Enhancing Interpersonal Communication in a Family - Case Study Example

Introduction Bruce and Susan Bright reside at a moderately urban part of Queensland Bruce is 44 and Susan is 41 and they are married for 21 years by now. Both of were full-time employed till around 6 weeks ago. But due to some unavoidable circumstances Bruce was retrenched from work which brought about tight economical condition to the family. The couple has three children Shane (20), Caitlin (17) and Mitchell (11). Both Shane and Caitlin are employed. Shane is associated with the navy and is posted in Jervis Bay. Caitlin is a part-time employee at a local mini market. Mitchell, the youngest sibling attends a primary school. Though his performance had always been commendable at the class but it deteriorated noticeably is the past few days. His attendance record has degraded accordingly. He has indulged in several clashes with fellow classmates which marks his corrosion in conduct. It has seemed an alarming situation to the school and the authority has expressed concern about the child. Susan’s family stays away from them but they are in stable and sound physical a well as economical condition. But Bruce’s parents split from each other years back and his mother Maureen moved away from the house; though she kept in touch with Bruce and his family. Now Royce, Bruce’s father is 73 years old and he is residing just two streets away from Bruce. But he is going through certain problems and he is unable to eat properly or maintain his house. Memory loss is another effect of age that has become fatal for him. Quite recently Royce underwent certain minor accidents. His living room caught fire when he left an electric heater on. A community nurse assigned to the Bright family is the in charge of making decisions about which support services are to be provided to them in order to resolve their problems permanently. Facts to be considered while making the decisions: The Bright family is in dire need of some sort of health and old age care services so that Royce, the 73 year old father gets to lead a peaceful life. He is suffering from health as well as psychological problems like Dementia caused by aging and these need immediate attention. The Aged care services decided by “Assessment for Aged Care” would be the best option for Royce as his son and daughter-in-law are both tied up with their stringent family condition. The kids are either busy working or too young to take sufficient care of their grand father. At the same time the Bright family needs continuous inspiration and aid to cope up with the taut economical condition. The young kid Mitchell needs attention so that he does not get deviated from the correct path for the future. A teen care service can always be of real help to guide him. The school counselling services can do great help to the kid as he might need assistance with the school home work and studies. There are chances that Mitchell is associated with wrong company which is leaving bad influences on him intriguing him to indulge into fights with classmates. It is quite normal that the kid feels bored and stressed with the current family condition and this is dragging him towards an unhealthy lifestyle. At the same time the family members need to take up the responsibility so that the kid feels secured and protected in spite of the adverse situations. The most crucial reason why the kid is facing so many problems is that his mother keeps busy in full time work and is unable to dedicate sufficient time to look after him. Two services that are to be provided on urgent basis include “Aged care service” and “Teen care support”. The neighbours and the entire community should support the family to come out of the tense condition successfully. Friendly approach and compassionate gestures can do a lot of help to the bright family. Need of community support service for Bright family A family is the basic unit which collectively forms a society. People who comprise a family are close to each other both emotionally and physically. Though the traditional definition of a family has changed visibly with the passage of time but the root of the contemporary society remains in it. (Weeks & Quinn 1995) The worsening economical and social conditions of today’s world often take its toll on the families. This is the reason why they need to seek help from the community services which have been specifically designed to meet the requirements of the families. The interventions that are made to help the families should be well-planned and strategic so that they actually help all the members and also alleviate their lifestyle to the normal standards. The bright family is undergoing both economical and social stringencies which is affecting the interpersonal bonding among the family members which is directly affecting the youngest one i.e. Mitchell. The child is unable to bear with the exaggerating pressure imparted by the retrenchment of Bruce and worsening health condition of Royce and as a result his studies and conduct is deteriorating. On the other hand the decline of the kid and the physical complications of the aged person might cause conflicts and stress on the couple’s relationship. These are reasons enough to make the family environment unhealthy and taxing. The strategies and support services can be suggested based on the fact that the family agrees and accepts the interventions without any hesitation. The decisions are to be made looking at the race, religion, financial status and the present context of the situation. (Friedman, Bowden & Jones 2003) I am able to facilitate certain changes in the family provided the members are ready to accept them. In case they are not receptive enough to the suggested changes, they should be stopped right at the moment. The perceptions of the family members about all the changes need to be taken into account so that later on there is no misconception or grievances arising out of the blue. There can be certain barriers while implementing the changes decided for the bright