Family Care Plan

I. INTRODUCTION

Family is a basic unit of Society. It consists of those individuals, male and female,

youth or adult, legally or not legally related, genetically or not genetically related, who

are considered by the others to represent their significant persons. In a field of nursing,

interest in a family unit and its impact on health, values, and productivity of individual

family members is expressed by family centered nursing that considers the health of a

Family as a unit addition to the health of individual family members.

The Economic resources needed by the Family are secured by the Adult members.

The Family protects the physical health of its members by providing adequate nutrition.

And health care services. Nutritional and Lifestyle practice’s of a Family also directly

affect the developing health attitude and life style practice of children.

Part of the nursing course is the Community Health Nursing where the students

were exposed in the different areas in the community it can be in the health center, home

visits and other health care services of the Government. The students were required to

have a Family Case Study where they will have an actual exposure to the family. The

students will identify the problem, explore and help the family find the solutions to such

problems or shortcomings. Through this case study the presenter was able to help a

family and explore the Town of Lucban.

II. FAMILY DATA

A. FAMILY STRUCTURE, CHARACTERISTICS AND DYNAMICS

FAMILY MEMBERS AGE SEX CIVIL

STATUS

POSITION IN

THE FAMILY

RELATIONSHIP

IN THE FAMILY

PLACE OF

RESIDENCE

Ronnie Hari Galleno 37 M M Head of

the family

37 A

Interior

Mabini St.

Brgy. 7

Jocelyn Deapera

Galleno

37 F M Mother Wife

Mark Anthony 17 M S Eldest Son

Mary Ann 15 F S 2nd child Daughter

Michael Angelo 14 M S 3rd child Son

Mark Andrew 6 M S 4th child Son

Mary Joy 5 M S 5th child Daughter

Micko John Ron 1 M S Youngest Son

Galleno family is a typical example of a nuclear family in which it is composed of

father, mother and children. The table shown that this family is considered as a big

family. Mang Ronnie, the head of the family was married to Aling Jocelyn. They are

blessed with six children. Most of the time the head of the family, Mang Ronnie was on

his job while Aling Jocelyn was the one responsible to household chores and taking care

of the children.

There is no obvious observable conflict between the members of the family. The

relationship of each members of the family toward each other was good. For them

siblings rivalry is normal. The couple equally shared decisions. They have open

communications within the family, parents allowed the children to speak up and share

their ideas in decision making. But still the final decisions were made by Mang Ronnie

and Aling Jocelyn. The children also said that they are more afraid on their father but also

shows their respect to him.

B. SOCIO-ECONOMIC AND CULTURAL CHARACTERISTICS

FAMILY

MEMBERS

OCCUPATION PLACE OF

WORK

MONTHLY

INCOME

EDUCATIONAL

ATTAINMENT

RELIGION

Ronnie

Galleno

Farmer Lucban 3,000 High School

undergraduate

Roman

catholic

Jocelyn

Galleno

Helper Manila --- High School

graduate

Roman

catholic

Mark

Anthony

--- --- --- High School

graduate

Roman

Catholic

Mary Ann --- --- --- High School

undergraduate

Roman

Catholic

Michael

Angelo

--- --- --- Elementary

graduate

Roman

Catholic

Mark

Andrew

--- --- --- Non Schooling Roman

Catholic

Mary Joy --- --- --- Non Schooling Roman

Catholic

Micko John

Ron

--- --- --- Non Schooling Roman

Catholic

Mang Ronnie has no regular income. He only had it whenever there is available

job in the farm. He’s income only ranges from 500 to 750 per week. Since he does

farming, he brings vegetables in their house to lessen their expenses. Their usual income

was adequate only for their basic needs making them hard to buy other important needs.

Due to low amount of income they weren’t able to send all their children in school. Their

eldest is high school graduate while the youngest is not yet schooling.

At the moment, Aling Jocelyn is now working in Manila as a helper. She only

started this month, to be exact she stated on March 1, leaving all her responsibilities to

her husband most especially to her eldest son and daughter who are still minors. Their

father goes to work early in the morning and comes back home late in the afternoon

which means the responsibilities are all in the eldest children.

The family lives near the house of their relatives; specifically their grand mother

who is just a few steps away from their house. They just go to their grandmother

whenever they need something when their father is not around.

When it comes to religious affiliation, the family is all Roman Catholic, the eldest

son admitted that they only go to church when there is an occasion like Christmas. Mary

Ann, on the other hand is the one who are more frequent to go to church among the

siblings, she brings her youngest brother with her wherever she goes, be it on the church

or just hanging out with friends. They have maintained good relationship with their

neighbors. The qualified members of the family participate in election, local and national

level but are not involved in other activities of the community or barangay such as

segregating waste, Mary Ann also admitted that they just throw their garbage in the lake

near their house.

