the consequence of the aggregate despondency of a human advancement having lost a huge piece of itself, brought about a few people sticking significantly more firmly to the structures and customs of their religion. In spite of the fact that life itself was delicate, passing, and regularly appeared to unfurl with a dismissive savagery, the structure and request of religious custom gave the conviction, genuine or not, that there was some structure and request to the more prominent universe. "… Sterility, chapter 11, or passing could strike anybody whenever, however ceremonies gave a countervailing guideline of request… Rituals brought the vast request into every day life by giving individual access to divine power."  Nonetheless, the certain conclusion drawn by numerous individuals was that the Church, customs or no customs, was feeble to stop the best human disaster anybody had encountered. All things considered, the environment in the decades including the wild wake following the Plague was one in which individuals were significantly additionally ready and keen on mainstream and logical ways to deal with issues like ailment, neediness, and other normal hardships. This move contributed vigorously to both the Renaissance and the Protestant Reformation itself. The appearance of the Renaissance, settled upon by most researchers as being around the center of the fifteenth century, agreed with what is named Early Modern Catholicism, a religion that got itself straightforwardly going after the general population's pertinence and trust with subversive components inside Renaissance science, craftsmanship, and writing which started in Italy and rapidly spread all through Europe. A few components of the Renaissance were purposefully subversive in assaulting the Church; others had subversive impacts in light of the fact that the logical or philosophical conclusions they came to were not as per Church tenets. Specifically, logical progressions established in the utilization of observation – which requested certain, unmistakable confirmation rather than confidence in reflections or religious creed – displayed an immediate test to the expert of the Church. The aggregate work of a progression of researchers, including Copernicus, Gilbert, Kepler, Galileo, Bacon, Descartes, and Newton, truly undermined an assortment of authority Church positions that appear to be over the top all things considered, for example, the request that the nearby planetary group – and undoubtedly, the universe – spun around the Earth. The Catholic Church's response to the moving tides was its own fairly savage push to reassert its energy and significance in both natural and profound spaces through an assortment of strategies going from cumbersome and brutal concealment of thoughts it considered impudent or ungodly, to a Reformation inside itself (the Council of Trent, 1545-1563) to counter the immense split in Christianity caused by the Protestant Reformation. A consistent topic, however, was an interminable Catholic emphasis on the utilization and estimation of customs both for less honorable reasons for control and power, and additionally more respectable compassionate and profound purposes. Indeed, even the Protestants, breaking so emphatically with the Catholics as they did, perceived the estimation of customs and used them to both propagate and increment their numbers and institutional quality as they rivaled Catholics to win the souls and psyches of the Renaissance-period Europeans. To comprehend these customs is to comprehend, in any event from one viewpoint, a time so far expelled from our own particular that it is troublesome for some, individuals to grasp the circumstances as much past elaborate brutality. Europe of the time was more than such a one-dimensional reality; it was, as all history seems to be, a background marked by individuals attempting to understand their lives, individuals who "amid the Early Modern time frame displayed an exceptionally complex affectability to customs. As the English legal scholar, John Selden place it in his Table Talk (London, 1689), 'to realize what was by and large put stock in all ages, the path is to counsel the liturgies.'" Indeed we should, giving careful consideration to whether Catholics or Protestants appeared to have a superior appreciation of why individuals may grasp as well as stick to custom. CATHOLIC VIEWPOINT After the fall of the Roman Empire, the Catholic Church rose to the part of the most intense and sweeping association on the planet, thanks to some degree to the minimal impact it acquired from its depraved intertwinement with the city component of the Roman Empire itself – Emperor Flavius Theodosius had proclaimed Christianity the state religion in 391 A.D., a to a great degree chance unforeseen development given the era of horrendous abuse persisted by Christians on account of the Roman government. Be that as it may, the Catholic Church guaranteed its authenticity and roots as far back as the underlying years after Christ's demise, holding the (later dubious) institutional conviction that its ecclesiastical genealogy was dropped straightforwardly from the witness (and later holy person) Peter, whom is considered under Catholic convention to be the main Pope. The Pope was, and is considered right up 'til the present time to be the Vicar of Christ, following up on His benefit and using His power; the Pope conveys the official title 'Vicar of Christ and the Supreme Pontiff of the Universal Church.' with regards to such an expanded feeling of significance, the Pope is viewed as trustworthy, a condition of flawlessness the Church keeps up was and is allowed by Jesus himself: Christ enriched the Church's shepherds with the charism of reliability in issues of confidence and ethics. The activity of this charism takes a few structures… The Roman Pontiff, leader of the school of clerics, appreciates this dependability in ideals of his office, when, as preeminent minister and instructor of all the steadfast - who affirms h>GET ANSWER