family. (Holtslander, L 2005)The internal barriers include indecision of the family members, fatalism and discouraging approach of the members. But all these problems can be resolved by strong and confident approach towards the problem and no negative labelling at all. Primary Health care principles Primary Health Care principles are the most important set of data that is commonly referred by the healthcare professionals. PHC can be defined as the healthcare services offered to the families, communities or neighbours by individuals or health care professionals. This is in practice for ages in the human society. In order to specify the requirements and services under this category the PHC principles have been collectively drafted. The World Health Organization has been quite active in nurturing the PHC principles. The principles were first drafted in 1978 which have undergone improvements and changes in order to provide maximum benefits to the society. Following are the main statements of PHC principles: 1. The PHC principle intends to promote as well as implement equity in the field of health care. This is the core principle of PHC which suggests absolute equity among the patients from al walks of life. 2. The health care professionals are suggested to show “bio-physiological-cultural sensitivity” to the patients. It enhances the interaction between the patient and the professional. 3. Health care being the primary need and right of all people residing in the society and hence the PHC principle suggests health care services to be affordable and also based on evidences. 4. There are certain steps that are to be followed while doing health promotions which include collection of information, gathering education on specific subjects, working in partnerships and active participation in various health care programs. 5. The patients should be treated with sufficient care so that they do not feel unwanted or deserted at any point of time. Aged and kids need special care which the professionals should be aware of. 6. Health care services should be multidisciplinary. They should cover all ailments both major and minor. 7. The professionals need to maintain “intersectoral collaboration” with the people and the society. 8. The health care interests and rights should be asserted by the community. 9. The Australian society bears cosmopolitan population and this is the reason why the services should be provided to the patients looking at their ethnicity, race and religion. This way the patients will feel connected to the healthcare professionals. (Watson, J, Hodson, K, Johnson, R & Kemp, K 2002) 10. The most important rule stated by PHC, for the professional is continuous evaluation and monitoring. There should be absolute equity and extreme efficiency on the part of the health care professional. ("PHC Principles") Suggestions derived from “The Calgary Family Intervention Model” “The Calgary Family Intervention Model” is quite helpful in deciding which particular intervention should be offered to the Bright family. This model is considered ‘the systematizing structure used to conceptualize the connection between the specific sphere of family performance and the precise intercession rendered by a nurse’ (Wright & Leahey 2000, p. 157) This is one model that aims to throw light on the three domains closely related to the improvement and promotions of the health care system. Following are the three domains depicted in the model: 1. Cognitive: The interventions of the Cognitive Domain puts forward those initiatives which bring about innovative ideas, various relevant opinions and educative information on the specified health related issues. (Wright & Leahey 2000) 2. Affective: The interventions classified under the Affective category aims to help the families with passionate poignant retorts so that they can break through the clogs affecting their independent problem sorting capabilities. (Wright & Leahey 2000) 3. Behavioural: The behavioural interventions aim at aiding the members of a family to behave or interact within themselves in a much eloquent and glib manner. It also helps them to enhance interaction with others apart from their close ones. (Wright & Leahy 2000) Though there can be certain barriers while implementing the strategies suggested in this model but at the same time with positive approach and continuous striving, all these issues can be resolved leading towards a permanent and well-accepted solution to the problems of the Bright family. Rationale behind suggesting support services to the Bright family The health of any family is highly influenced by numerous economical, social and cultural aspects. (Weeks & Quinn 2000) The contribution of women to the society and their role in raising the kids has changed over time which has reflective effect on the current social situations. The Australian society features high mobility wherein families have extended but they reside far away from their relatives. This is the reason why the nuclear families consisting of parents and kids require being self-sufficient (Weeks & Wilson 1995). Other factors that create direct impact of the kids and also the adult members of a family are poverty, divorces, cultural differences and violence. The health of the family members are often impacted by the cultural influences that are specific for particular ethnicities and races. (Tsey, K, Whiteside, M, Deemal, A & Gibson, T 2003) Divorce creates a negative effect on the families and this is the reason why people feel deserted and suffer from a number of psychological problems. (Sullivan) In the given scenario of the bright family, Bruce’s mother Maureen parted from his father Royce that made him lonely and prone to emotional breakdown. At the age of 73 he is forced to stay alone which is quite risky as he is suffering from shortage of memory and eating disorders. At the same time the kids are deprived of their grand mother’s affection which could have helped them a lot in the adverse situation. Spouses, who are unhappy with their economical