C. HOME AND ENVIRONMENT

Their house is made up of woods and bamboo from flooring to wall. And

considering the big number of the family, and the space is about 4mx5m, it is too small

for them. In that little space, when you enter you can already see the whole house, the

flooring which has spaces in between the woods can cause accident or injury to any

members. They have Television but the electric supply is connected to their

grandmother’s house. They do not have proper sullage system for their waste. Their

water is from communal faucet system. They wash their dishes outside their house coz

there is an available faucet outside. They cook food and store them in proper container.

There is presence of accident hazards inside and outside the house, the stepladder which

can be slippery and the back door has no proper security once they were doing something

their youngest sibling has the possibility to fall outside the house. They are also near a

river which is the usual dump area of some of the residents there which may cause flood

when it rain hard and may be a nest for different pests. They also have a pet cat and dog

which they have reported leaving fur on seats and bed covers.

The family has a good neighborhood with few gossipers around. They usually

talked with them and the children play with other children. The infrastructures nearby is

BHS of Barangay 7. They travel by walking when the destination is a walking distance or

by tricycle which is always available in the area.

D. HEALTH STATUS OF EACH MEMBER

FAMILY

MAMBERS

ILLNESSES STAGE HEALTH

ACTION

Ronnie Hari

Galleno

Muscle ache 1-2 days Rest

Jocelyn Deapera

Galleno

Cough and colds 5 days Rest

Mark Anthony Cough and colds 3 day Self medications

Mary Ann Cough and colds 3 days Self medications

Michael Angelo Cough and colds 3 days Self medications

Mark Andrew Cough and colds 5 days Self medications

Mary Joy Cough and colds 3 days Self medications

Micko John Ron Cough and colds;

Diarrhea

5 days Consulted to BHS in

Banahaw

The family experiences common illness such as cough and colds which they relate

to the cold, rainy weather. Parents did not consult their felt sicknesses in the RHU, only

the younger children were brought to center for management esp. the youngest child who

experienced diarrhea and when their child needs an immunization. Since cough and colds

were the problems and these were consulted only when they can no longer manage these

at home.

The family eats 3 times a day but the quantity and the quality of foods sometimes

were not enough to give them nutrition. They cooked meat or fish if budget would allow.

As a result of low income the family was not able to provide complete balanced

diet to the members. Their usual meals are rice and dried fish, can goods, egg, squash and

ampalaya. Micko John Ron is bottle fed with “am” because he experience diarrhea once

fed with milk.

E. VALUES AND PRACTICE ON HEALTH PROMOTION/

MAINTAINANCE AND DISEASE PREVENTION

DPT HEPA B OPV MEASELSNAME AGE BCG 1 2 3 1 2 3 1 2 3Mary Joy 5

Micko John

Ron

1

The couple doesn’t let their children without complete immunization. They

understand the importance of complete immunizations. They are aware that it is given

free in the health center so they took the opportunity to give the rights of their children.

Mr. and Mrs. Galleno usually have 5-6 hours of sleep at night, waking at 4-5 in

the morning to do household chores. Children usually sleep after watching television and

wake up at 5:30-6 A.M esp. the eldest son and daughter to prepare their foods. They do

not do exercise and believed that working and doing tasks in the house are enough

exercise. The young siblings always have afternoon nap. The children are observed to be

walking barefoot outside the house and inside wherein the floor is dirty.

III. FAMILY NURSING PROBLEMS

A. IDENTIFICATION FAMILY NURSING PROBLEMS

Health Problems

Clues/Cues 1st Level of Assessment

2nd Level of Assessment

Cough and

Cold as

Threat of

cross

infection

from

communica

ble disease

case

Most of the kids had

cough and colds for not

more than 5 days

“Naghkakahawahan

kasi pag may sipon ung

isa nagkakaroon na din

ung iba”, as verbalized

by Daughter

Family lives in about

4m by 5m house

Family seldom

practices covering mouth

when coughing or

sneezing and doing

handwashing

Health

Threat

Threat of cross infection from

communicable disease case as health

threat due to:

