AMISH CASE STUDY DISCUSSION PAPER

AMISH CASE STUDY DISCUSSION PAPER

AMISH CASE STUDY DISCUSSION PAPER

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

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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.

Study Questions

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. Mill
er confided her interest in taking the baby
to the folk healer, what would you do to le
arn more about their simultaneous use of
folk and professiona
l health services?
5.     List three items to discuss with the M
illers to prepare them fo
r their consultation at
the medical center.
6.    If you were preparing the reference fo
r consultation, what would you mention about
the Millers that would help to promote cu
lturally congruent ca
re at the medical
center?
7.    Imagine yourself participa
ting in a meeting with state
and local health department
officials and several local physicians and nur
ses 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 Orde
r 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 pr
omoting health in the Amish community?
11.   List three Amish values to consid
er in prenatal education classes.
12.
Develop a nutritional guide for Amish wome
n who are interested in losing weight.
Consider Amish values, daily lifestyl
e, and food production and preparation
patterns.
13.   List three ways in which Amish express caring.