Final Family Assessment Paper JB 2020 PDF

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Bransom Family Assessment Paper

Jordan Bransom Tarleton State University School of Nursing NURS 3360 Family and Community-Based Nursing Nancy Gaither, MSN, RN, CNE November 1st, 2020

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Family Assessment Paper The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is very important when it comes to assessing individuals or families. These privacy rules are a set of national standards and are important to this paper because of the right to privacy to the family being assessed. Office for Civil Rights (2013) stated that major purpose of the HIAPA is to classify and lower the cases in which a persons protected heath information may be utilized or revealed by protected organization/units. This paper utilizes HIPAA by providing information involved to the student and professor only. The purpose of this paper is to assess a family to see what structures, home environment, community, roles, and adaptations affect their daily lives. The family I have chosen is the Bransom family. I have interviewed them on September eleventh and thirteenth for two hours each day. Each day I would interview them at five o clock and the interview would last till seven o clock. Structural Data Family Internal Structure The family that I have chose to assess is the Bransom Family. They are located in Crowley, Texas in the United States. The Bransom family is a traditional/nuclear family who has two married parents, and three kids all living in the same household. Kaakinen et al., (2018) states, “Two generations of the family, parents, and their own or adopted children residing in the same household” (p. 16) is the composition of a nuclear family. The family birth order is the Father age 51, the Mother age 46, oldest Daughter age 26, the middle Daughter age 23, and youngest Daughter age 22. The Bransom family culture is European American. The family history originated from Ireland and migrated to America. Over ten million Americans claimed

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the Irish ancestry beginning in 1980. In the United States today, Irish are considered to be descendants of the Roman Catholic who arrived among 1830 and World War 1. Mr. Bransom stated that his family never really knew exactly where their ancestors came from and when but that they only know they are descendants of the Irish. (E.D. Bransom, personal communication, September 11, 2020). The Bransom family identified as Christians and regularly attend a Church near there home city. The Bransom family is middle class and they have no intentions in moving up or down in the social classes. Family External Structures Family health is a big priority when it comes to all families. Kaakinen et al. (2018) states, “ It is important to note that this framework is not about patient-centered care, which focuses on the individual, but is about people-centered care that expands the care to individuals, families, and society” (p. 5). The framework is known as Integrated People-Centered Health Services and it recognize that family health as a whole is important rather than just one individual. The environment is ever changing and has multiple effects on the family. The Bransom family is affected by seasonal allergies that mainly affects all the individuals in the home. There is also animals present in the home that could affect the family with dandruff and external irritants brought in from outside. When it comes to the environment any virus or cold could adversely affect the family. Now in todays world the Bransom family is affected by the arrival of the coronavirus (COVID-19). Mrs. Bransom states that not only do they have to worry about the flu and other sickness but they have to now worry about COVID-19 (T.K. Bransom, personal communication, September 11, 2020). During the interview with the Bransom family, they were screened with the Davis Home Environmental and Safety Assessment Tool (see Appendix A for Safety Assessment Tool). The

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Bransom family home was built in January 2019. The home was not tested for lead. The home does not have a basement. The home has an attached built in garage. The home does not have a radon detection system. The home does not have a combustion heating source, gas, kerosene, or propane heater, and no wood stove. The house does have a fireplace but is not in currently use. The house is not run by gas but is electric. The water system does not contain any lead pipes and were tested for contaminants. The house has smoke detectors in every living space including bedrooms. The Bransom family has fire evacuation and disaster plans just in case of an emergency. They do not currently have carbon monoxide detectors and are not needed. They have their house sprayed with pesticides every six months. They do not currently have any rodent infestation and has an occasional insect appear. The Bransom family mother occasionally uses air fresheners, candles, or plug ins when guest come over about two times weekly. Mrs. Bransom states that the family usually uses an air filter that purifies the air that not only helps eliminates smells but also helps their allergies (T.K. Bransom, personal communication, September 11, 2020). Mrs. Bransom cooks a lot of fish that includes tuna which is about 1-2 times weekly. They eat a lot of fresh fruit and vegetables daily but are not locally grown. They have no medical products containing mercury. The family has no one who smokes and no cigarette products are located within the household. Home and Community The Bransom family home is a two story traditional style home that is warm and comforting in a rural area. The community they live in is peaceful and quiet. Although the community is not gated, it is very safe and full of friendly neighbors. The community has a Homeowners Association (HOA) that allows the people of the community to put their voices in and handle problems that arise. The community of homes is right next to a police station that

