N480 ISSUU Family Assessment - The Jacobs Family

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THE JACOBS FAMILY Michael Preston CSUSM NURS 480 Family Assessment ISSUU Visual Report


Who are the Jacobs? In the 2019 HBO series Euphoria, the Jacobs family make up the primary antagonists of the show. The Jacobs family is a nuclear one, consisting of parents Cal and Martha, and their two biological sons Aaron and Nate. To support the family financially, Cal owns a construction company that his younger son Nate will one day inherit. Marsha is a stay at home mom. The family functions very poorly, with a clear lack of communication that has led to harbored resentment amongst all members. Cal and Marsha dated in high school, with their first son, Aaron, being an unplanned pregnancy that occurred shortly after graduation. Before learning Marsha was pregnant, Cal had developed romantic feelings for his best friend, Derek. After learning his girlfriend was carrying his child, Cal repressed those feelings and married Marsha. Having lost the ability to explore his sexuality in his youth, Cal cheats on his wife regularly by pursuing short relationships with young men and transgender women that he meets online. Due to the emotional distance between her and her husband, Marsha has turned to alcohol – particularly wine – as a coping mechanism. Aaron is not respected by his father and younger brother, both of whom see him as unfitting to run the family business. Nate is very intelligent, and held to an incredibly high standard by his father. As a result of the high pressure from his father, as well as a traumatic experience from discovering evidence of his father’s affairs at age 11, Nate has developed a manipulative, angry, and violent personality. After undergoing a traumatic head injury, Cal unleashed his years of repressed anger towards his family before leaving them permanently. In the wake of this recent off-time event, the remaining members of the Jacobs family will need to improve their communication skills in order to adjust to the transition.


FAMILY OVERVIEW

CAL JACOBS A 43 year old man, ex-husband to Marsha Jacobs and biological father of his two sons, Aaron and Nate Jacobs. According to Erikson’s psychosocial stages of development, Cal is in the generativity vs. stagnation stage. This stage occurs during middle adulthood, in which one must choose whether or not to invest into developing a positive legacy for themselves (usually through career or children) (Kaakinen et al., 2018, p. 395). While Cal does have a strong career in the form of his construction company, he has chosen to neglect raising his sons in favor of pursuing affairs with teenagers and young adults, which was ultimately the downfall of his relationship with his family. This shows that Cal is stuck in stagnation.

MARSHA JACOBS GGG A 42 year old woman, ex-wife to Cal Jacobs and biological mother of her two sons, Aaron and Nate Jacobs. According to Erikson’s psychosocial stages of development, Marsha is in the generativity vs. stagnation stage, similar to her ex-husband. Unlike Cal, Marsha is in generativity, as proven by her continuing to care for her two adult sons after Cal left the family. However, when looking at other aspects of Marsha’s life, she is also in stagnation in relation to her marriage, as Cal’s adultery has effectively ruined their relationship (despite outwardly presenting to be healthy).

AARON JACOBS A 24 year old man and the oldest son of Cal and Marsha Jacobs. According to Erikson’s psychosocial stages of development, Aaron is in the intimacy vs. isolation stage. This stage occurs during early adulthood, where one has to choose to seek out intimate relationships or isolate themselves from the world (Kaakinen et al., 2018, p. 395). Aaron is looked down upon both by his father and his younger brother, both of whom see him as a man incapable of handling the family business. Despite this, Aaron’s only significant relationship is that with his family. This shows that he is in isolation by not pursuing outside relationships.

NATE JACOBS An 18 year old man and the youngest son of Cal and Marsha Jacobs. According to Erikson’s psychosocial stages of development, Nate is in the identity vs. role confusion stage. This stage occurs during adolescence, where one explores independence and develops a more strong sense of identity as they transition to adulthood (Kaakinen et al., 2018, p. 395). This stage is also important for developing ethics. Nate has a very strong sense of self, willing to commit manipulation and acts of violence in service of his own goals. On the cusp of early adulthood, albeit with a flawed ethical standard, Nate has found his identity.


CAL’S ABUSE & ADULTERY

The most prominent problem in this family is Cal’s treatment of them. Aaron is emotionally neglected by his father, likely because his father subconsciously blames Aaron for his own loss of youth. Marsha is similarly neglected, as her husband dedicates himself to his work and affairs rather than spending time with his family. Nate, on the other hand, is smothered by his father’s expectations of masculinity and power, which may stem from Cal’s internalized homophobia inherited from his own father. The result of this is a family with complex, resentful feelings towards each other, and no outlet to diffuse those negative feelings. All of these communication issues were exacerbated when Cal withstood a traumatic head injury, resulting in him venting years of repressed feelings to all three members of his family before leaving them permanently. In the wake of Cal leaving, Nate has been thrust into the position of patriarch of the house, taking over the family’s business in his father’s absence. Following the recent loss of her husband, Marsha fell further into alcoholism, and Aaron isolated himself more as well. In order to adjust with this major family transition – the sudden absence of an abusive figure – the family will first need to improve their communication abilities.


CHALLENGES Years of no open communication has created a group that is unable to discuss family shortcomings constructively, choosing instead to repress feelings.

STRENGTHS Due to Cal’s construction company and connections within the town, the Jacobs family is very financially stable. After Cal left, Marsha encouraged her sons to talk about the family’s past with her in a casual, conversational manner.

Communication that does occur is often structured as gossip rather than productive, healing discussion.


COMMUNICATION

VERBAL

NONVERBAL

Cal both praises and punishes Nate regularly for his behavior.

