Summative Assessment

To complete this assignment, read the scenario below and address the specific questions and issues indicated. Review the SOC313 Family Document-FOUND BELOWfor specific information on each member of the family.

Grandmother Ella has had cancer for years now and has followed
alternative remedies from the time she was first diagnosed. Ella had a
period of remission; however, the cancer returned and has metastasized
to her bones, liver, and lungs. She is in the hospital after collapsing
from weakness. She is being released from the hospital as she wishes
to spend her last days and months at home. Ella has her preferences for
care, 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 when Ella’s life ends.
Ella feels stressed by the discord and discomfort of family members.

For this assignment, you are required to use the outline form with
subtopic headers from the Week 3 assignment. Address the following
items in your work:

1. Synthesize the current research that is relevant to this scenario.
   Discuss the current practices for end of life and palliative care from
   the Western Medicine as well as the Complementary and Alternative
   Medicine perspectives.
2. Comprehensively discuss the cultural and/or traditional issues that
   could arise at this time. Consider how the integration of Complementary
   and Alternative 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 each of the following possible scenarios:
     • Ella wishes to continue the Complementary and Alternative practices.
     • Ella is coerced into following mainstream medical advice.
     • Ella’s husband, John, insists that, as father and husband, his family traditions should be followed.
   • Examine the biological basis for care 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 Type II 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 (son with leukemia and brother with HIV)
3. Discuss the micro, meso, 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 (meso) reacting to the situation?
   • Using your local area, research and discuss two community resources
     (macro) that support Ella’s needs for care and/or improve her quality of
     life. Evaluate the ability of these community resources to meet the
     needs of this diverse family’s circumstances adequately.
4. Discuss the relevant medical issues and the advantages and
   disadvantages of hospital versus home. In this case, when discussing
   medical issues 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) affected the family?
6. Analyze the current scenario as it pertains 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. Discuss the impact of lifespan development on the perspectives of
   the various members of the family (i.e., their intellect, cognitive
   abilities, insight, and judgment) as well as their sociocultural
   perspectives, preferences, understandings, and positions on the
   situation.

The Final Paper

• Must be 8 to 10 double-spaced pages in length (not including title
  and reference pages) and formatted according to APA style.
• Must include a separate title page with the following:
  • Title of paper
  • Student’s name
  • Course name and number
  • Instructor’s name
  • Date submitted
• Must use five scholarly sources
• Must document all sourced material in APA style .
• Must include a separate reference page that is formatted according to APA style

FAMILY DOCUMENT
Throughout this class, we will meet two families, the Maldonado’s and the Olson’s. The two families are considered extended family via Sarah and Joe Miller. We will learn about their relationships, work environments, and the psychosocial effects related to health challenges faced by each family. You will use this document for the discussions and written assignments. We begin with the Maldonado family.

Manny and Donna Maldonado have been married for 42 years. Manny is age 65 and Donna is 63. Sarah, Mike and Becky are the children of Manny and Donna Maldonado. Sarah is the eldest daughter, followed by her brother, Mike, and her sister, Becky.
 Manny is Hispanic American and owns a 20,000-acre produce farm that has been in his family for three generations. Although Manny speaks and understands English, he prefers to speak Spanish. This creates a language barrier between Manny and other family members who do not speak Spanish. Donna is fluent in Spanish, having learned the language from Manny and his family.  Donna works on the farm with her husband. She has long suffered from mood swings, which is mostly frustrating to Manny. He says it is “brujeria,” meaning her moods are caused by witchcraft and “mal d ojo” or “evil eye.” He believes someone put a spell on Donna. When this is believed to be the case, the person will visit a Curandero (healer) who will perform a healing ritual. o Sarah works as a nurse, and recently took Family Leave of Medical Absence (FMLA) due to her children’s recent issues. o Joe is the President of Illusion Technologies. Joe’s parents are John and Ella Miller. More details about Joe are shared in the Olson family section below.  Lucy, age 20, has a history of severe substance use disorder, along with having been diagnosed with bipolar disorder. In the past two years, Lucy has had four different jobs.
She is unable to hold a job long-term. She now works on her grandparent’s produce farm.  Josh, age 17, has been sneaking away with friends, smoking marijuana and skipping school.  Evan, age 10, was recently diagnosed with leukemia; however, he has not yet started treatments. Evan’s doctors have recommended chemotherapy, radiation, and a bone marrow transplant. Sarah and Joe intend to follow this treatment plan. o Mike Maldonado is age 36. He currently works for a state University as a tenured faculty of the College of Agriculture and Life Sciences. Mike was recently diagnosed with HIV. o Dan was Mike’s husband. He recently passed away at the age of 38 due to an AIDS-related illness. They were married for 10 years. Mike and Dan did not have any children. o Becky is age 33. She is divorced and working on the family produce farm as well as attending a local college at night to complete her bachelor’s degree in Child Psychology. She has one child, Abe.  Abe is age 12. He is a good student, but his behavior has changed recently, showing anger and defiance towards both of his parents and several teachers at school. His mother, Becky, has been treating Abe’s behavioral changes with diet and alternative medicines.

