The paper will further discuss aging/geriatric issues and models of care, and nursing roles related to comprehensive individual and family care throughout the continuum of chronic illness. Scenario Alkalis Simon White is a 34-year-old married black female who was diagnosed tit Schizophrenia Paranoid Type at the age of 22. Alkalis was born and raised in Atlantic City, New Jersey. She is currently married to William White, 35-year-old truck driver and NAS no children Alkalis states while growing up, seen experienced “seeing and talking to people” and having “imaginary friends” that others did not know existed.

Alkalis also stated, “l felt like a superhero, only I had the super power”. During her teenage years, Alkalis stated her imaginary friends were replaced with “mean and scary characters”, further stating “they taunted me saying my family was not real” and that she was part of a conspiracy. It was during this time that Alkalis began drinking alcohol and smoking marijuana. At 16 years old, Alkalis states her mother caught her drinking alcohol and became angry, stating she was irresponsible like her father and making up stories and lies.

In response, Alkalis unsuccessfully attempted to explain to her mother that the alcohol and marijuana helped to “calm the voices” and made her feel “normal”, to no avail. Alkalis feels high school was difficult by stating “it was a struggle for me to focus” but did graduate. Upon completion of high school, she enrolled at Henry Parker Community College for interior design. It was during this time that she attacked a roommate with a knife stating, “She was the devil and I was God’s messenger”. At this time, the police were notified and Alkalis was hospitalized with the diagnosis of schizophrenia.

After four years, she graduated with an Associate of Arts Degree. Alkalis has a home- based interior design business, which she feels is not prosperous due to her mental illness. She feels that the stigma associated with schizophrenia had hindered her ability to succeed with the interior design industry. Lash’s husband, William White, 35-year-old, is aware of her mental illness and wants to focus on Alkalis having a “normal life”. Alkalis describes him as a “very caring man”, but has blunted emotions towards him. She questions and doubts her husband’s love due to decreased conversations of having children.

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She feels her husband thinks she is incompetent to be a mother. Alkalis is estranged from her mother, Evelyn Simon, 54-year-old, stating, “l could not live up to her expectations like my brother”. Alkalis does keep in touch with her younger brother Brian Simon, 30-year-old. Alkalis is currently attending mental health therapy sessions with Mr.. Jones, whom she likes. She is actively looking for a mental health support group meeting which she could attend. Lash’s goals are to decrease anxiety, maintain her home-based interior decorating business and to avoid a serious relapse.

Individual Developmental Assessment Individual Developmental Tool and Character’s Developmental Stage The Heavyweight’s (1972) Developmental Tasks (Individual) assessment tool was utilized to obtain an accurate level of tasks for Alkalis White. According to Heavyweight’s (1972) Developmental Tasks (Individual), Alkalis is in the Tasks of Middle Age years). Expected Individual Developmental Tasks for this Stage Alkalis is expected to achieve and acquire tasks for her individual development (Heavyweights, 1972).

The expected tasks are: assist teen-age children to become responsible and happy adults, achieve adult social and civic responsibility, reach and maintain satisfactory performance in occupational career, develop adult leisure time activities, accept and/or adjust to physiological changes in middle age, relate to spouse as a person, and adjust to aging parents (Heavyweights, 1972). Examples of Character’s Status with Individual Developmental Tasks Alkalis has not met he Expected Tasks for Middle Age (Heavyweights, 1972).

Due to her mental illness, Alkalis and near husband do not nave any children (Happenings, Lash’s mental illness interferes with social and civic responsibilities. Alkalis fears her clients will have a negative perception of her, if her mental illness is revealed. This fear hinders her ability to be more involved in the growth of her interior decorating business. Alkalis and her husband, William, have limited participation in leisure time activities together (Heavyweights, 1972). Alkalis does enjoy reading magazines with the latest ideas for interior decorating and reading her Bible.

Alkalis also keeps a Journal at the request of her therapist, for her to explore her own emotions and feelings. Lash’s current medication regimen interferes with her marital relationship due to the side effects. The marital relationship between Alkalis and William appears strained at times and Alkalis has doubts of Williams love and fidelity (Heavyweights, 1972). Alkalis feels William “puts off’ having children because she would be incompetent as a mother. James Simon, Lash’s father is absent and her illness is a barrier to having a relationship with her mother (Heavyweights, 1972).

Family Development Assessment Family Developmental Tool and Family Developmental Stage The Devalue Family Developmental Theory: The Eight-Stage Family Life Cycle and Developmental Tasks (Friedman, 1998) assessment tool was implemented to acquire Lash’s Family Developmental Stage. According to The Devalue Family Developmental Theory, Alkalis is at Stage l: Beginning Families (married couples without children, also referred to as ‘Married Couples’ or the Stage of Marriage’ (Friedman, 1998). The Major Family Goal of Stage I is to adjust to living as married pair (Friedman, 1998).

Expected Family Developmental Tasks for this Stage Stage I of Oddball’s (Friedman, 1998) family development expects these developmental tasks: establishing a home base, a place to call their own; establishing a satisfying system for obtaining and spending money; establishing a system of acceptable patterns of who does what and accountability; establishing a continuity of a satisfying sexual relationship with emotional communication; establishing relationships with relatives and interactions with friends and associates; family planning and establish a philosophy of life as a couple (Friedman, 1998).

Examples of Family Status with Family Developmental Tasks Alkalis and William White are currently struggling to meet the developmental tasks for Stage I Beginning Families (Friedman, 1998). Alkalis and William have a home base, a first floor rental apartment. The White’s income cycles and is unstable as Lash’s interior decorating business is not doing well and Williams paycheck pays all the current bills. It appears that Alkalis takes care of the home and all that it entails with William Just bringing home a steady weekly income (Friedman, 1998).

Maintaining mutually satisfying sexual intimacy and emotional communication is not met due to he increasing side effects of Lash’s medication regimen and her thoughts of him having an affair along with doubting his love. The medication side effects hinder communication and mostly revolve around Lash’s ability to manage a normal life. Relationships with family members are strained as Lash’s father is absent and she is distant from her mother; however, she occasionally communicates with her brother Brian (Friedman, 1998).

Alkalis continues to feel her mental illness is a stigma and fears her friends will behave differently towards her once illness is known along with re blunted emotions related to medication side detects (Friedman, 1 conversations regarding family planning have stopped. Her husband, William, wants Alkalis to manage a normal life first. Alkalis feels her husband thinks she would not be a competent mother. Alkalis and William White do not have a workable philosophy of life as a couple (Friedman, 1998).


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