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makes the area have a sense of security. The Bransom family is very active in their church and the HOA. The family not only attends church on Sunday but Wednesday as well. They are active in home groups that are created through their church. They participate in food drives to help the community called Meals on Wheels. Genogram or Ecomap The genogram and ecomap are both tools to show the family visually. “Genogram and ecomaps provide health care providers with visual diagrams of the current family story and situation” (Kaakinen et al. 2018, p. 127). The data is gathered from the family and is plugged into these diagrams for better understanding. They help form a plan of action and interventions if needed. The genogram is a visual illustration of the family tree that helps demonstrate the family history. The ecomap is a diagram that shows outside sources that either are helpful or harmful and how the family relates to them. For the Bransom family the model chosen to visualize them was the genogram. The Genogram was chosen because of how close the family is with just each other. They have more connection within the family then they do with other social support. Garth (2016) states, “It goes beyond a traditional family tree allowing the creators to visualize patterns and psychological factors that affect relationships”. The genogram shows the Bransom Family tree for three generations (see Appendix B for genogram). Family Interactions Data Communication Patterns “Communication is an ongoing, complex, changing activity and is the means through which people create, share, and regulate meaning in a transactional process to make sense of their world” (Kaakinen et al., 2018, p. 24). Communication between family members is

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exceedingly essential because it facilitates each member to convey their desires, wishes, and apprehensions to each other. Straightforward and open interactions establish an environment that allocates family members to reveal their discrepancies as well as affection and respect for one another. The Bransom family struggle daily between functional and dysfunctional communication. Their functional and affective communication forms with them being open and communicative with each other, each family member does their best to relay issues or problems that occur so they do not hold them in, and they affectively make plans with each other to avoid discrepancies. Their dysfunctional communication forms when one member of the family withholds truth from another that the dilemma involves and when too many people are involved in a problem or argument when they do not belong in it. “The problem my family has with dysfunctional communication is that we tend to either hide the truth from someone to keep them from being angry or we might involve another member to prove our point in an argument, this creates issues to grow larger than they should be” (M.F. Bransom, personal communication, September 11, 2020). Congruent and incongruent communication is when an action is similar to words and when an action is non-similar to words being said. The family can have congruent communication when they are able to speak freely. This blocks all forms of incongruent communication because nothing is being hidden. The Bransom family may hold in their feelings causing their non-verbal actions to not match their words, making that person’s actions seem off. This is an example of areas of closed communication. The communication is closed when they family member is angry or feels they need to hide information. The Bransom family internal variables that affect their communication is high expectations. One day each family member

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could have astounding communication. The next day that communication might go away. This could lead to each family member getting offended and having absent realization that every day is not the same, therefore instigating miscommunication/harmed feelings. External variables affecting communication in this family is distance with college, busy with work, and friends. The youngest daughter is away at college. This affects family communication because they must rely on phones to communicate. The other members of the family all work most hours of the day which also make them rely on phones for communication. Although it is a positive aspect, friends sometimes block communication between family members. All of the young adult members of the family have extensive relationship with their friends that may put a hold in communication with family. Although many things affect communication between families, the Bransom family have affective communication patterns that are healthy and they maintain its effectiveness. Family Power or Influence The Bransom family is influenced by the parents of the household. Both parents equally form the head of the household and hold the power. They come together to consider and plan out important decisions that are made that affect the family. Although the decisions being made are usually up to the parents, they always welcome ideas or opinions from the whole family. “My parents are excellent at talking with each other when it comes to decision-making. They take in each other’s opinion. They also want their children’s input as well. It is important to them that they hear what we think” (J.A. Bransom, personal communication, September 13, 2020). Family decision making is not held lightly and is a very gentle process. Kaakinen et al., (2018) states:

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Family decision making is not an individual effort but a joint one that is steeped in culture and that family’s history. Therefore, each family has its own style of making decisions for the whole family as well as for its members (p. 24). For the Bransom family, they come together as a team to form important decisions, especially when that decisions affects the family as a whole. The variables that affect family power is age and situation. As the children have aged, they have had more interest in giving their opinions and want them to be taken into consideration more. Situations that affect each member solely or affects the family as a whole determine who has the power to make a decision. For example, if the children are affected only, then they may have more say on the topic than their parents, now that they are entering adulthood. The Bransom family is respectable at sharing authority when it is needed. Family Roles All family roles help with the family’s function and capabilities. Each family member can be the same or different. Kaakinen et al., (2018) states: Roles in the family are defined as formal when they are associated with position and structure. Roles can be defined according to the job that a role performs to help the family function on a daily basis. Other roles are informal and often fall under the aspect of being related to the family member’s personality (p. 22). The formal roles of each family member: The father is the parent, the spouse, the son, the primary provider, and housekeeper. The mother is the parent, the spouse, the daughter, provider, and caretaker. The oldest daughter is the daughter, sibling, and self-provider. The middle daughter is the daughter and sibling. The youngest daughter is the daughter and sibling. The

