SOC313_Introduction_to_the_Miller_Family.pdf

To complete this assignment, read through the scenario below and address the specific questions and issues indicated. Review the “Introduction to the Miller Family” document for specific information on each member of the family.

Grandmother Ella has been dealing with cancer for years now and has tried alternative remedies and juicing.  She went into remission for some time, but now the cancer has returned and she is in the hospital.  Her husband, of American Indian descent, has his ideas about what needs to be done as Ella comes to the end of her life.  Ella has her preferences, though she is now so weak that she has given up in many ways.  The family members are each experiencing their own fears and are grieving as they face the loss that will occur as Ella’s life comes to a close.  Ella prefers to die at home and has felt stressed by the discord and discomfort of family members since being hospitalized. 

You are the social worker for this case.  You meet this family in the hospital setting as they are considering whether the patient will remain there for her final days or whether hospice and palliative care will be provided for her in her home. 

For this assignment, you will:

  1. Synthesize the current research that is relevant to this scenario.
  2. Discuss the cultural or traditional issues that could arise at this time.  Consider how the integration of alternative and complementary medicine and beliefs, mainstream medical practices, and cultural/traditional rituals and practices might create issues and what they might include.
    • Describe how the family might react to the following possible scenarios:
      • Ella wishes to stick with alternative and complementary practices.
      • Ella is coerced into following mainstream medical advice.
      • Ella’s husband insists that, as father and husband, his family traditions should be adhered to.
    • Examine the biological basis for and describe how the choices for care might affect the other family members with respect to their individual problems, if at all.
      • Son Sam, the alcoholic
      • Daughter Lila, with diabetes
      • Grandson Josh, starting to have drug problems
      • Granddaughter Lucy, bipolar with more entrenched drug problems
      • Daughter-in-law, Sarah’s stress related to her family’s medical issues (nephew with leukemia, brother with HIV, and her father’s perspective that they are all “crazy!”)
  3. Present the micro, mezzo, and macro influences affecting both the patient and the diverse family members in this scenario as impacted by Ella’s medical condition and prognosis.
    • What are the pertinent and likely family (micro) conflicts and differences, and concerns that could be encountered? 
    • How is the neighborhood and extended family (mezzo) reacting to the situation?
    • If she returns home, what considerations need to be taken into account as part of her discharge plan? Using your local area, research and present the needed or preferred community resources (macro) that would be available to them.  Critique the ability of these community resources to adequately meet the needs of this diverse family’s circumstances.
  4. Discuss the relevant medical issues and the advantages and disadvantages of hospital versus home.  When discussing medical issues in this case, use appropriate medical terminology. 
  5. Discuss the psychological and social issues that are present and will possibly be more pronounced at this stressful time.  How has the fact that this illness has been ongoing (chronic) impacted the family?
  6. Analyze the current scenario as pertaining to diversity, as well as to cultural, psychological and social perspectives and influences, taking into account the stories that you have been discussing throughout the course.
  7. Consider the impact of each person’s perspective as it pertains to their lifespan development (i.e., their intellect, cognitive abilities, insight, and judgment) as well as their sociocultural perspectives, preferences, understandings, and positions on the situation.

Writing the Final Paper

The Final Paper:

  1. Must be eight to ten double-spaced pages in length, and formatted according to APA style as outlined in the Ashford Writing Center.
  2. Must include a title page with the following:
    1. Title of paper
    2. Student’s name
    3. Course name and number
    4. Instructor’s name
    5. Date submitted
  3. Must begin with an introductory paragraph that has a succinct thesis statement.
  4. Must address the topic of the paper with critical thought.
  5. Must end with a conclusion that reaffirms your thesis.
  6. Must use at least three scholarly sources.
  7. Must document all sources in APA style, as outlined in the Ashford Writing Center.
  8. Must include a separate reference page, formatted according to APA style as outlined in the Ashford Writing Center.

Expert Solution Preview

Introduction:
This assignment is based on a case scenario of the Miller family dealing with the end-of-life care of Grandmother Ella, who has cancer. As a medical professor, I will provide answers to the questions related to this scenario and evaluate the biological, psychological, social, and cultural perspectives of the family and their impact on each other and Ella’s care.

1. Synthesize the current research that is relevant to this scenario.
There is a considerable body of literature that stresses the importance of respect for patients’ preferences in end-of-life care. Research shows that patients who are dying feel better when their wishes are taken into account concerning the location of death, pain management, and cultural issues. Moreover, the integration of alternative and complementary medicine and beliefs alongside mainstream medical practices has shown to improve quality of life for terminally-ill patients.

2. Discuss the cultural or traditional issues that could arise at this time. 
Cultural/traditional beliefs and practices might impact the end-of-life care of Grandmother Ella. Her husband’s American Indian descent might influence his belief about death that could conflict with Ella’s preferences. As pointed out in the case, Ella prefers to die at home, which is a common cultural preference among African Americans and other minority groups. Moreover, Ella’s use of alternative and complementary medicine could conflict with the mainstream medical practices recommended by the hospital staff.

3. Examine the biological basis for and describe how the choices for care might affect the other family members with respect to their individual problems, if at all.
Grandmother Ella’s condition and choices for care could impact her family members in various ways. For instance, Son Sam, the alcoholic, might struggle to accept Ella’s condition and react negatively, while Daughter Lila, with diabetes, might feel overwhelmed by providing caregiving to Ella and experience health complications in the process. Granddaughter Lucy, bipolar with entrenched drug problems, could experience a further decline in her mental health due to the stress associated with end-of-life care. Daught-In-law Sarah has already stressed, so handling another situation will worsen her condition.

4. Present the micro, mezzo, and macro influences affecting both the patient and the diverse family in this scenario as impacted by Ella’s medical condition and prognosis.
The Micro influences affecting the patient and the family include differences in opinion about end-of-life care choices, stress, and grief. Mezzo influences include the neighborhood and extended family’s reactions and support. Macro influences are the availability of community resources like hospice and palliative care services and their adequacy for the family’s diverse needs.

5. Discuss the relevant medical issues and the advantages and disadvantages of hospital versus home.
There are several medical issues related to Ella’s end-of-life care, like pain management, nutrition, and symptom control. The advantages of providing palliative care at home include familiarity, comfort, and emotional support, while the primary advantage of the hospital setting is access to medical intervention. Disadvantages include costs and emotional distress associated with staying in an unfamiliar and sterile hospital environment.

6. Discuss the psychological and social issues that are present and will possibly be more pronounced at this stressful time.
The chronic nature of Ella’s condition aggravated by the emotional and financial burden of end-of-life care has significantly impacted the family’s psychological and social well-being. The family members are grieving, fear losing their loved one, and struggling with stress due to their individual problems and providing care to Ella. Increased stressors and prolonged grieving can cause adverse psychological and social outcomes for the family.

7. Analyze the current scenario as pertaining to diversity, as well as to cultural, psychological, and social perspectives and influences, taking into account the stories that you have been discussing throughout the course.
Diversity cultural, psychological, and social perspectives play an important role in this scenario. Every family member has a unique situation and is dealing with challenging issues. Grandmother Ella’s preference to follow alternative and complementary medicine and cultural beliefs, while other family members, are conflicted between different cultural and medical practices. Understanding and respecting diversity is crucial in handling end-of-life care for individuals, including their physical and emotional needs.

Conclusion:
End-of-life care presents a unique set of challenges for the family as they try to balance individual preferences, cultural beliefs, and medical requirements. The Miller family is no different. As a medical professor, an understanding of the biological, psychological, social, and cultural perspectives is crucial in providing appropriate and adequate care for all individuals, including family members.