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Family Assessment Paper 2382
Instructor
Introduction
The family just recently moved to my neighborhood and we casually said hi to each other. I went to their house and introduced myself and informed them of my intentions. I explained to the family that I was going to perform a family assessment and that this was about assessing the family processes and interactions and identifying both the weak and strong points in the family. I further discussed with the family that the purpose for this assessment was purely academic, confidentiality will be maintained and no diagnostic tests of any kind will be made.
Permission was given before scheduling the interview and verified again prior to start. This was verbally consented and there was no need to sign any papers. Therefore, we set up the appointment for 5 o’clock in the evening on Saturday February the 11th 2012 and the interview was going to be at their home in the living room. As of my plan I wrote and grouped my interview questions.
I was to interview the kids first and then finish up with the parents, the mother being the very last because of the abuse questions and assessment.
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Proficient in: Family
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I had the abuse assessment forms in envelopes for them to fill out at the end of the session. I planned to get the genogram with both the parent. So on this day of interview all the five family members were present. We gathered in their living room and being covered with all the information, the environment was tens free.
I interviewed the kids first. And theirs was general, and I mostly wanted to know what their roles were in the family as a whole.
Structural Assessment
Family composition/ separate genogram attached
The family consists of three kids, ages 15, 13 and a 6month old. The Kids’ names are Pt, Ks and Ax. None of the parents have been married before. This was their first one. They also have two large dogs and a small cat that they recently adopted. Nobody else lives at home with the family Home and community environment.
They live in a single family house. Pt has his own room, ks has her own room too and the parents share the room with baby Ax. They stated to don’t know many people yet in the neighborhood but so far it is a calm environment. They live near a community park, library, the kids’ school and day care is just a couple of blocks away, a hospital, dental clinic, a fire department nearby as well as a shopping center. Occupation and education background
Mother is pursuing a RN. nursing degree and works 1 day a month in a nursing home. Father is a truck driver and is gone most of the week. He is mostly in Texas and Chicago. They both attained an equivalent of a high school diploma back in Poland. Mother is mostly the caregiver in the house while the father is the provider. This is a family that moved from Poland ten years ago, they lived in California before moving to Minnesota six years ago. Kids Assessment
The oldest kid, a teenage boy just said he loved helping in the house especially since the baby came and he has been doing a lot of that. He does dishes, helps younger siblings with their assignments (mother is very busy with school and sometimes does not understand English very well). He said he wishes his dad would be home more but he also understood that he had to provide for them and pay the housing. He was a very calm young man and pleasant to talk to. Next I interviewed the 13 year-old girl, I had to talk about fashion at some point to get her attention and it worked.
Morbidly obese and she said she has been trying to lose weight but she can’t stop herself from eating anything sweet she lays her hands on. She said she really wanted a girl sibling when her mom first said she was pregnant but when her baby brother was born she got over it fast .She is very helpful with the baby too and loves him dearly. Sometimes offers to sleep with him so her mother can get some sleep. Structural family relationship-
Bb’s family is from Poland and she does not have any relatives in the United States. Rn is also from Poland. His brother lives in Chicago thus he can’t help with the new baby and daycare is too expensive. So for now Bb has to stay home and watch baby Ax. However, she also goes to school and when she is gone to school; she has a lot of trouble finding help with the kids. She is doing evening classes so that Pt and Ks can help babysit after school. And that has been working out so far but would love to find a permanent solution. Cultural and religious tradition
The family is white from Polish background. Bb and Rn were born and raised up in Poland. Their first two kids, Pt and Ks were born in Poland but have grown up mostly in the US. They speak multiple languages but more articulate in English. The family is a staunch Catholics and they go to a polish church in Minneapolis. They celebrate religious holidays like Easter and Christmas. They value Christianity and believe that Church is the basis of spirituality. The family also believes in baptism and eating sacrament so they have all their kids baptized.