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informal roles of each family member: The father is the family jester. The mother is the encourager and harmonizer. The oldest daughter is trouble-maker. The middle daughter is the scapegoat. The youngest daughter is the peacemaker. The variables affecting family role that are relevant to the family now is the external environment. Since Covid-19 as hit the family it has shifted the father’s role more the primary provider than anything else. The mother has also become more of housekeeper than a caretaker to alleviate stress from her husband. Socialization This family’s child rearing practices are simple yet effective. They have raised the children in church and nurtured their faith. The parents try their best to be role models for their children. They have been raised in a private Christian school to not only get the best education but to continue their efforts to raise their children with morals. In the Bransom family the children are very important and their needs are usually met first. The parents have sacrificed a lot for their children because they are the legacy of the family. The parenting style that the Bransom family parents have is authoritative parenting. Dewar (2017) states, “The authoritative parenting style is an approach to child-rearing that combines warmth, sensitivity, and the setting of limits”. Thus, this style allows for security but free passage for individuality in character for each child. The children in the family have grown up and they have taking responsibility to socialize through college, church, and community settings. The whole family participates in socializing with individuals they have met through church, the neighborhood, college, and their own work environments. Their cultural, social class, and age may affect their socialization. Some cultures may not be involved outside their own culture, this on the other hand does not affect the family. Their social class and age affect them more. Their social class is the middle class which may affect

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what they may be able to do or afford when hanging out with other families. Their age also starts to affect the amount of socialization that occurs, especially the parents. “I am at the age where I am not hanging with my friends as much as I would have a few years ago. I just got engaged and I am at the point in my life where I want to focus on myself and my new life, instead of socializing and going out” (K.N. Bransom, personal communication, September 13, 2020). Family Health and Adaptation The health beliefs and values of the Bransom family are simple. They believe how you treat your body in turn affects the health of it. They believe in vaccinations to create a safe environment for the whole family. They also strongly believe in prayer to help the member who gets sick. Their nutrition includes meat, poultry, fish, veggies, carbs, wheat, whole grains and naturally grown foods. They believe that eating out is treat for the whole family and usually occurs once a week. They have dessert usually one time a week. They do not believe in diets, only healthy eating. The Bransom family mother is a big believer in preventative practices and homeopathic medicine for her family. Husney (2019) states, “Homeopathy, or homeopathic medicine, is a medical philosophy and practice based on the idea that the body has the ability to heal itself”. She also encourages use of vitamins and herbs to help alleviate and prevent sickness. The whole family regularly attends doctor appointments when scheduled. The family does not partake in the use of tobacco, vaping, or recreational drugs. The father has one or two drinks of alcohol on the weekends. The Bransom family parents usually get about nine hours of sleep and adequate exercise about two to three days a week, which includes walking the dog around the neighborhood. The two oldest sisters usually get about 9 hours of sleep and do not usually participate in exercise at the moment. The youngest daughter usually obtains seven to eight hours

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of sleep and exercises one to days a week. The health history of the father’s side includes colon cancer and hypertension. The healthy history of the mother’s side includes heart disease and breast cancer. The father has a diagnoses of hypertension. The oldest daughter has polycystic ovarian syndrome (PCOS) and celiac disease. The middle daughter has PCOS, prediabetes, and carpal tunnel syndrome. The mother and youngest daughter are healthy. The entire family attend the same primary health care provider in their rural hometown. Stress and Adaptation The family stressors that were identified by the family is income and the level of connectedness they establish together. The family is middle class and make decent money. With all the bills and helping out their children money can be tight and cause stress. The other stressor is the level of connectedness of the family. With a big family it is hard to “get everyone on the same page”, sometimes this can cause stress if fights break out. The family strengths they recognized are how loving each family member is toward other members and how selfless each person can be with their time. They value time spent together and coming together as one is valuable to the Bransom family. The family weaknesses are being too prideful and too verbal at times. Pride is the downfall and root of arguments in the Bransom family. The coping strategies of the family is counseling. This enables the family to be able to talk openly and to bring forward problems that may be to uncomfortable to openly share with their family members. Counseling also is a great way for each family to learn how to share information appropriately. The Bransom family overcome these weaknesses everyday and cope effectively. Developmental Stage and Tasks

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Duvall’s Family Developmental and Life Cycle Theory looks at the development of the family over a long period of time that is able to be mapped, which is based on various roles, unique events of life and the interactions between each family member. The stage the Bransom family is in is stage six: launching the children. The task that should be accomplished are “launching youth into adulthood and maintaining a supportive home base” (University of Nebraska, 2012). The Bransom family has been very successful in these tasks. They are almost finished with introducing their children into maturity and they have maintained a safe home environment for affective care of their growing children. Conclusion The purpose of this paper is to assess a family to see what structures, home environment, community, roles, and adaptations affect their daily lives. The family I chose was the Bransom family. The Bransom family is a rural small town family, that have concrete morals and ideas that make them a happy and successful family. The have weakness and strengths that they overcome and that pushes them to grow. They create a safe and effective environment to live in through their home...