Individual Developmental Tool and Character’s Developmental State

The Harvighirst’s (1972) Developmental Tasks Assessment tool was utilized to obtain an accurate level of tasks for John. Havighurst’s theory thrives on the assertion that development is a continuous process taking place throughout entire lifespan. It occurs in stages where an individual move in stages from one to the next through resolution of tasks that emerge in every state. People that have completed developmental tasks gain a sense of satisfaction and pride. The society also recognizes them as contributive members. Failure to complete a developmental task results to a feeling of failure and the society cannot respect or uphold such individuals. According to harvighirst’s (1972) Developmental Tasks, King is in the Task of Late Maturity (60 years – death).

Expected Individual Developmental Tasks for this Stage

John is expected to achieve and acquire tasks for his individual development (Havighurst, 1972). The expected tasks are: adjust to decreasing physical strength and health, adjust to reduced income, adjust to death of spouse, establish explicit affiliation with own age group (elder of society), and adopt/adapt social roles tin flexible way.

Examples of John’s Status with Individual developmental Tasks

John has not met the expected tasks in this developmental stage (60 years-death) (Havighurst, 1972). Due to his physical condition, John is struggling with social and civic responsibilities and duties. John fears that the society will have a negative perception of if he is placed under home nursing care. He is feels that no one will support him and has limited retirement income. He did make reasonable savings when he was still working but he is afraid that he will spend his saving on his medical treatment and medication. As a matter of fact, sometimes he regrets about his smoking habits when he was still young, energetic and active. These fears make his life lonely and makes him depressed. He feels like he has no meaning in life.

Family Development Assessment

Family Developmental Tool and Family’s Developmental Stage

The Duvall Family Developmental: The eight-Stage Family Life Cycle and Developmental Tasks (Friedman, 1998) assessment was used to acquire John’s Family Developmental Stage. According to The Duvall Family Developmental Theory, John is at Stage VIII: Aging Families (retirement to death of one or both spouses) (Friedman, 1998). The Major Family Goal of Stage VIII Disengagement (Friedman, 1998). John is trying to adjust to his decreased physical strength, adjustment to loss of spouse.

Expected Family Developmental Tasks for this Stage

Stage VIII of Duvall’s (Friedman, 1998) family development expects these developmental tasks: Maintain a satisfying living arrangement, adjust to a retirement income, establish comfortable household routines, maintain marital relationships, nurture spouse, adjust to loss of spouse, maintain intergenerational ties, care for generational aging relatives, keep interest in things and relatives outside the family, and continue to make sense of one’s existence (life review and integration) (Friedman, 1998).

Examples of Family’s Status with Family Developmental Tasks

John is currently struggling to meet the developmental tasks for Stage VIII: Maintain a satisfying living arrangement (Friedman, 1998). John is surviving on his savings and limited retirement money. His condition does not allow him to make comfortable living because he cannot attend to tasks. As a retired coal-mine worker, he has been forced to spend the little savings he had on medication. He does not have close relatives near him, except his old friends. Additionally, John does not belong to any social group in the society. Immediately after the diagnosis of COPD, John decided to research the disease and seems to have accepted his status. He is well-informed on the management of the disease and hopes that he will manage it with the help of a physician.

Individual Development Stage by Havinghurst

According to Havighurst’s (1972) Developmental Tasks, John is working on the tasks of later maturity, which is 60 years old through death. He is trying to adjust to his decreased physical strength because he often feels fatigued, and his health is declining due to his decreased pulmonary function system (PFS) and blood gases, coughing, anorexia, and the sense of hopelessness/impending doom as he is trying to deal with the symptoms of his illness.

He has adjusted to retirement and reduced income with a small pension from a power plant and is collecting social security. He has adjusted to the death of his spouse Cathy having died two years earlier, but on occasion misses her. He hasn’t established any affiliations with his own age group due to him retiring and his failing health. He hasn’t adapted to social roles in flexible ways because he has not been interaction with his own age people. He has established satisfactory physical living arrangements as he still lives at home (Havighurst).

Holistic Family Assessment

Define Family Assessment

Family is defined as a group of people whom live together either and are related to either blood or marriage or have a strong bond between each other. There are several different types of families such as nuclear, traditional, blended, and gay families.

The Wong and Eaton (2001) Family Assessment tool was used to assess John’s family (see Appendix A). This tool allows the nurse to observe and evaluate the dynamics of John’s family.

Summary of Family Assessment and Ecomap Findings

The Wong and Eaton’s (2001) Family Assessment tool enabled to view a clearer assessment of John which includes family composition, home and community environment, occupation and education of members, and cultural and religious traditions (Wong & Eaton, 2001). The functional assessments areas include family interactions and roles, power, decision-making, and problem-solving, communication, and expression of feelings and individuality (Wong & Eaton, 2001).

Structurally, the immediate members consist of John King 68-years-old and he is a widower (Wong & Eaton, 2001). John has no children. John lives alone with no immediate family members in his household. John currently lives in a house that he and his late wife Cathy bought it together 30 years ago. Adequate space is noted with safety features including a back door, smoke and carbon dioxide detectors. The house appears clean (Wong & Eaton, 2001). John is a college graduate with a Bachelor’s degree in Social Works. John does not have a source of income except the retirement pension plans and social security. John has a firm belief in God because he states he reads the Bible and listens to hymns.

Functionally, the John’s Family unit is cool and distant. These characteristics appear to be the result of having no children and no distant relatives close by. (Wong & Eaton, 2001). John makes all the decisions concerning his life (Wong & Eaton, 2001). John primarily initiates communication with his close friend to make them aware of his wishes concerning his declining health.