1. Inability to recognize presence of

health threat

2. Inability to provide home

conducive to health due to:

a.Inadequate family resources

b. Inadequate knowledge

regarding importance of proper

handwashing

c. Inadequate knowledge

regarding preventive measures

like covering mouth when

coughing or sneezing

Health Problems



Accident Slippery pathway Health Accident hazards as health threat due

hazards

such as fall

and

poisoning

leading to the house

especially when raining

The house is located

near the river

The back door is open

and no railings or stairs

Medicine bottles are

kept on top of a cabinet

which is within reach of

children

Threat to:


health threat due to:

a. Lack of adequate knowledge

regarding accident promoting

practices and condition

2. Inability to make decisions with

respect to taking appropriate health

actions due to:

a. failure to comprehend the

nature of the problem

b. low salience of the problem

c. absence of parents

Health Problems



Accident Slippery pathway Health Accident hazards as health threat due

hazards

such as fall

and

poisoning

leading to the house

especially when raining

The house is located

near the river

The back door is open

and no railings or stairs

Medicine bottles are

kept on top of a cabinet

which is within reach of

children

Threat to:




regarding accident promoting

practices and condition



actions due to:




c. absence of parents

Health Problems



Improper Garbage are dumped at Health Improper Garbage Disposal as health

Garbage

Disposal

the river

Flies are observed

outside the house

Threat threat due to:




regarding proper segregation

and waste disposal

Health Problems



Unhealthy

lifestyle and

personal

practices

such as

walking

barefoot,

seldom

handwashin

g and lack

of exercise

The children walked

barefoot sometimes

outside the house

The pathways are

slippery and muddy

The house floor is

unkempt

The family reported

that they seldom do

handwashing

Health

Threat

Unhealthy lifestyle and personal

practices as health threat due to:




regarding consequences of

such practices or habits



actions due to:




c. misconceptions

3. Inability to provide home

conducive to health due to:

a. Inadequate family resources

b. Failure to see benefits of

improvement

c. lack of knowledge regarding

importance of frequent and proper

handwashing

d. lack of knowledge regarding

preventive measures

e. negative attitude which is not

conducive to health threat

B. SCORING OF EACH FAMILY NURSING PROBLEM

1. Cough and Cold as Threat of cross infection from communicable disease case

Criteria Computation Actual

Score

Justification

1. Nature of the Problem presented

2/3x1 0.67 It is a health deficit that requires immediate interventions t prevent the transfer to other family members

2. Modifiability of the Problem

2/2x1 2 Problem is easily modifiable since knowledge regarding mode of transmission, proper hygiene and other preventive measures are available. Proper foods should be given like plenty of fluids and Vit. C such as Calamansi juice

3. Preventive Potential 2/3 x 1 0.67 Moderately preventive since

preventive measures are available

but environmental condition such

as limited space is present

4.Salience 1/2 x 1 0.50 Family perceived the condition

not needing immediate attention

Total Score 3.84

2. Family Size beyond what family resources can adequately provide

Criteria Computation Actual

Score

Justification

1. Nature of the Problem presented

2/3x1 0.67 It is a health threat that requires attention

2. Modifiability of the Problem

2/2x2 2 It is modifiable if Mrs. Ofelia will have a job to support and help family in financial resources

3. Preventive Potential 3/3x1 1 The available family resources can be utilized t o encourage growth promoting experience for members