or social condition, at times indulge in minor domestic violence which can be fatal on the mental set up of the kids present in the family which is probably the case with 11 year old Mitchell. He has suddenly become unable to concentrate on his studies and has been involved in fights with the fellow classmates. These are all signs of disturbed mental state which can lead to severe complications and destroy the future of the kid. Poverty is another reason why the family members are suffering from depression and hopelessness. As Bruce, one of the earning members of the family has been retrenched, the economy has suffered noticeably. Obvious needs of a family which include housing, children’s education, transportation expenses, health care etc are not being met in a proper manner. Paying of utility bills, financial and mental stress caused by unemployment are other reasons why the situation get worsened. (Thornthwaite, Kingston & Walsh 1995, p. 61) Immediate attention should be provided to sort out this critical situation in the Bright family. Support to resolve teenage problems occurring with Mitchell Mitchell is an adolescent kid and this is the most crucial time that is going to decide his future and life. But the child is deprived of his mother’s continuous care because she is busy with the full tile job. At the same time the siblings are tied up with their own hectic schedules. He has developed mental distance with not only his family but also with his classmates. Most probably he is being influenced by bad company and getting into trouble. He needs assistance to cope up with these problems both from the family and other sources. He should be referred to the “Mental health team for children”. The mental health team consists of a number of skilled professionals who are experienced in counseling kids so that they can overcome all their family problems successfully. The counseling sessions should also include the Mitchell’s family as the family members are in close contact with the kid. Best results can be obtained if the child spends quality time with the father. The first step towards solving Mitchell’s problem would be interviewing his family and assessing their perspective towards the condition. With proper and thorough interaction mental health team will be able to understand what services exactly the child needs and they will also suggest the names of the organizations that provide free counseling help to the kids. This is available for free as the Australian government provides subsidy in order to help the young generation of the country. As the kid is not doing well in his studies and being absent at the classes, he probably needs help from the school counselors. He should get ample assistance with the school home work so that the gap can be bridged easily. Now there are chances that Mitchell is feeling bored with the drudgery of the day to day life. This is the reason why he should get involved in certain extra curricular activities as it will lift up his spirit and at the same time will make him more sociable. Meeting quality young people with similar interests will make him feel entertained and happy. He can join the Police Citizen Youth Club wherein they promote a number of sports activities like swimming and indoor cricket. Gym and discos are available for complete entertainment of the adolescents. His father can help him recover from the situation by providing mental support. The other family members should be equally compassionate and supportive to the kid. The teen correction services is a must-provide to the Bright family kid Mitchell. He is suffering from concentration problems and also social withdrawals. Counselling from experienced professionals can do wonders to his career and this is the reason why he should be offered several counselling sessions. The kid should be treated with great care and encouragement by the family members so that he feels protected and loved. Parents should create an environment at home wherein the kid stays away from all distractions. The kid should also be informed that in order to acquire good earnings in future, he needs to attend school on regular basis. Interaction between the teacher and the parents can always help sort out this sort of a situation. It should be investigated whether the kid is being bullied or teased at school and whether this is the reason of his withdrawal or not. If this is the case, the kid should be sent to another school wherein he can get to study in a better environment. (“Dropping Out of School | Stumbling in School.") Discussing the problem with the kid is quite necessary in order to obtain persistent and positive outcomes. Aged care for Royce The federal government holds the primary responsibility to provide aged care support to Royce, the 73 year old person staying alone at home who is unable to manage a healthy living due to various age related problems. The “Queensland Health” operates around twenty aged care facilities that have residential provisions. ("ACTION POINTS FOR AN AGEING POPULATION")They cater to the customized requirements of the old people. Royce is 73 years old and he is a patient of dementia. This disease is defined as the chronic loss of formerly acquired mental functions. 