Family Care Plan Nursing Family

Family Care Plan

Nursing Family Care Plan

The Case:

Father, 75, recently diagnosed with small cell carcinoma. On home hospice care with 4-6 months to live; worked in the Philadelphia Naval yard. Former regular smoker, recently quit.

Mother, 76, obese, suffers from Insulin-Dependent Diabetes Mellitus. Has no relevant work history (stay at home mom). Also a former regular smoker; quit at the same time as Father.

Son, 50s, has an ongoing drug addiction. Currently abusing benzodiasipans (klonopin xanax) despite being on controlled methadone maintenance. No children, and no available work history. Regular smoker.

Diagnosis

Quality of life and access to care, jeopardized; related to father's recent diagnosis and expected rapid decline, mother's limited mobility due to obesity and insulin dependent diabetes, son's unreliability due to drug use as manifested by his continued abuse of benzodiasipans during a supervised pharmaceutical regimen.

Objectives:

Ensure regular access to healthcare professionals for all family members, as well as implementing methods for achieving reliable in-home self-care to improve the quality of life and health within the next six weeks.

Family Assigned Interventions:

-Careful monitoring of blood sugar/insulin levels in mother, strict adherence to dietary restrictions in order to improve overall well-being and reliability of health

-Proper care techniques learned by mother and son to assist in quality of life improvements for father

-Renewed efforts on part of son to resist drug addiction, including therapy and support group attendance

Nursing Interventions

-Provide regular in-home care to father as required, largely to lend support/relieve pressures in the family

-Instruct mother in use of testing supplies and dietary regulation and ensure understanding

-Monitor son's drug use as much as possible, watching for sign of future medical distress

Evaluation

Regular visits with brief questions (mother's blood sugar levels and diet, incidents with father, son's drug use, problems reaching medical appointments, etc.) will evaluate the success of these measures.

Diagnosis 2

Family processes, altered; related to father's illness and hospice care as evidenced by the fact that father was the only outside-the-home worker and therefore likely the active caretaker until the point of his diagnosis, creating new level of responsibility for mother and new responsibilities altogether for son.

Objectives

Developing understanding of and competence in new roles in the family dynamic for all three family members (includes father's acceptance of reduced role in order to maintain quality of life during end-of-life care) within two weeks.

Family Interventions

-Mother can attend cancer support groups and receive advice and education through other channels regarding proper methods of providing care and improving quality of life for her husband

-Son can explore employment options as well as discuss various needs and responsibilities with his parents in order to determine his most effective utilization within the changed family dynamic

-Father can provide the levels of self-care that come easily, but should educate himself regarding his condition and ease care by allowing others to help when necessary

Nursing Interventions

-Provide educational materials/answer questions for both mother and father

-Assist son with psychological transition of increased responsibility/familial dependence

-Instruction of proper care techniques for mother and father regarding father's condition

Evaluation

Levels of comfort and competence in new family roles should be easily assessed in regular visits through brief questioning. Monitoring father's health through standard vital sign and other appropriate tests will determine level of care; questions determine quality of life. Assessment of son for ability to act with increased responsibility may take a longer evaluative period.

Diagnosis 3

Possibility of resumed smoking by mother and father further reducing quality of life and ability to provide care, related to long-time smoker status and high rates of recidivism in smokers, as manifested in (and exacerbated by) the son's continuing status as a regular smoker

Objectives

To ensure that the mother and father remain non-smokers, and to mitigate the effects (both psychological and physiological) of the son's continued smoking. Son's cessation of smoking would be a secondary objective, but is not immediately advisable given his drug dependency status