4. Salience 1/2x1 0.50 The family recognized the

problem as a serious and

needing immediate attention

Total Score 4.17

3. Unhealthy lifestyle and personal practices

Criteria Computation Actual Justification

Score

Nature of the

Problem

2/3 x 1 0.67 A health threat that does not need

immediate attention

Modifiability of

the Problem

2/2 x 2 2 Problem is easily modifiable since

knowledge regarding healthy lifestyle are

available

Preventive

Potential

3/3 x 1 1 Consequences of unhealthy practices such

as COPD, parasitism, increase risk for

heart problem and others are preventable

Salience 1/2 x 1 0.50 Family perceived the condition not

needing immediate attention

Total Score 4.17

4. Accident hazards

Criteria Computation Actual Score Justification

Nature of the

Problem

2/3 x 1 0.67 A health threat that

does not need

immediate attention

Modifiability of the

Problem

2/2 x 2 2.00 Problem is easily

modifiable since

preventive measures

such as institution of

railings (may be

improvised) and

clearing of molds on

slippery pathways

could be done

Preventive Potential 3/3 x 1 1.00 Preventive measures

are available

Salience 0/2 x 1 0.00 Not perceived as a

problem

Total Score 3.67

5. Improper Garbage Disposal

Criteria Computation Actual Score Justification

Nature of the

Problem

2/3 x 1 0.67 A health threat that

does not need

immediate attention

Modifiability of the

Problem

2/2 x 2 2.00 Problem is easily

modifiable since

knowledge

regarding proper

waste management

are available

Preventive Potential 3/3 x 1 1.00 Communicable

diseases carried by

flies and rodents

could be prevented

Salience 1/2 x 1 0.50 Family perceived

the condition not

needing immediate

attention

Total Score 4.17

C. LIST OF HEATH PROBLEMS ACCORDING TO RANK

Rank Identified Nursing Problem Score

1 Improper garbage disposal 4.17

2 Unhealthy lifestyle and practices 4.17

3 Family size beyond family resources can adequately provide 4.17

4 Cough and colds 3.84

5 Accident hazards 3.67

IV. PLAN OF CARE

HEALTH PROBLEM

FAMILY NURSING PROBLEM

GOAL OF CARE

OBJECTIVE OF CARE

INTERVENTION PLAN

NURSING INTERVENTION

METHOD OF NURSE FAMLIY- CONTACT

RESOURCES REQUIRED

Unhealthy lifestyle and personal practices

A. Inability to recognized problem due to fear on its consequences like economic cost and the lesser knowledge of the extent of the problem.

B. Inability to provide needed materials for the maintenance of personal hygiene like slippers and soap due to financial

At the end of nursing interventions family will be able to know the importance of healthy lifestyle and personal hygiene

After the nursing intervention family will be able to: Identify

diseases caused by the condition.

Develop positive changes of behavior regarding personal hygiene.

Include personal hygiene

Help the family in identifying the problem.

Involve the young members in the discussion.

Discuss the following:

-importance of having good nutrition-encourage to avoid can goods -Diseases that poor hygiene and walking may cause.-Importance of personal

Home visit

Material resources:Visual aids PamphletsHuman resources:Family cooperation time and effort of student nurse.Financial resources:Money for the nurse travel expense.

problem. in their family budget.

Apply information about the condition.

hygiene in preventing those diseases.-Way of rendering personal hygiene. Discuss

within the family the course of action open to them:

-Provide everyday bath on dependent family members.-Assign the older siblings to do the responsibility when parents are not around.-Provide strict or proper implementation of frequent hand washing and wearing of slippers always. Explore

with the family other ways of maintaining proper personal hygiene despite of limited facilities.

HEALTH PROBLEM


GOAL OF CARE

OBJECTIVE OF CARE

INTERVENTION PLAN



RESOURCES REQUIRED

Cough and Colds

A. Inability to recognized problem due to fear on its consequences like economic cost and the lesser knowledge of the extent of the problem.B. Inability to provide needed materials for the maintenance of medications due to financial problem.

At the end of nursing interventions family will be able to know ways and techniques on how to prevent cough and colds and to avoid contamination of other members of the family

After the nursing intervention family will be able to: Identify

diseases caused by the condition.

Develop positive changes of behavior regarding prevention to be infected

Include vit. C rich foods in their family budget.

Apply information about the condition.

Help the family in identifying the problem.

Involve the young members in the discussion.

Discuss the following:

-importance of having good nutrition esp. having adequate intake of fluids and vit. Rich foods-instruct to cover mouth when coughing or sneezing -Importance of personal hygiene in preventing those diseases.-Way of rendering personal hygiene. Explore

with the family other ways of maintaining proper personal hygiene despite of limited facilities.

Home visit


HEALTH PROBLEM


GOAL OF CARE

OBJECTIVE OF CARE

INTERVENTION PLAN



RESOURCES REQUIRED

Family size beyond what the family resources can adequately provide.

A. Inability to recognized condition due to attitude in life which hinders recognition and acceptance of the problem.

B. Inability to make decisions with respect to taking appropriate actions due to Inadequat

e knowledge as to alternative courses of action opens to them.

Fear of consequences of action like economic cost and physical health.

C. failure to utilize community resources for health due: Fear of

consequences of action like economic and physical

At the end of nursing interventions family will be able to make appropriate actions to maintain family size based on a sense of responsibility for love and life.

After the nursing intervention the couple will be able to: Identify the existence and extant of the problem. Identify their responsibility to their children in relation to love and life. To enumerate the different ways/ method of family planning. Select a method they both decide after knowing the advantage and disadvantages of each.

Help the couple identify the existence of the problem

Analyze to the couple their responsibility to their children.

Discuss with the family the different alternative courses.

Explain and analyze with the couple the advantages and disadvantages of each method.

Encourage to utilize existing services I the health center.

Inform couple in the hour of consultation.

Home visit


consequences.

Negative philosophy in life that hinders the effective utilization of community services.

