professional association

Family Health Assessment Part I: Taylor Family

Family health assessments focus on the entire family as a unit and then subsequently on each individual member of the family unit. Using Gordon’s eleven functional health patterns allows for a framework for nurses to form the nursing assessment leading to the nursing diagnosis (Green, 2018). The Taylor family graciously allowed a family health assessment to be completed on their family. The following is a summary of this assessment with family health pattern strengths, barriers to health, and family system theory to assist the family in health promotion and wellness.

The Taylor family consists of father, Edward (42), mother, Lynn (38), children LeAnn (18), Sara (15), and Jacob (13). Mr. Taylor is disabled military and does not work. Mrs. Taylor is college educated and the breadwinner and caregiver. Daughter LeAnn is in the first year of college at a local university, daughter Sara and son Jacob are in high school. The Taylor’s are a middle class, Caucasian family, living in the suburbs. Mother and children practice Catholicism while the father claims to be agnostic.

The overall health of the family consists of Crohn’s disease, severe malnutrition, two pack a day smoker, and post-traumatic stress disorder (PTSD) in the father. Mrs. Taylor has high cholesterol, high blood pressure, and maintains regular gynecologic exams. All three children claim to have no medical issues and receive regular physical exams including immunizations. The family states they value spending time together especially on vacations but that with the father’s health conditions this is not feasible.

As a family, there is no routine mealtime due to after school activities of the children and the father’s inability and/or unwillingness to eat a proper diet for his condition. Mr. Taylor receives home health total parenteral nutrition (TPN) to infuse nightly of which, per his wife, he will not comply. Most of the meals, cooked by Mrs. Taylor or either daughter, are quick meals (out of a box), or fast food. Carbonated beverages are the usual drink.

Each child has a bedroom and states they are usually in bed by 10p.m. Mrs. Taylor sleeps in the master bedroom but Mr. Taylor prefers to sleep on the couch due to his need to get to the restroom rather frequently. Mrs. Taylor and each child state they tend to get six to eight hours of sleep a night. Mr. Taylor stays up all night and sleeps throughout the day most of the time.

No bowel or bladder problems were identified by the mother or children other than occasional constipation. Due to Mr. Taylor’s Crohn’s disease, he has chronic diarrhea following attempts to eat.

Regular physical activity does not occur for the father or mother. The children participate in extra-curricular activities through school and complete chores around the house. All members of the family claim a rather sedentary life.

Mr. Taylor suffers from PTSD and has received counseling in the past through the Veteran’s Administration. The mother utilizes her family priest for any counseling needs while the children have had no counseling for any mental or emotional conditions.

No sensory deficits were identified other than mild hearing loss in the father due to his military career. The mother wears contact lenses; the oldest daughter and the son wear glasses.

In regard to self-perception and role relationships, Mr. Taylor views himself as a burden to the family and feels that his wife and children think the same. He states that his relationship with his wife is very strained but insists that he is following the doctor’s orders. Mrs. Taylor and the two daughters would like for the father to seek additional emotional help and infuse his TPN as per the doctor’s order. The son thinks his father is following the doctor’s orders. Mrs. Taylor feels she is a parent to her husband most of the time. She feels he has caused most of the problems within the family but states she does not have time to seek counseling alone or as a couple due to the children’s and her own work schedule.

The couple states they did not have any trouble conceiving children but with the husband’s condition they no longer sleep together nor do they maintain a sex life. Mrs. Taylor has discussed sex and sexuality with each child. The oldest daughter is having difficulty with her sexuality and claims she thinks she is a lesbian but does not wish to tell her parents at this time.

Coping mechanisms are not healthy within the family. Mrs. Taylor will not discuss any issues regarding her family in a healthy manner. She states she usually just lets her frustration build and then cries. The children remain busy with college and high school life.

Functional strengths within the family include, they do maintain regular doctor, dental and ophthalmology visits, though the father may not be compliant, and they do maintain regular sleep patterns though the father sleeps during the day. Primary barriers to health lie with Mr. Taylor’s non-compliance with the infusion protocol prescribed and dietary constraints of his condition, the unwillingness to seek counseling to learn effective coping mechanisms, and the relatively sedentary lifestyle of the family.

Application of the family system theory provides for the inclusion of the whole family. With this understanding, the chronic illness is not exclusive to the patient; it is mutually shared by the family and can directly or indirectly affect the illness and the family (Cecilio, Sturiao dos Santos, & Marcon, 2014). Within this family is a conflict-oriented style of problem solving and family denial. Working with the family system theory, this family would be served well with structural family therapy (Bowen, 2018).

Regardless of the interventions chosen, Wright and Leahey state that the interventions should be a result of the collaboration between the nurse and family, should be a reflection of the nurses working diagnosis, and should match the family’s style of relating. Furthermore, the interventions should draw on the family’s strengths and resources, should be consistent with the family belief system, and include alternative interventions (2012).

References

Bowen, M. (2018). Eight Concepts. Retrieved from: https://thebowencenter.org/theory/eight

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