John’s ecomap (see Appendix B) shows that the strongest bonds are with his two close friends and his nurse, primary and now new friend Susan whom he met from COPD support group. John gives and receives most energy from his nurse and his two friends. King receives moderate support from his other family that lives far away. There is no negative energy flow with his family members. Reading the Bible and listening to hymns gives John gives a strong sense of self-worth and fulfillment. John’s ecomap illustrates that he gives and returns energy to several sources.

Describe Two Uses of Family Assessment Findings

The family assessment findings (Wong & Eaton, 2001) for King will be beneficial in helping him understand the disease process of COPD and his relationships with family members. Understanding the need of continuing therapy sessions with his nurse will increase his awareness and progress of his illness (Wong & Eaton, 2001).

The family assessment findings indicate John’s need for resources to help with the cost of treatment plans and other local non-profit organizations (Wong & Eaton, 2001). An example to help with costs of therapy would be to attend a self-help group and become self-reliant. John joined a local self-help group for COPD where others are experiencing the same issues and is getting help with feelings of isolation and stigma. In the social group, John will realize that he is not the only one struggling with the condition.

Aging/Geriatric Issues and Models of Care

Two Aging Issues for John King

According to HealthinAging.org (n.d.), aging population tend to face different challenges. As their lungs age, they are likely to develop one or multiple conditions associated with COPD. When lungs age, adults become vulnerable, and they may have a health problem that can lead to another condition or injury if not properly managed. John King, 68-year-old Native American male with the diagnosis of COPD. The two aging issues that need to be addressed are the potential pneumothorax and respiratory failure (HealthinAging, n.d.). For people with COPD, life becomes more challenging because routine physical activities and sleeping become more difficult. Patients feel tired much of the time, and at times, they have to cope with oxygen tanks when in public.

Models of Care and Interdisciplinary Care

The two models of care that would be beneficial for John’s chronic illness would be the Chronic Care Model (CCM) and the Stanford Chronic Care Model (Golover & Joshi, 2015). CCM has six constructs of self-management support, decision support, delivery system design, clinical information systems, health care organization, and community resources (Glover & Joshi, 2015). This Model of Care would be useful for John because the model provides a team approach of healthcare professionals to improve the outcome of his chronic illness. Additionally, John lives alone, and the model would help him manage the condition at the individual level. The Stanford Chronic Care Model utilizes six principles associated with self-management tasks (Glover & Joshi, 2015). These are solving problems, making decisions, utilizing resources, forming a patient-provider partnership, making action plans for health behavior change, and self-tailoring. John would benefit from the use of this model because he would learn how to handle tasks and become less over dependent as the disease progresses. This would be in line with his wishes in life.

Nursing Roles

The roles of nursing to benefit John would be the nurse as teacher and the nurse as resource. The nurse as teacher would teach John the basic facts about COPD and the necessary treatment (Thoracic Society, 2013). By encouraging John to take an active role in his chronic illness, he will be better informed for decision- making regarding his care. The nurse can teach King the importance of adhering to medication. The nurse as resource can help John with referrals for local support agencies or social groups (Thoracic Society, 2013). The resource nurse may evaluate John’s physical conditions and advise the clinician on necessary changes.

Conclusion

Chronic illness is an irreversible, progressive disease that presents accumulation, or latency of disease states or impairments that involve the total human environment for supportive care and self-care, maintenance of function, and prevention of further disability” (Glove & Joshi, 2015). Nurses need to understand the illness experience to provide holistic care (Thoracic Society, 2013).COPD is a chronic condition covering three old-age diseases; emphysema, asthma, and chronic bronchitis. The etiology of COPD is thought to be caused by multiple factors, but exposure to dust and smoking are the leading causes.

The Family Assessment Project Paper presents John King, a 68-year-old married Native American male with the diagnosis COPD for two years. The Havighurst’s (1972) Developmental Tasks (Individual) was utilized to determine John’s level of task development. The stage of developmental task for John is Tasks of Old age-death (above 60 years). At present, John has been unable to complete the Tasks of old age related to his physical condition.

The Duvall Family Developmental Theory: The Eight-Stage Family Life Cycle and Developmental Tasks (Friedman, 1998) was used to define John’s Family Development Stage (Friedman, 1998). Currently, John is in Stage VIII: Aging Families. The Goal is Disengagement (Friedman, 1998). John accomplishes most of the tasks individually because he lives alone.

The Wong and Eaton’s Family Assessment tool (Wong & Eaton, 2001) was implemented using both structural and functional assessment areas. The Family Assessment findings are displayed in Appendix A. The King’s family assessment reveals a widowed man living in a house with limited income (Wong & Eaton, 2001). With his inability to engage in productive work, he remains a burden to himself. John does not subscribe to a religion, but he reads the Bible and likes listening to hymns (Wong & Eaton, 2001). He has little no children and only distant relatives and he lives on his retirement and social security income. John makes decisions concerning his health. John’s family ecomap (see Appendix B) illustrates the interpersonal relationships of its members.

The two aging concerns for John’s chronic illness addressed were pneumothorax and respiratory failure (HealthinAging.org, n.d.). With the potential for pneumothorax and respiratory failure, John will need to participate in rehabilitative programs or be placed under palliative care. Teacher and resource are relevant nursing roles related to comprehensive individual care (thoracic Society). John will benefit from a nurse teaching him on the need to adhere to medication.