Functional Assessment
Family interaction and roles
Bb does not work much, but just once in a month. She stays home with the kids; she wishes she could work more because they are falling behind on the mortgage and can’t afford to buy things that she would want to have. For instance she wants a newer car but she can’t afford one now. However, they are managing although they have been able to cut back on other things that they were used to, before, such as family trips.
Baby Ax was an accidental pregnancy and they were all much unprepared for it. It was especially hard on the family when Bb had to stop working because she had HTN and gestational diabetes. She was on bed rest for most of the pregnancy. The family has been through a lot lately and they are not doing well with the baby. Rn is complaining paying all the bills and finds it very hard to help with the baby. Power decision making/problem solving
The family believes in authoritative rearing of kids and parents work well with the kids when they have done something undesirable. They do not believe in whipping the kids but discipline in denying privileges and giving time outs. Mother is mostly the disciplinarian. According to Bb, they agree on punishment according to what the kids have done and they both support each other in disciplining the kids. The power and decision making is the father’s role and they will consult with him even when he is far on matters that need his attention. Abuse assessment.
I used the abuse form that I had prepared from the questions on (Varcarolis, 2007 pg. 591) to interview the mother on abuse. I asked her the four questions from the abuse assessment screen (figure 26-2). 1. Have your ever been emotionally or physically abused by your partner or someone important to you? 2. Within the last year, have you been hit, slapped, kicked or otherwise physically hurt by someone? 3. Within the last year has anyone forced you to have sexual activities? 4. Are you afraid of your partner or anyone you listed on the assessment list?
The mother denied being abused physically emotional or sexually in the past year. She denied feeling unsafe. She denied being threatened and said she felt safe in the home. Her verbal and nonverbal communication was congruent. Father also denied any kind of abuse and really expressed lots of appreciation about the wife instead. I also asked the following questions regarding their kids on (Varcarolis, 2007 pg. 598). 1. What arrangements do you make when you have to leave your child alone? 2. How do you discipline your children
3. When your infant cries for a long time how you do get him to stop? 4. What about your child’s behavior bothers you the most?
These questions were to assess the possibility for children abuse and neglect but the results were negative regardless of the stressors the parents disciplines their kids fairly as I mentioned earlier in the power decision making / problem solving. They never leave the baby alone in the home and they attend to the crying baby promptly and calm him down by meeting his needs. Generally, the rationale for the screening is to ensure consistent and accurate assessments and protection of all individuals and or families at risk for domestic violence, maltreatment and neglect. (Varcarolis, 2007 pg. 587) On the same note women are victimized about six times more often than men (Varcarolis, 2007 pg. 586). Communication
Different communication techniques were used during this interview, it included open ended questions, seeking clarification, focusing and summarizing. There were also some non-verbal communication such as silence, nodding of the head, eye contact, smiles, movement of hands, looking up unto the roof, looking down onto the floor and movement on the seats. Active listening played a major role in data generation. There were also some interruptions with the kids seeking attention, dad and mom at different times taking breaks to smoke and a couple incoming phone calls. Expression of feelings/individuals:
The family showed respect and peace among themselves members listened to each other’s opinions. No curse words to each other during the interview and I was very impressed with the respect to one another overall. Even though the father is away, he calls 3-4 times a day to talk to the kids and his wife. They are a close-knit family and try to stay together even during a crisis. Dad said love, patience and peace is the key to their long lasting marriage of their18 years. Regardless of all the stress they are going through, financially and with the baby care, they are clinging together still. Mother also expressed a nonverbal communication congruently in support dad’s statements Self-destructive behavior:
Both parents smoke in the home and this is very unhealthy for the kids and to themselves. Father also drinks a lot on the days when he is off. This family eats out a lot too even with the limited finances, this in itself is expensive and choice of foods are not always the healthiest considering the fact that the family members are obese or overweight.