Nate is very independent from his family, often operating outside of the law in service of his own goals and refusing to explain his motives to the family when caught.

Marsha initiates conversation with her sons after Cal left them. Aaron isolates himself from the family, and only speaks during gatherings when he needs to be with them.

Nonverbal communication within the family is done primarily through glances and intimidating body language.

FAMILY CULTURE The Jacobs family do not identify with any religion. Due to their high social status in their town, the Jacobs family participate in activities together to maintain appearances. An example is how the family comes together to make chili at the town carnival each year.


FAMILY SYSTEMS THEORY

The Family Systems Theory is built upon 4 key concepts (Kaakinen et al., 2018, p. 38-40): 1. All parts of the system are interconnected. 2. The whole is more than the sum of its parts. 3. All systems have borders between the system and their environment. 4. Systems can be broken down further into subsystems. The Family Systems Theory breaks individuals, the family, and their environment into contained and overlapping systems. This allows the provider to locate stressors within and outside of the family, as well as holistically assess and provide care to the family members as individuals and as a collective unit (Kaakinen et al., 2018, p. 38). Because of its versatility, the Family Systems Theory has quickly become a staple framework for many family nurses. A core idea of the Family Systems Theory is the idea that a family develops adaptive or maladaptive behaviors over time in order to promote stability within the system (Kaakinen et al., 2018, p. 38). This can be seen in the way that Cal imposes his will on Nate in order to assert dominance within the family, and the way that Nate acts out against his peers as a result. This cycle of abuse is even more clearly illustrated when looking at the family in three generations, which is a method that nurses using the Family Systems Theory often employ (Kaakinen et al., 2018, p. 38). Bud Jacobs – Cal’s homophobic and verbally abusive father – pushed Cal into sports and imposed traditional masculinity onto him in order to suppress Cal’s sexuality. This is a behavior that Cal perpetuated towards his own sons, especially Nate. As such, in order to promote stability in the Jacobs family, an important consideration will be to turn this maladaptive behavior of dominance between men in the family into something more constructive and healthy. Aaron and Marsha’s needs will also need to be addressed when planning care for this family. Family nursing is important because it caters to the needs of every family member. As such, even though the most obvious maladaptive behaviors can be seen between Cal and Nate, there are undoubtedly issues with Aaron and Marsha’s relationship to the family as well. Aaron is isolated and disrespected by the majority of his family members, but does not have any relationships outside of them that he can escape to. And Cal and Marsha’s marriage has been broken for many years, as Cal regularly neglects and cheats on his wife with strangers. When Cal left the family following his head injury, he left with a path of destruction in his wake. As such, even though the primary stressor within the family is gone, they will still require guidance to recover and adapt to the change.


NURSING INTERVENTIONS

Support family needs, strengths, and resources through family interviews (Ackley et al., 2020, p. 385). Rationale: Family interviews give the nurse an opportunity to assess the family’s understanding of and expectations for care (Alsem et al., 2014).

Allow family members to verbalize their feelings (Ackley et al., 2020, p. 385). Rationale: Listening to what family members have to say will help the nurse understand their thoughts (SmithBattle et al., 2013). It is also valuable for the Jacobs family to speak about their feelings more openly.

Refer for family therapy and other family-oriented resources (Ackley et al., 2020, p. 378). Rationale: Targeted family therapy leads to better evidence-based interventions and improved health outcomes (Ventura & Bagley, 2017).


NURSING OUTCOMES

Members of the Jacobs family will be able to describe their needs for care as a group to a nurse. They will also be able to describe the state of their family and why they believe intervention is or is not necessary.

Members of the Jacobs family will be able to openly discuss their emotions individually with a nurse. Because open communication is difficult within this family, being able to speak candidly with a nurse is an important first step.

Members of the Jacobs family will pursue individual and family therapy, to receive more targeted, continuing evidence-based interventions. Every member of the Jacobs family has complex trauma relating to their family life, and seeking therapy will be the most effective way to adapt to it.


REFERENCES

Ackley, B. J., Ladwig, G. B., Flynn, M. M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnosis handbook: An evidence-based guide to planning care. Elsevier. Alsem, M. W., Siebes, R. C., et al. (2014). Assessment of family needs in children with physical disabilities: Development of family needs inventory. Child: Care, Health and Development, 40(4), 498-506. Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Family health care nursing: Theory, practice, and research. F.A. Davis Company. SmithBattle, L., Lorenz, R., et al. (2013). Listening with care: Using narrative methods to cultivate nurses’ responsive relationships in a home visiting intervention with teenage mothers. Nursing Inquiry, 20(3), 188-198. Ventura, A. S., & Bagley, S. M. (2017). To improve substance use disorder prevention, treatment and recovery: Engage the family. Journal of Addiction Medicine, 11(5), 339-341. doi: CREDITS: This presentation template was 10.1097/ADM.0000000000000331.

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IMAGES https://www.popbuzz.com/tv-film/euphoria/nate-jacobs-brother-family-portrait-theory/ https://euphoria.fandom.com/wiki/Cal_Jacobs https://euphoria.fandom.com/wiki/Marsha_Jacobs https://euphoria.fandom.com/wiki/Aaron_Jacobs https://vaguevisages.com/2022/01/09/euphoria-cast-hbo/euphoria-cast-hbo-jacob-elordi-nate-j acobs/ https://www.youtube.com/watch?v=-Hw3asQ1Hk4&ab_channel=slowish


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