HEALTH PROBLEM


GOAL OF CARE

OBJECTIVE OF CARE

INTERVENTION PLAN



RESOURCES REQUIRED

Improper A. Inability to After the After Help the Home Material

waste disposal

recognize problem and make action due to economic cause and failure to comprehend the possible outcome of improper way to dispose wastesB. Inability to provide clean environment.C. Failure to see benefits of abiding the rules.

nursing interventions family will be able to decide appropriate action in segregating waste and maintain clean environment

the nursing intervention family will be able to identify condition as a problem. Enumerate ways on how to use other materials in providing clean envi.

family identify the existence of the problem.

Analyze to the family the ways to follow in disposing of waste

Allow family the enumerate the different ways on achieving the goal like:

-not throwing garbage in the river- segregating the waste properly- maintaining clean environment

visit resources:Visual aids PamphletsHuman resources:Family cooperation time and effort of student nurse.Financial resources:Money for the nurse travel expense.

HEALTH PROBLEM


GOAL OF CARE

OBJECTIVE OF CARE

INTERVENTION PLAN



RESOURCES REQUIRED

Accident / fall hazards

A. Inability to recognize problem and

After the nursing intervention

After the nursing

Help the family identify

Home visit

Material resources:Visual

make action due to economic cause and failure to comprehend the possible hazard.B. Inability to provide environment conducive to health maintenance due to inadequate financial resources.C. Failure to see benefits of investment in home environment.

s family will be able demonstrate appropriate action in preventing fire hazards.

intervention family will be able to identify condition as a problem. Enumerate ways or courses of actions.

the existence of the problem.

Analyze with the family the extent and magnitude of the problem.

Analyze to the family the need of preventive and safety measures.

Involve the family in identifying the ways of prevention.

Cleaning of the pathwaysHave enough lighting inside and outside the house.Encourage to save money for the materials needed.

aids PamphletsHuman resources:Family cooperation time and effort of student nurse.Financial resources:Money for the nurse travel expense.

V. PROGRESS NOTES

Heath Problems Assessment and Evaluation

Cough and Colds Discuss with the family the possible ways to prevent cough and colds keeping their back dry, to have rest

and by giving rich in Vit. C such as calamansi juice Discuss with the family the complication of cough and

colds Explain the importance of daily changing of clothing

Evaluation-ResolvedPoor personal hygiene They take a bath every other day

Discuss the important of proper personal hygiene. Advice to take a bath every day Discuss the consequences if they disregard the

importance of proper personal hygiene.Evaluation-Their habits on personal hygiene was develop

Family size beyond family resources can adequately

Having a big number of children Encourage to have family planning

Evaluation-UnresolvedImproper waste disposal Assess the sanitary condition of the environment

Note al the observation seen Determine factors affecting these condition Explain the importance of sanitation to the family

health emphasize e consequences that may occurs if unsanitary

condition persist Make plan with the family about appropriate action

takenEvaluation-Unresolved

Accident or fall hazard There once an accident on their bamboo stairs Advice to reconstruct their bamboo stairs Avoidance of children to play on stair.

Evaluation-Accident was avoided

VI. SUMARY, CONCLUSION AND RECOMMENDATION

This family case study represents the Galleno family residing at 3 A. Interior

Mabini St. Brgy. Lucban, Quezon. The family is composed of Mr. Ronnie the head of the

family, Mrs. Jocelyn his wife and their 6 children. Due to financial problems, they just

live in a small house with inadequate home facilities, and not pleasant environment.

Other problems identified were the poor personal hygiene of their children and having

couch and cold as a common illnesses that they have and inadequate living space to their

family.

The researchers became interested to choose this family as their study. After the

problems were identified, family nursing care plan were made and implemented. Through

the proper supervision and health teachings given, health problems of the family were

simultaneously resolved due to their willingness and participation in the management and

treatment of their problem.

The researchers recommended that follow up care to the family be provided so

that other identified problems which were no given much attention during the study be

solved. The researchers also recommended to succeeding student to have further

comprehensive family nursing care plan to be implemented on the same family.

CONCLUSION

After making this study, the presenters concluded that the family despite the

financial constraints was able to make small changes for the improvement of their living.

Though the children were left alone in the house, you can see that they were able to take

care of each other. The mother decided to work and because of that the children

expressed their excitement to come back in the school. After careful analysis and

thorough examinations, the researcher is able to conclude that family problem stems out

from poverty coupled with ignorance and aggravated even more by their attitude of

negligence and disregard.

RECOMMENDATION

Based on the conclusions the students recommend:

1. Motivation for the improvement of their health status.

2. Similar study on the same family giving greater priorities to problems which

are not resolved.

3. Encourage to utilize the free health services of the government by regular

consulting in the health center.

4. Continuous home visit should be done for accurate assessment of the health

status of each member of the family.

Documents

Family Care Plan