Amish Culture Considerations for Healthcare

The Amish people are a religious group residing primarily the United States and Canada founded by Jakob Amman, a Mennonite bishop in Switzerland. The Amish emigrated to the United States and Canada in the 1700's due to religious persecution.

The Amish people settled in Northeastern Ohio in the early 1800's. Agriculture is traditionally the way in which the Amish make their living. Although furniture making, restaurants/bakeries and tourism are other options.

In the past, Amish people have refused modern day technologies such as automobiles, electricity, and telephones.

Important facts:

Amish speak Pennsylvania Dutch. Amish men are required to grow a beard once married, as it reflects the image of the Lord. Marriage with a first cousin is forbidden, but marriage to a second cousin is more widely accepted. Some homes have no hot water, electricity, or telephones although cell phones utilized for conducting business are becoming more popular. Smoking tobacco is only permitted in areas where tobacco is grown. (The Cleveland Clinic, 2017)

Due to their strict RELIGIOUS beliefs, healthcare may be considered a challenge but...

Most Amish people do believe in modern medicine. They may prefer folk medicine or alternative choices, herbal remedies and natural therapies. They do see doctors, visit hospitals and utilize opticians and dentists.

Health trends: Studies have shown that the Amish have a much lower incidence in cancers. According to Inglish (2016) in Ohio, "the Amish have only 40% of the rate of cancer that other Ohioans suffer."

Further, a gene has been found in among 5% of Amish studied that protects against cardiovascular disease. Additionally, they have been found to have a lower rate of type II diabetes, some credit this to their level of physical activity. (Inglish, 2016)

"Good Health is considered a gift from God. "

The Amish feel that taking care of their health is important, and while modern medicine may help with illness, ultimately it is God who heals them.

Health insurance is not typically used by the population, and healthcare services are paid for with cash, and often expect discounts on their medical bills.

If/when necessary, Amish citizens will under go anesthesia for surgical procedures, allow dental work, blood transfusions and even organ transplants with the exception of the heart. They do not believe in the use of birth control and believe that children are a gift from God.

Tips for HEALTHCARE Providers:

  • Doctors are expected to be experienced and well versed, they do not appreciate interns or residents. They prefer being able to sit and have discussions with their physicians and like to be on a first name basis.
  • The Amish learn well with return demonstrations, pictures and modeling behaviors. Many do not understand language past an eight grade level.
  • Transportation is often an issue and can be costly for the patient. Due to this, appointments should be scheduled together and this should be kept in mind for follow up.
  • If the church is paying for the Amish patient's treatment, the church's clerical representative needs to be consulted when a decision is to be made.
  • If the Amish patient is hospitalized, expect large amount of visitors, as friends and family have to travel together.
  • Terminal Amish patients prefer to die in their own home. Many of the elders prefer to terminate care at the end of life as a way to conserve resources because many costs are paid by the community and the church.
Important Nursing Considerations:

Preventative Care: Most of the Amish population do not understand the importance of preventative care and medicine. This includes health screenings (cholesterol, blood sugar, cancer), PAP smears, breast exams and mammograms. This also includes IMMUNIZATIONS. More recently, the Ohio Amish suffered a large outbreak of measles due to the lack of immunizations. At the time of the outbreak, it was estimated that of the 33,000 Amish in Ohio, only about 8,000 had been vaccinated (Tribble, 2014). It is important that when given the opportunity to educate the Amish patient and their family that vaccines become a part of the conversation. It is recommended that the Amish person understand that contracting a preventable communicable disease could lead to disability, as disability is feared worse than death. This may encourage the Amish patient to accept immunizations.

Home Health Care: Home health care should be suggested for an Amish patient if necessary. It is less costly than hospitalization. It allows the patient to remain in their environment where they are more comfortable, which could lead to more effective health education. Further, it removes the problem of transportation for the Amish patient and community. Nurses should discuss home health care with their Amish patient when indicated.

Readability level as determined by read-able.com is a TEN indicating that this presentation should be easily understood by 15 to 16 year olds.

References

Cleveland Clinic. (2017). Treating the amish and addressing their health care concerns. Retrieved from http://www.health-share.org/health-info/docs/1700/1783.asp?jerseys-2103.html

English, P. (2016, November 15). Inherited physical disorders and the amish baby boom | Owlcation. Retrieved from https://owlcation.com/stem/Some-Inherited-Physical-Conditions-and-Illnesses-of-the-Amish

Tribble, S. J. (2014, June 24). Measles outbreak in ohio leads amish to reconsider vaccines : shots - Health news : NPR. Retrieved from http://www.npr.org/sections/health-shots/2014/06/24/323702892/measles-outbreak-in-ohio-leads-amish-to-reconsider-vaccines

PRESENTATION CREATED BY AMY MALMEDAHL, INFORMATICS FOR PROFESSIONAL NURSES AT THE UNIVERSITY OF CINCINNATI

Credits:

Created with images by hansol - "amish" • eyeImage - "amish girls parade" • werner22brigitte - "amish people persons" • tpsdave - "wisconsin landscape scenic" • Joe Shlabotnik - "Gettysburg" • JoeKeim - "amish people joe keim amish country"

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