Aurora Devalon N480 Family Assessment The Adams-Foster Family
Meet the Adams-Foster Family
Stef is one of the matriarchs of the Adams-Foster family, referred to as mom. She is a 42 year old police officer with the San Diego police department. Stef is Brandon’s biological mother and adoptive mother of the other 4 children. She has a very strong personality with bold opinions and is often the disciplinary parent. All of the children have close relationships with her and reach out to her for advice. They are a family with adolescents and her and Lena make sure to adjust their relationships with their kids and work on their relationship together as they prepare for them to start leaving for college,
Brandon is the 18 Year old biological son of Stef. He is the oldest of the Adams-Foster children. Brandon is a good student and an excellent piano player. He eventually begins to get in trouble when Callie is introduced into the family. He has feelings for her and to his moms’ dismay, attempts a relationship with her. He is a sensitive guy who believes in doing the right thing the majority of the time. He has a great relationship with his family although he does try to maintain some independence and privacy.
Neptune is the farthest planet
Mercury 2 Mercury is the / 8 smallest
Venus 5/ 8 Lena is the other matriarch of the Adams-Foster family, referred to as Mama. She is a 39 year old school vice principal at the school all 5 kids have attended. She is very open minded, reasonable, and loving. She strongly believes in resolving issues in a calm and controlled manner. She is soft-spoken and often encourages her family to have open discussions and talk about their feelings.
Meet the Adams-Foster Family
Callie is 17 years old and the half-sister of Jude. Callie comes from a troubled background and has spent time in juvenile hall. She has a very strong, independent personality and is very protective of herself and her brother. She is not one to open up freely and tends to shield herself. She gets herself into legal trouble several times in the series but she is always trying to do the right thing and stand up for people who can’t stand up for themselves. She talks about wanting to work in the legal system in the future.
Mariana is the 16 year old twin sister of Jesus. She is very bright and has a girly, flirtatious personality. She is very interested in computers and coding. She is extremely close with her brother and often looks to him for advice and comfort. She is easy to get along with and develops a close relationship with her other siblings. She has one of the closest relationships with Stef and Lena as well. She has strong leadership qualities and is popular in school but also falls to peer pressure several times throughout the series. She does have difficulty coping with her brothers injury. She sneaks in to see him in the ICU, which upsets her.
Mercury 2 Mercury is the / 8 smallest
Venus 5/ Venus is terribly8 hot
Jude is the 15 year old half-brother of Callie. He also came from a difficult background and spent much of his early life in foster care. He has always has a positive outlook on life and loves being a part of the Adams-Foster family. He is very comfortable talking to Stef and Lena and confides in them about his sexuality.
Jesus and his ConditionTraumatic Brain Injury
Jesus is the 16 year old twin brother of Mariana. He has a very close relationship with his sister and is very protective of her. Prior to his TBI he was very easy going, caring, popular, and funny. He was on the wrestling team and the robotics team. He takes the blame with his moms often for things Mariana has done. He has a great relationship with his girlfriend Emma. He also wants to have a relationship with his birth parents. Traumatic brain injuries (TBI) are defined as “a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury (CDC, 2019).” TBI incidence rates occur higher in males than females and adolescents and young adults 15-24 have a peak of TBI incidences (Pei & O'Brien, 2021). TBIs can result in cognitive and sensory deficits that vary person to person and vary in symptom length. Executive function, memory, attention, processing speed, attention, and difficulties managing emotion are domains most affected after a TBI (Rabinowitz & Levin, 2014). In the fourth season of the series, Jesus manages to shoot himself in the head with a nail gun and a nail embeds itself “several inches into his frontal cortex” A few weeks later he gets in a fight and is punched in the forehead worsening his TBI. Jesus struggles greatly with the skills he loses and lashes out in anger, and shows continued frustration and sadness. He has difficulties with speech, word association, memory, walking, his temper, eating and drinking, He ends up needing around-the-clock care and the family takes it upon themselves to bring him home and Lena takes over primary care of Jesus.
