Family We are not extremely close, but I

Family structure is an organized relationship between the family and other social systems.  Today, our society structure is a multitude of values, lifestyles, and family forms than ever before. The family I have chosen are my next door neighbors.  We will call them the “X” family.  I have known them for about 10 years as my neighbors.  We are not extremely close, but I know them well enough.  They are forthcoming with information regarding their family, as they know that I am a nurse.  They occasionally ask for my advice, and when I give them any, they value it. This is a Caucasian family in a rural community.  This family is considered to be a Grandparent Family.  The grandparents are in the retired adult stage, and the children are in the school-age stage.The family consists of a Grandmother (65), a step-Grandfather (65), and 2 children Female (14), and Male (10).  The grandmother and step-grandfather are Catholic, the children have no religious affiliation as well as their parents.  Originally, it was just the Grandparents, both retired, and then the parents of these 2 children split up and they both lost custody.  The mother (35) dabbled in drugs and alcohol since High School, and the father (42) as well.  Both parents were highly addicted to Methamphetamines living in Texas, until the birth of their first child.  Upon splitting, the mother moved back to New York with her children, staying temporarily with her parents.  During this time, the father returned to using, and the mother started using Heroin and selling Methamphetamines.  She got caught trafficking to another state and is currently on the run living in another state far from the children.  The grandmother gained custody of the children, and has since returned working part-time at their school.  The step-grandfather remains retired.  The mother works periodically under the table.  The father is disabled due to an injury sustained on the job.  The children are of school-age.  The grandmother is highly active in the community, and likes to shop a lot.  The step-grandfather is an alcoholic, and his activities consist of horseshoes, gambling, hunting, and hanging out with other alcoholics that are his friends.  The female child spends a lot of time by herself on her phone or laptop, is unsure regarding her gender identity, and is highly defiant to the grandparents.  The male child also spends a lot of time by himself on his phone or Xbox, he occasionally goes outside with other friends in the neighborhood, and he attempts defiance but follows and obeys the rules. I am going to use the Systems Theory for this family, as I believe this will be most helpful to assist the family that I chose.Neuman’s (1983) theory is consistent with a family systems approach. Originally, her theory did not discuss the family as  such, but it was later expanded to include the family as the recipient of nursing care (Neuman, 1972). The family is described as an appropriate target for both assessment and nursing interventions. The way each member expresses self influences the whole and creates the basic structure of the family. The major goal of the nurse is to help keep the structure stable within its environment.Betty Neuman’s Systems Model provides a comprehensive holistic and system-based approach to nursing that contains an element of flexibility. The theory focuses on the patient response to stressors and using nursing interventions for maintenance of patient wellness.Using the Neuman’s Systems Model nursing process, following the steps  with specific categories of data about the patient, the assessment, nursing diagnosis, implementation, outcomes, and evaluation.First using the assessment of the patient, looking at the stressors; the response to these stressors; the interaction of the family; lifestyles and coping; and the differences between the family members.  Second, the nurse makes a diagnosis by interpreting the data collected through the assessment. The third step in the nursing process is to set goals with the family.  The nurse creates a plan focusing on strengthening the family. That plan is implemented using nursing interventions. Finally, the nursing process is evaluated to determine whether or not homeostasis has occurred.  If not, then the goals are reformed.Assessment:  The family profile as described above- Grandmother & Grandfather, aged 65; and Female child, age 14; and Male child, age 10.  The Grandparents are married, and the children are of school age.  The current stressors are the grandparents to act as grandparents & parents to the grandchildren.  The grandchildrens’ stressors are when will they return to their parents.  Their lifestyle patterns are the grandparents are retired and the children are enrolled in school.  The grandmother is the head of the household.  She is very active in the church & community.  She eats a well-balanced diet, no smoking, and drinks 1-2 glasses of wine nightly.  She spends leisure time with family, watching television, and shops.  The grandfather is not happy that the children are living with them, and is not supportive.  He also eats a well-balanced diet, quit smoking 1 year ago, and drinks heavily every night.  He spends leisure time hunting, fishing, or playing horseshoes.  The female child is the eldest of the two children, and leads the younger sibling.  She is defiant with showering, changing clothes, doing homework, and doing chores.  She does not eat a well-balanced diet, she eats meals high in carbohydrates, but still remains thin.  She is not physically active, and spends her leisure time lying around the house on her phone or laptop.  The male child, is the youngest, and he follows his sisters lead.  He is usually apt to follow directions from the grandparents without resistance.  He does not eat a well-balanced diet, mostly junk foods, high in fats & oils, but still remains a healthy weight.  He also is not physically active, and spends his leisure time playing on his xbox or on the computer playing games.  Their anticipation of the future is that they will establish a set routine and goals to adhere to, as well as, possibly returning to their parents.  They will establish healthy eating habits and incorporate better leisure and physical activities.The grandmother has orthopedic conditions that require medical care.  The grandfather has hypertension and hyperlipidemia that requires medical care.  The grandchildren are healthy, and see a doctor for yearly physical exams.  They are all up-to-date with immunizations.  They are all independent with self care.   The grandparents have healthy sleep habits.  The grandchildren require more sleep and need to go to bed earlier than they are, since they have difficulties getting up in time for school.  The grandparents have healthy eating habits.  The grandchildren need to incorporate better eating habits.  The grandmother and grandfather both drink alcohol, whereas the grandfather drinks to excess.  Each family member experiences episodes of anxiety and depression.  The grandparents have active social and religious activities.  The grandchildren need more social interactions, they spend most of their time alone or with each other.  They all need to establish a better support system.  They are financially stable and have good transportation.Nursing diagnosisInability to provide a home environment conducive to health maintenance and personal development due to Ineffective communication pattern within the family.Altered role performance, Role strain.Potential for Enhanced Capability for Healthy lifestyle- nutrition/diet, exercise/activity.The outcomes are that the family with provide a home environment conducive to health maintenance and personal development within a year.  The family will have the capability for a healthy lifestyle with nutrition/diet and exercise/activity within 3 months to a year.  The nurse would implement the plan of care by using a group approach with educational materials.  The family will be evaluated every 3 months to confirm that the anticipated changes have occurred.  If the set changes have not been met, the goals will be reformed.The Neuman’s system model as applied by the nurse with this family helped to identify the stressors of the “X” family from various aspects.  This was helpful to provide nursing care with the family in a comprehensive manner. The application of this theory revealed how well the interventions could be used for solving the problems within the family.