Introduction to the Miller Family

Women are subservient to males, and males may be dependent on the female of the household. There is a high incidence of alcohol abuse among men. Adolescent children are often less mature for their age. Family and friends should be allowed to remain with a dying patient, and organ donation is viewed as helpful to others. The belief that nothing new happens today that has not happened in the past may affect what illness/sickness leads people to seek health care. I should maintain a distance appropriate for care delivery and investigate health care beliefs or practices. Monitor for signs and symptoms of safety issues within the family unit. Do not assume that maturity is linked to age. Provide time and space for family to be with hospitalized family

I will be using the patient initials (MK), throughout this paper when I reference her. I asked the patient a list of questions about her life and I will summarize the answers for you now. MK is an alert and oriented 84 year-old female who is happily married and lives with her husband of 56 years. MK is retired and worked as a high school secretary for 20 years in the town she lived in. She grew up in Pennsylvania with her parents and was the oldest of five children. Her family medical history includes cardiac disease and diabetes with all of her brothers and sisters still alive. MK has three of her own children who all live with in a 30 minute drive from her home and they speak frequently on the phone with her and her husband. MK and her husband are going on a vacation together this summer to South Carolina with her son and his family. MK still hosts holidays and family gatherings at her home with only a couple holidays hosted by her son at his home. MK and her husband receive social security and her husband’s pension as their income. They have Medicare and also a supplemental insurance through AARP. MK enjoys her exercise class, reading, her card club, traveling and is also very active in her church including being on the bereavement committee. MK still drives her own car around town to visit friends and shop but prefers not to drive at night

The family is struggling to find their identity in the face of this illness. Each family member reflects values in keeping with their Southern Baptist background with faith playing an integral role in their daily lives.

My first inclination is to better understand Rico’s culture and customs; by doing so, I would be able to better convey my feelings within the framework of his world view. In the PMH lecture on “Meeting Patients Where They Are,” Dr. Farr discussed twelve domains that comprise a culturally competent approach to healthcare. One domain involves communication, which I have discussed in detail above; using a medical translator eliminates errors and bridges the gap to the patient. The model of cultural competence emphasizes understanding the patient’s heritage, family roles and organization and religiosity. I was able to quickly research Mexican American culture, and its attitudes on death and dying, which provides me great insight into Rico’s case. I found that in Mexican culture caretakers are often female family members, and that the family as a unit is expected to care for the elderly. One quote in particular illustrated Rico’s particular resistance to palliative care, as “reluctance to use such programs may be attributed to a cultural resistance to sharing familial problems with outsiders.” By understanding Rico’s cultural background and long held beliefs, I feel I can best understand his mindsight and trepidations; I can also better understand his resistance to his son’s wishes for palliative care. In addition, to meet the patient where he is I would need to better understand his deep religiosity. I would likely call a spiritual care consult to talk with Rico about the benefits of palliative

5. Give examples of each of how you communicate information to the patient’s care team regarding family dynamics and social economic situations.

The way I approach families with ill children will vary depending on the illness, its severity, time since the diagnosis, and expected life span of the child. The family’s ability to adapt to health stressors will depend on their resources and perceptions as described in the double ABC-X model. A second characteristic of families coping with illness stressors I found to be unique was that a health decline in one partner in a marriage is related to a decrease in marital quality. As a HSP this will be imperative to keep in mind, as having a strong parental subsystem will rely on both parents maintaining a healthy relationship despite illness. Ensuring the couple maintains a healthy relationship will be crucial for the children’s perceptions while their parent is battling an

It is essential for family physicians to spend more time hearing and understanding the everyday struggle that patients face living with such a chronic disease. The need is to attempt to improve upon the undesirable effects of various symptoms and thus play a pivotal role in boosting the overall quality of life of a patient.