Erikson’s- Identity vs Role confusion
Every child in the Adams-Foster family is 15-18 and categorized as an adolescent Brandon- In this stage of the series Brandon is learning that his actions have consequences. He is trying to find out what his life looks like after being forced to give up going to Julliard when he takes the SAT for someone and gets caught. He is trying to mend his parents trust, figure out what he wants in life (which leads to him breaking up with Courtney), and find a way to still incorporate music in his life, which he does to help Jesus recover. Callie- Callie is in a very difficult situation. She is trying to find her voice in helping her childhood friend get out of jail for a crime he says he didn’t commit while also dealing with her position in Juvenile hall where there is a potential to go to prison. She isn’t sure how to give all of her attention to either one, especially while she is still trying to graduate. She is less focused on what others think of her and more focused about her future working to better the legal system. Mariana- Mariana is trying to establish herself as a leader. She takes over running the robotics team and struggles to find a balance between getting things done on time and being “bossy.” She is also working on figuring herself out in relationships, she makes some decisions that leave her boyfriend unable to trust her and she is fighting to be wanted and accepted by him and her peers. Jesus- Jesus goes from being incredibly independent, popular, and busy before his TBI and then has to figure out how to handle being dependent on others, lonely, and unable to handle his own emotions. He also is trying to manage his relationship with Emma while going through his recovery. He is not used to not being in peak physical and mental shape and he has difficulties adjusting. Jude- This season Jude is experimenting with marijuana with his boyfriend that he had previously been banned from seeing. He tries to find his independence and chooses friends and his relationship over the trust of his moms. He starts lying to his family and sneaking around. This is also a time where Jude is exploring his sexuality.
Traditions Culture and Religion ● ● ●
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Non-traditional family led by two mothers Foster and adopt children Some birth family members are involved as well as Stef and Lena’s parents Financially stable, Lena is able to take a leave of absence to care for Jesus Accessibility to good healthcare Family dinners are very important Mariana’s quincenera- Stef and Lena want her and Jesus to have a connection to their Latin AMerican culture. No religion practiced- Stef and Lena are pretty against organized religion Lena is a spiritualist- believes in love, kindness, and good actions and behaviors. She also prays while Jesus is in the hospital
Communication ●
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Overall, this family has good communication with each other Family dinners, meetings, and talks are very important Stef and Lena are approachable and willing to have discussions with the family, even on difficult topics Each family member does have some difficulty with communication at times Callie and Jude have some communication issues with each other due to Jude not trusting her with information Jesus wants to protect his birth father and makes excuses for him rather than having an open dialogue with him or his moms, leading to his injury Mariana has trouble communicating with others when in a leadership role Brandon moves in with his girlfriend and her son this season and doesn’t want to listen to or take his moms’
Challenges ●
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Strengths
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Stef and Lena are caring, compassionate, and selfless. They have a strong desire to help others and it shows in the adoptions of Mariana, Jesus, Jude, and Callie. They are loyal and protectiveThey all stand up for each other and take care of one another Patience- they show incredible patience with Jesus following his accident helping him with his outbursts, motor skills, and mental health All of the kids are encouraged to express their thoughts and emotions and are given a safe environment to do so. The are always there together to celebrate important milestones during Jesus’ recovery like coming home from the hospital and him being able to read again.
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Jesus’ condition makes it difficult to express his emotions and often lashes out Stef and Lena don’t always see eye to eye on parenting style. Stef takes the doors off all of the kids’ rooms, Lena doesn’t agree Stef and Lena start to become increasingly worried about their children after the accident and pushes the kids away Mariana feels like she doesn’t have as much family support when everyone is concerned for her brother All of the kids are teenagers and get into trouble that Stef and Lena have to manage while struggling with Jesus in the hospital The family home has stairs where all of the bedrooms are and Jesus falls trying to get up them to be around everyone and not feel so lonely.
Family Systems Theory This theory is key to helping nurses to understand and assess families as an organized whole and/or as individuals within family units who form an interactive and interdependent system. The Family Systems Theory is broken down into four concepts that provide a framework for thinking about the family as a system (Kaakinen, 2015). Concept 1: All parts if the system are interconnected The family consists of Jesus’ two moms, biological twin sister, and 3 adoptive siblings. They all make changes in their life in order to help Jesus recover. Lena takes a leave of absence from her job to take care of Jesus, Mariana has to learn to hide her emotions, Brandon learns how to use music as therapy, and the family converts their “family space” in the dining room to accommodate Jesus’ bed and supplies. Concept 2: The whole is more than the sum of its parts The stress of Jesus being in the hospital puts a strain on the relationship Lena and Stef have as well as the relationships the two have with their other children. Stef is harsher towards the others, becomes stricter, and increases punishment intensity in an effort to keep them close. She also puts strain on her marriage by making decisions about the kids on her own when she would normally make them with Lena. Lena also has to adjust to Jesus lashing out on her, as she is his caregiver and now spends the most time with hm. Concept 3: All Systems Have Some Form of Boundaries or Borders Between the System and Its Environment The Adams-Foster family have pretty flexible boundaries. Their one closed boundary lies in Jesus’ care. They refuse to have him stay at a rehabilitation facility and choose to take him home instead. Emma, Jesus’ girlfriend, is a big part of his life and she is welcomed into the home to spend time with Jesus and help him with his recovery. Although they are hesitant, they also allow his birth parents to have some contact as well. Concept 4: Systems Can Be Further Organized Into Subsystems This family has many subsystems that are all involved in Jesus’ life and care. They include mom-mom, moms-kids, birth siblings, adoptive siblings, kids- grandparents, kids-significant others, kids-birth parents. This family includes many people out of the direct system due to the nature of the adoptions of four of the children.
