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BJ’s Last Testimony. Family Medicine Case Presentation 15 January 2010. Asuncion- Dalman - Doromal - Dy - Generoso -Mejia- Ong. Case background. Family system. Family System. Family System. Patient Single, Young adult, Lives alone Several partners Parents
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BJ’s Last Testimony Family Medicine Case Presentation 15 January 2010 Asuncion-Dalman-Doromal-Dy-Generoso-Mejia-Ong
Family System • Patient • Single, Young adult, Lives alone • Several partners • Parents • Father works as the church minister, • Mother is the children’s primary caregiver • Family • Eldest brother, 2 younger sisters
Family Life Cycle • Launching • Goal: Being one’s own person • Secondary task • Differentiation of self from family of origin • Development of peer relationships
APGAR Modified from Smilkstein G: The family APGAR: A proposal for family function test and its use by physicians, J . Family Practice 6(6), 1978. Reprinted by permission of Appleton and Lange, Inc
Other Family Issues • Other family issues • Religion • IglesianiKristo • Father is a minister • Patient’s decision and confidentiality • Only the mother knew • Communication to other family members • Pneumonia not responding to antibiotics • Why the need to confine in an ICU
Psychosocial Issues • The Family Profile • Cultural and Religious reprisal • A lifestyle preached against by church and family • His being as a moral fault • His disease speaks against his whole family • Financial burden • Class C family • HMOs do not cover this risqué lifestyle disease • Cannot proceed to church’s hospital for confidentiality
Psychosocial Issues • The Family Profile • DNR and INC doctrines about life • No clear practice on remembering those who died • No doctrine on the issue of DNR • Bereavement and Acceptance of loss • No clear understanding of how this came about • Difficult to communicate to family members the reason for BJ’s confinement • The issue of communicating his testimony to their community
Family Wellness Plan • Acceptance of Grief • DNR