Stages: (Friedman)
Observation of family member’s interactions: Positive interactions were seen within the family members. The children were seen playing and interacting very well, and occasionally coming to the parent for attention and seeking clarifications on what to eat and not to eat. Leadership/Submission: Leadership and submission characteristic are evident within the family system. Though at times parents have episode of arguments, but they are always quick to come to a compromise. Father enforces rules and advices the wife to follow suit in order to have a common voice. Activities shared: Both parents stated “we take them on a walk and sometimes biking and occasionally weekend trip when the time permits but we are barely surviving so we have not done anything for a longtime now. Emotional
Support: Emotional Support was observed when the mother heard the last baby crying, she hurriedly rush to the scene to see what went wrong. Household chores responsibility: Household chores mainly domestic in nature rest primarily on the mom. But husband agreed to help whenever he is home. The children are also very helpful especially when their dad is gone. Caregiver- Shared or primary: Mother is the primary caregiver. Division of tasks: Mother is the one mainly doing chores in the house, when the husband is around he does not do much because he is “always tired”, mother’s statement.
Stressors/strengths
The mother sometimes feels unappreciated because she is taking care of the home and the kids while husband is away and wishes the husband would recognize how tough of a task this is. She feels like the house is not always clean and she loves to keep her house clean and neat but also understands that the baby is priority now. She gained 50 pounds with the pregnancy and she wants to lose it fast, she worries with her age she might never look the same again. The children are very well mannered and they understand that there is time for everything. They will follow instructions on when to go to bed and when to turn off all their gadgets (I-pod).Father hates his job but is willing to do it for as long as he can support his family. He realizes that it’s the sacrifice he has to make. Their financial situation is a big stress.
The whole family has had to cut back on a lot of things and become very frugal in their spending. They would love to get ahead with the bills and be able to afford some holiday, but that is not going to happen soon so they try to do fun things in order to forget about their situation. Rn being gone is also a stressor for all the other family members and him. The baby is a joy but also a stressor since they have to make a lot of changes to take care of him. Their main strength is spirituality and lots of patience with one another.
They get their strength from having good communication techniques. Clinging together unto their marriage is one of the big strengths in this family. Most families break up during situational crises that bring so much stress until couples can’t put up together any longer. Mom stated “it is and has been very difficult but out we won’t fall apart.” So much patience was expressed.
Thinking in Action journal
This assignment was one of the most complex and challenging one so far in this semester. When we were given the instructions during clinical orientation, as well as in the 2381 lab, I thought it was going to be a simple assignment of which it wasn’t. However, at first I had more fun preparing for the interview, going up and meeting the family. Setting up the interview appointment was itself very exciting to me and this really incited me to looking forward to that scheduled day of 02/11/12. Before I knew it, the day of the interview was here and I arrived at the interviewee family home right on time so that do not interrupt with any of their plans. Amazingly they were all set in their living room ready for me. It started all well with open ended question since I had given them all the information prior and had verbally consented the interview at the time of scheduling. All went well with therapeutic communication and I gathered as much information as possible.
I observed all their non-verbal in congruent with verbal communication. I demonstrated active listening a lot which of course enabled them to provide more information. I was amazed with how much they opened up for me. They answered all my questions in details without any signs of hesitation. This confidently revealed to me the big strength of my therapeutic communication giving me the feeling of empowerment and trust winning as a student nurse. At the end of the interview I was glad that I answered their all questions and gave them all the information as needed. I enjoyed this day and I will always remember it!!. As I started writing my paper, it was a little more challenging to organize all the data I collected appropriately, but eventually I managed. Although it was time consuming, it also was a very good learning experience.
Works Cited
Ackley, J. B., & Ladwig, B. G. (2011). Nursing Diagnosis Handbook. St. Louis: Elsevier Mosby, St. Louis. Varcarolis, E. M., & Halter, M. J. (2010). Foundations of Psychiatric Mental Health Nursing. St.Louis, MO: Saunders Elsevier. Varvogli, L., & Darviri, C. (2011). Stress Management Techniques: evidence-based procedures that reduce stress and promote health. Health Science Journal,
Child Care Assistance for postsecondary Students.
www.getreadyforcollege.org/pdfGR/ChildCare.pdfSimilar
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