Problem: Jesus’ TBI was sudden and life
altering for him as a high school popular athlete who was forced to have to relearn to walk, talk, and manage uncontrolled emotions. It also changed the way his family had to act and live as well.
Interventions 1) Refer Jesus and his family to support groups. Jesus puts himself at risk for injury due to his feelings of isolation from his friends and family and could use extra support. Rationale: A new diagnosis or serious injury can have a negative effect on the patient and the family. Effective outside assistance might be a factor in modifying the challenges confronted by these patients and families (Thompson et al, 2014). Expected Outcome: Jesus and the rest of the family will be given resources including a list of support groups and therapy options. Jesus will be able to express his feelings and find ways to feel less lonely by the end of the first session. The family will also learn to keep group talks and activities downstairs where Jesus is. 2) When teaching Jesus a new skill set up a series of practice attempts that will enhance his motivation and alleviate frustration. Begin with simple tasks with positive reinforcement and progress to more difficult concepts. Rationale: Distributed practice with correct recall attempts can be a very effective teaching strategy especially when used overtime (Gross et al, 2014) Expected Outcome: Jesus will learn skills in order from easiest to most difficult with time in between and encouragement. By the third rehab appointment Jesus will learn not to get frustrated with harder tasks knowing that he has accomplished other tasks. 3) Encourage and support the family’s decision to take Jesus home and assist in his care and ensure they have the adequate resources to do so Rationale: Parents need to be able to negotiate with health staff as to what this participation will involve and negotiate new roles for themselves in sharing care of their sick child (Kelly, & Kelly, 2013) Expected Outcome: The family will have all education materials and resources necessary to take over care for Jesus at home by the time Jesus is discharged. The nurse will give detailed instructions including phone numbers, websites, reasons to bring Jesus to the hospital, etc.
References Centers for Disease Control and Prevention. (2019). Surveillance report of traumatic brain injury-related emergency department visits, hospitalizations, and deaths—United States, 2014. https:// www.cdc.gov/traumaticbraininjury/pdf/TBI-Surveillance-ReportFINAL_508.pdf Gross, A. L., Brandt, J., Bandeen-Roche, K., Carlson, M. C., Stuart, E. A., Marsiske, M., & Rebok, G. W. (2014). Do older adults use the method of loci? results from the active study. Experimental Aging Research, 40(2), 140–163. https://doi.org/10.1080/0361073x.2014.882204 Kaakinen, J. R., Coehlo, D. P., Steele, R., Tabacco, A., & H., H. S. M. (2015). Family health care nursing: Theory, practice, and research (5th ed.). F.A. Davis Company. Kelly, P., & Kelly, D. (2013). Childhood cancer-parenting work for British Bangladeshi families during treatment: An ethnographic study. International Journal of Nursing Studies, 50(7), 933–944. https://doi.org/10.1016/j.ijnurstu.2012.11.004 Pei, Y., & O'Brien, K. H. (2021). Reading abilities post traumatic brain injury in adolescents and adults: A systematic review and meta-analysis. American Journal of Speech-Language Pathology, 30(2), 789–816. https://doi.org/10.1044/2020_ajslp-20-00213 Rabinowitz, A. R., & Levin, H. S. (2014). Cognitive sequelae of traumatic brain injury. Psychiatric Clinics of North America, 37(1), 1–11. https://doi.org/10.1016/j.psc.2013.11.004 Thompson, R., Kerr, M., Glynn, M., & Linehan, C. (2014). Caring for a family member with intellectual disability and epilepsy: Practical, social and emotional perspectives. Seizure, 23(10), 856–863. https://doi.org/10.1016/j.seizure.2014.07.005 Visuals https://youngentertainmentmag.com/now-fosters-part-2/ https://www.stan.com.au/watch/the-fosters https://www.vulture.com/2017/02/the-fosters-recap-season-4-episode-12.html https://www.popsugar.com/entertainment/photo-gallery/47639587/image/47639826/Noah-Centineo-as-Jesus-Adams-Foster-on-Fost ers https://twitter.com/thefosterstv/status/622528881279561728 http://www.ksitetv.com/interviews-2/the-fosters-david-lambert-on-a-road-trip-with-callie-idyllwild-a-j/69150/ https://goodtrouble.fandom.com/wiki/Stef_Adams_Foster https://goodtrouble.fandom.com/wiki/Stef_and_Lena https://www.pinterest.com/pin/172825704425175986/ http://www.jcoleman.co.uk/adolescence