Family Assessment Rubric – will be sent
Sample Paper for family assessment will be sent

Family Assessment

Family Centered Nursing – health care that focuses on the health of the family as a unit, as well as the maintenance and improvement in the health and growth of each person in the unit. The recipient of care is the family itself (Harkreader, 2000).

Three beliefs that underlie the family-centered approach to the nursing process:
1. All individuals must be viewed within their family context
2. Families have an impact on individuals
3. Individuals have an impact on families

What is a Family?
? Two or more people who are emotionally involved with each other and live closely together (may be unrelated either biologically or legally) (Friedman, 1992).
? A family is whom the family says it is ? a set of relationships that the client defines as family, may be biological or legal or social ties.
? A family involves commitment over time.
Family Forms
Social trends affect families
There is a decline in traditional families
Divorce rate is over 50%
1. Nuclear family
2. Extended family (multigenerational)
3. Single parent family
4. Adoptive family
5. Foster family
6. Blended family
7. Alternate patterns of relationships
? Communal
? Homosexual

Family Theories ? used to explain the dynamics of family relations; gives a conceptual approach to family assessment.
1. Family developmental theory-stages of the family throughout its generational life cycle, divided into 8 stages (Duvall)
? Married couple without children
? Early childbearing family
? Family with preschool children
? Family with school age children
? Family with teenagers
? Family launching young adults
? Family in middle years (empty next to retirement)
? Family in retirement and old age
2. General systems theory
? Family is viewed as a social system existing and interacting with larger systems of the community
? The family is goal directed
? Can be open or closed
? An open family is healthy because there are interactions within the family and the external environment. As the needs of its members change, the family can adjust to maintain harmony and balance. When the open family system loses its balance, outside help can assist in its stabilization
? A closed family excludes others, functions in isolation, and is a pathological model (abusive family, family has secrets)
These models can be used in assessment by looking at what developmental stage the family is in and whether the family is an open or closed system and what type of support or input is available to the family.

Family Tasks ? described by Duvall and Miller as tasks that the family must accomplish in order to contribute to the mental health or mental illness of family members.
? Physical maintenance and safety (food, clothing, shelter, health care)
? Allocation of resources: meeting family needs and costs, provision for education
? Division of labor
? Socialization of family members: transmits beliefs, values, attitudes and coping mechanisms
? Reproduction and release of family members
? Maintenance of order, authority and decision making
? Placement of members into the larger society
? Maintenance of motivation and morale; meeting personal and family crises, refining a philosophy of life and family loyalty through rituals, nurturing and support of members

Parenting Styles ? 3 types
? Authoritarian ? obedience is expected
? Authoritative ? ultimate authority, yet some negotiation and compromise allowed
? Permissive ? little or no control over child?s behavior, rules are inconsistent and unclear
Assessment
Structure ? how the family is organized
Roles ? who does what
Power ? how are decisions made
Communication ? processes
Functions ? how does the family accomplish its tasks and goals
Resources ? ability to meet financial needs, support
Diagnosis
Compromised family coping
Disabled family coping
Ineffective family therapeutic regimen
Interrupted family processes
Readiness for enhanced family coping

Planning
? Needs to be negotiated, collaborative, and realistic
? Goal is to assist family to optimal functioning
? Considers developmental stage
? Incorporates family goals

Interventions (examples)
? Acknowledge feelings
? Explore coping skills
? Limiting the source of the problem
? Explore solutions
? Give options
? Role model
? Identify destructive behaviors
? Collaborate with other disciplines
? Support communication between family members
? Assist in problem solving
? Support conflict resolution
? Assist in the use of internal and external resources
? Provide health care information
? Provide health promotion information
? Assist family to identify strengths
? Encourage journaling to record activities
? Support role of caregiver
? Assist with role changes
? Assist with respite care
? Assist family to obtain services such as housecleaning, legal and financial services, home health care, hospice, food services

Evaluation