4. Different diseases have afflicted your life through your family. What advice do you have for those who are stricken with disease or whose family is dealing with a member stricken with disease on how to cope and

In a social context, the illness is rare in the population and can have detrimental effects on families in the beginning stages. Social support is needed not only to the person with the illness

It has been just over two years since a man’s wife, once an active and jubilant woman, has been diagnosed with a rare form of cancer. Her now brittle body is taken over by the agonizing symptoms. As her motor functions diminish, she is no longer able to do the things she once did, and she is no longer able to take pleasure in the things she once loved. The fast spreading cancer has begun to define her. Assistance is required for her to complete even the simplest of tasks, and she spends most of her time in a great amount of pain. The pain is worsened when she is forced to watch her husband suffer as he cares for her. Doctors tell her that she has less than a year left to live and that the cancer will get worse progressively. She has lived a

Ella is spending all her last days in hospice care due to her disease. Ella is an elderly lady who has breast cancer and the doctor diagnosed not to live that much longer. Ella is now facing the last stage of her cancer. I am the social worker for this case, and I must determine the best care for Ella. Cancer leaves a big impact on your life and your family life too. Looking at Ella and her husband’s life style and their health this will help me to find the right kind of care. Ella’s cancer had gone into remission with her cancer years ago now it has come back. Even though the new medicine could prolong her life, I think Ella is ready for this all to be over with. As Ella faces the last stage of her life she wants to live her life happy and

I enjoyed reading your thoughts on physical illness and how it affects the family unit. Physical illness commonly leads to both distressed family relationships and romantic relationships in the household (Wetchler & Hecker, 2015). This special topic made me think about the impact of a child’s chronic physical illness on the family unit. Aside from the strain on the child, parents of children with chronic illness report symptoms of anxiety and depression, as well as conflict and monetary strain due to inconsistencies at work (Distelberg et al., 2016). These mental health symptoms in combination with the stress of providing could cause a significant strain on the marriage, further compounding family functioning. I have personally see pediatric

When one spouse is sick they are more likely to fight and end, compared to those in which chronic illness is not an issue. A family member who become caregivers are more likely to be depressed. People do not think about illness when they are young, healthy and making commitments to someone else. People tell themselves that they will be there for each other in “sickness and health” but chronic illness can get in the way. Chronic illness is physically and emotionally exhausting. The Spouse who becomes the caregiver may struggle with patience and regret while the spouse suffering from chronic illness may be feeling

In addition, the illness is ever changing and when the parent’s health visibly declines the life changing stressor is repeated and the child must adapt to the new changes. When an illness advances the home will revolve more around the illness then the family. This generally results in an increase in the child’s responsibilities in the home assisting in the care of the ill parent and possibly taking on the care of the younger siblings who are not developmentally able to care for themselves. This results in less time or opportunity for adaption and can result in despair and hopelessness. During school age and adolescence years peer relations are an important part of psychosocial development. Common ground to base friendships are diminished and disinterested feedback makes relationships distant or non-existent because of the lack of understanding peers have about the child’s situation. Isolation and withdrawal are common for the child. These children are at risk for lifelong physiological and psychological damage and are in desperate need of education and intervention.

Ella’s illness will have a huge impact on John as this is her husband and life partner and she is dissipating before his eyes, this will make him feel hopeless and experience feelings of anger. John will have feelings of depression and John may experience feelings of confusion or guilt since he persisted that Ella continue the use of Alternative Medicine. Since John is probably the closest to Ella he will have to deal with his emotions as well as her emotions, often this can be overwhelming for life-partners as John and Ella. Because John and Ella have been married for a very long time, it is vital that he remain strong, be honest with Ella, don’t shy away from the situation or allow her to see he is worried by her end-of-life transition. The awaiting of Ella’s death will put more stress on John than imaginable it is vital John keep an open line of communication, as well as do not try and fix the feelings but openly express his compassion through their distress. John must remind Ella of happy times they once previously shared. Although John may feel the need to spend all his time with Ella, it is