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BJ’s Last Testimony

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

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  1. BJ’s Last Testimony Family Medicine Case Presentation 15 January 2010 Asuncion-Dalman-Doromal-Dy-Generoso-Mejia-Ong

  2. Case background

  3. Family system

  4. Family System

  5. 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

  6. Impact of illness

  7. Family Life Cycle • Launching • Goal: Being one’s own person • Secondary task • Differentiation of self from family of origin • Development of peer relationships

  8. 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

  9. Stakeholder Analysis

  10. 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

  11. Addressing Disease within a Family Framework SCREEM

  12. Social-Cultural-Religion-Economic-Education-Medical Tool

  13. Medical issues and intervention

  14. Psychosocial issues and proposed intervention

  15. 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

  16. 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

  17. Family Wellness plan

  18. Family Wellness Plan • Acceptance of Grief • DNR

  19. Learning issues

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