Next, we will meet the Olson family.
Frederic Olson was married to Mary Olson. Mary passed away 10 years ago at the age of 77. Frederic is age 87. Ella is the only child of Frederic and Mary Olson.
 Fredric has pronounced symptoms from Parkinson’s disease. He has tremors and balance problems, along with muscle stiffness and gait (manor of walking) changes. He struggles to begin any movement. However, once he is moving, he cannot stop easily. His gait has changed to smaller steps and shuffling.  As he progresses through the stages of the disease, Frederic needs increasing assistance with his activities of daily living (ADLs), which entails bathing, dressing, food preparation, eating, taking medications, et cetera. He recently moved to an Assisted Living community and only leaves the facility for medical appointments. The family visits Grandpa Frederic on an alternating schedule at his new home every week. The Assisted Living community has regularly scheduled social events in which Grandpa Frederic actively participates. o Ella is married to John Miller. Ella and John are both 70 years old. John and Manny Maldonado are best friends. Ella and Manny grew up together on their neighboring farms. Ella and John recently sold their 10,000-acre farm to the Maldonado family since the two farms were adjacent to each other. o Ella has been trying to heal herself from breast cancer using a variety of natural means. She grew up on a farm and was accustomed to using home remedies. Therefore, Ella is not willing to utilize Western medicine practices. o While the alternative health care methods kept Ella in remission for a few years, recently she learned the cancer has returned. In addition, the cancer has metastasized to her lungs and bones. Ella has chosen to forego Western medical treatment options such as chemotherapy, radiation, and pharmacological breast cancer treatment medications. She has requested to live out her last days at home. Ella has agreed to be admitted to Hospice home care, with John as her primary caregiver. Ella and John are seeking quality palliative end of life care. o John, Ella’s husband, is of Native American origin. He is well educated and uses Western medicine, but relies heavily on Native American methods, such as meditation and banishing bad spirits from their home. John speaks fluent Spanish, having learned the language as a child. o John is an attorney for the Maldonado produce farm and his son’s company, Illusion Technologies. o John and Ella’s children are Sam, age 50, Lila, age 45, and Joe, age 43.  Sam is divorced and has no children. He works as a foreman on the Maldonado produce farm. He is an alcoholic and has been diagnosed with severe substance use disorder due to his alcohol addiction. His alcohol use is affecting his position as the foreman. Over the past few months, he has experienced emotional outbursts, missed work, and started arguments with the workers, third-party wholesalers, and Al Goldberg (Olson family).
Sam has been upset that his parents sold the family farm to the Maldonado family instead of passing it down to him.  Lila, age 47, is married to Al Goldberg. She is a Social Worker for the state. Her job is very stressful as her caseload includes at-risk children. There is a great deal of documentation required; therefore, she works many 10 to 12 hour days. Lila is overweight and has Type II diabetes. She has not controlled her weight or diabetes well. Recently, her doctor changed her medication. She is now taking daily insulin injections to help manage her diabetes.  Al, age 47, Lila’s husband, is the general manager of the Maldonado family produce farm. Al had first option for buying the Olson family farm. He opted out of purchasing the farm and agreed with the sale to the Maldonado family. He has no known health issues; however, due to an early childhood trauma, he is afraid of hospitals and funeral homes.  Alisha is Lila and Al’s only child. She is 20 years old and is currently attending college full time on a nursing scholarship. The college campus is an hour away from her parent’s home. She lives on campus in the dorms, does not work at this time, and has no known health problems.  Joe, who is Sarah (from the Maldonado family) Miller’s husband, is the President of Illusion Technologies, a rapidly growing company with 50 employees. He has a patent pending on two security-based software programs that could be worth millions. He and his father are in negotiations to purchase land to build a state-of-the-art office building.  Sarah, Joe’s wife, is a nurse and recently took a Family Medical Leave of Absence (FMLA) due to the health and behavioral problems with her children. Details about Joe and Sara’s children are shared in the Maldonado family section.

The family members share a long history of friendship and love of farming. They have shared many life events, such as holidays, births, and deaths. Their families have been intertwined for generations through the raising of the children and grandchildren. For the most part, the families get along well. However, even though they share some of the same cultural traditions and backgrounds, they do clash from time to time. For instance, some of the Olson family members are not in full agreement with Ella’s use of home remedies and alternative treatments for her breast cancer. However, the Maldonado family understands and supports her choices. Further, Ella is encouraging Sarah Miller and Mike Maldonado to pursue Complementary and Alternative Medicine (CAM) to treat Evan’s leukemia and Mike’s HIV. The members of both families are dealing with very busy schedules and major health challenges.