10% prevalence of dementia is observed among people above the age of 65. The patients often fail to perform simple activities which they used to be familiar with before. They face severe difficulty while expressing themselves. They start losing normal level of alertness and often forget their daily habit. This can be an issue with hygiene and safety. They neglect caring about themselves and also fail to look after the house which is definitely the major problem with Royce. He forgets when he last washed or ate. Cooking seems very tough for him and accidents can occur at any point of time. As it has been observed that Royce forgot an electric heater at the living room and it caught fire. This happen s to be a major safety hazard to both the family and the community. A big fire can cause severe damages to the nearby houses which is one reason why Royce should be sent to a nursing home where there are attendants to look after him through 24 hours a day. Dementia patients also have the habit of wandering here and there and at this point of time they forget about the safety of their house and also themselves. In this situation Royce can at any time move out of the house leaving it unsafe and meet an accident or get lost which is probably the most fatal effect. Other problems can also cause due to this psychological problem. As Royce is unable to cook properly, he will surely lack nutritional foods which are necessary for him at this age. It would gradually make him feeble and sickly. Dementia is one of the diseases which affect the aged people. The commonest symptoms like disorientation, memory loss and confusion are closely associated with day to day life of an individual. All of the issues when combined with poor coordination and mobility of the patient can all affect the family’s safety. Apart from the friends and family, the health professionals should help out the patient. Royce hasd splitted from his wife Maureen years back. His son and the family is already into trouble with their economical conditions and young kids’ problems. Hence a nursing home should be the right choice for his treatment. While assessing the medical aids required for Royce, the ACAT team will do the needful. ACAT and its activities The Aged Care Assessment Teams aim to help the aged people in Australia and also assess what kind of care they require. When older people suffer from certain age-related psychological or physical problems like dementia, the ACATs investigate the situation and assess which type of care will meet the needs of the individual. They also provide information on the care options that will suit the requirements of the aged person. They will arrage for the referral needed to consult the resedential community care services. The funds necessary for this pourpose are basically provided by the Australian government. These funds are transferred to the Territiry and State governments which they pass on to ACATs. Based on the assessments of ACATs, the old people are provided with residential care, Extended Aged Care at Home and also EACH packages specifically designed for dementia patients. Royce needs the dementia treatment resendial programs. For this his family will need to interact with the ACATs which are made by nurses, doctors, health professionals and also social workers. The Bright family need this service for the aged member’s security. They need suggestions on how they should deal with the present situation and rest will be taked care of by the ACATs. All the packages suggested by ACATs are subsidized by the government of australia. The family can go ahead and discuss the specific problems with ACAT right at their home or even at the hospitals. The members of the ACATs will ask them a number of pre-set questions so that they can assesss the needs properly and come up with the best possible solution. If the family approves their suggestions, the local doctors will be called up for further information. The ACATs are available all through the country at the community care centers, hospitals etc. The Bright family can also get in touch with them via their community nurse or call up the “Carelink Centre” and “Commonwealth Respite” at the free number 1800 052 222. ("Department of Health and Ageing - How Aged Care Assessment Teams (ACATs) Can Help You.") How Bruce can be helped in this situation? Bruce who has been retrenched from his employment is undergoing a stressed state of mind and economy. The family needs his support and he is unable to do the needful and this is the reason why he is suffering from guilt and depression. He should take positive initiative towards encouraging Mitchell, the troubled kid. Spending time together with the kid will benefit both of them. As gar as his employment is concerned, he can seek help from Centerlinks. This is a Statutory Agency of the government of Australia which aims to help people seeking employment. ("Centrelink - Giving you options.") Bruce can get all required information about his rights and the options that he can try out for earning. The Centerlinks also feature programs that can educate an individual about the skills necessary to find jobs. He can also get the facilities of paying less for the professional courses at Tafe College via Centerlinks. Another organization that can help him out is the Salvation Army Employment Plus. This organization finds jobs for thousands of people across Australia every week. They are connected with the cosmic network of government agencies, individual employers, support providers for specific needs, training professionals and local consultants. ("The Salvation Army, Employment Plus - Home "we never give up".")This is the reason hwy they can increase the scopes of employment several folds. They also help individuals with counseling and support while they are up to the job hunt. Seeking help from any of these two organizations can change Bruce’s employment status which will surely help the family. Conclusion The Bright family needs implementation of certain changes in their family structure which is possible when they are receptive to the changes. The strategies that can help them include enhancing interpersonal communication and understand the roots of the problems. Regular counselling for Mitchell will surely help him to regain his concentration and good conduct. Royce’s problems can be resolved with active aid from the aged care services offered by the federal government of Australia. If the interventions suit the mental set-up of the family and they are able to implement those, improvement will be visible over a short span of time. References "ACTION POINTS FOR AN AGEING POPULATION." ACQI. 12 Aug. 2009 . "PHC Principles." PHC Home. 13 Aug. 2009 . 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The Salvation Army, Employment Plus - Home "we never give up". 15 Aug. 2009 Read More