How to Use the Calgary Family Assessment Model (CFAM)

The model of family assessment using Calgary Family Assessment Model (CFAM) provides a chance for nurses to conduct interviews on assessment of families. The Calgary Family Assessment Model makes use of three categories that include functional, structural, and developmental. All these have subcategories that help to understand the strengths, weaknesses, and resources which a family needs (Wright and Leahey, 2012). A nurse can make use of the information presented to identify the problems in the family, identify the perspectives, understand the challenges that the family faces and to identify ways to solve those problems. This paper is going to discuss the assessment of a man named Tom suffering from chronic pulmonary cancer by incorporating a family’s living experiences through the Calgary Family Assessment Model. 

The names of the family members for the person interviewed have been changed to retain confidentiality. Tom Harrison is the man suffering. He is 40 years old and is married to Ivy. They have a son together who is called Derrick. The structural model of the CFAM is also divided into an internal and external context. It helps the nurse to identify the members of the family that are being assessed and to identify the relationship which exists between the members of the family and people that are not members of the family. The internal context of the analysis includes factors such as family composition, sexual orientation, subsystems, gender, boundaries, and rank order. External factors would include items such as the extended family, race, and ethnic group of an individual. 

Family Structure Assessment 

The family of Tom Harrison is made of Tom who is 40 years old, his wife Ivy who is 37 years old, his son Derrick who is 10 years old, and Tom’s mother, who is 72 years old. Maria has been suffering from arthritis, a problem which was caused due to aging. She was forced to move and live with Tom, her child where she can receive proper care and attention. Ivy spends most of her time taking care of Maria as her nature of work allows it. Tom works as a software engineer and has a very busy schedule. Derrick, the son to Tom and Maria, attends school. Everything was going quite well for the family until Tom was diagnosed with pulmonary cancer. This resulted in straining of the family both financially and emotionally. 

Extended Family 

Tom maintains a close touch and communication with his extended family. Kennedy is one of Tom’s cousins who Tom keeps a close touch. Kennedy takes time to inquire how Tom is doing by visiting him regularly and keeping in touch. Kennedy and Tom schooled together and have shared several memories from the time they were children. Tom’s dad passed on as a result of an accident when Tom was 28 years old. As a result, Tom stays with his mother and takes care of her. The extended family includes the paternal and maternal side of Tom. Tom has three paternal uncles named Dexter, John, and Fred. One of Tom’s aunts passed away several years ago. Tom also has one maternal aunt called Betty and one uncle called Thomas. Thomas is the uncle who is the father of Kennedy, Tom’s best friend and cousin. Tom does not have any grandparents as they passed away several years ago. 

Medical History of Members 

The medical history of the family points to the fact that there have been other cases of pulmonary cancer, cardiovascular disease, and chronic respiratory disease. Tom’s paternal grandfather passed away as a result of pulmonary cancer. One of Tom’s aunt passed away as a result of breast cancer which caused several complications in the lungs. One of Tom’s cousins was also recently diagnosed with breast cancer and she was going through chemotherapy. On Tom’s maternal side, there is a history of chronic respiratory disease and cardiovascular disease. Tom’s uncle, Thomas is aged 75 years old, and has suffered from two strokes and was once diagnosed with chronic bronchitis. There is a history of smoking on the maternal side of the family causing a greater risk in the development of pulmonary cancer. Tom’s mother used to smoke but quit once she realized that she was pregnant with Tom. 

Sexual Orientation 

Tom is heterosexual and noted that he carries the responsibility of bringing up his son Derrick to be responsible and moral. He teaches his son Derrick to be social and to be able to interact with people of different gender. Tom also noted that he was taught by his mother to be open-minded and sometimes found it difficult to cope with pulmonary cancer which he was fighting. The family of Tom also holds equality in their gender roles where both Tom and his wife can participate in house chores and cook. However, Tom’s illness has drained his energy and he rarely participates in any work at home. 

Ethnicity 

Tom is the descent of a family that is native American. Both of Tom’s paternal grandfather was a native American and Tom believes that he has more native American blood in him. His paternal grandmother and maternal grandparents were from the European descent. 

Race 

Tom’s race is white as a result of having grandparents from European descent. Tom’s wife is also from the European descent and their son is also white. 

Social Class 

Tom describes his social class as the upper middle class. Tom graduated from high school and studied software engineering in the University. Tom is employed as a software engineer in one of the leading technology companies. Tom also noted that his wife works in a leading online fashion store. The pay is good and the family can sustain living in a decent home and pay their bills comfortably. However, Tom noted that his illness has strained his family both emotionally and financially. Tom has been out of work from time to time and Ivy has had to take some time off to take care of Tom. 

Religion (and/or Spirituality) 

Tom is religion and is a Catholic. He notes that he was brought up in a Christian home since both his parents were Christians that participated in the local church community. While Tom is relatively inactive in church activities, Tom’s wife participates actively in the local church and takes time to pray for Tom due to his illnesses. 

Environment 

Tom noted that both his pay and that of his wife enabled them to sustain living in a decent home. The family bought the house they are living in approximately five years ago. The family has moved two times over the past ten years. They live in an urban area where they have close access to cancer treatment facilities. 

Family Development Stage 

Stage of the Family Life Cycle 

The stages of the family life cycle include home leaving, marriage, families that have children, families with adolescents, and exits from the family system. Tom is at the third stage of the family life cycle, the stage where they have children. Tom left his home during his mid-twenties after he had landed a lucrative job as a software engineer. He got married to Ivy in his late twenties and went to the second stage. Tom and Ivy have since had one child, Derrick, who is ten years old and hence are in the third stage of the family life cycle. The third stage involves adjustment as the two parents include children in their lives (McGoldrick, 2011). They face financial obligations as they take care of the child and have tried to establish connections with the extended family so that they can play a role of grand-parenting for the child. 

Development Tasks for the stage life cycle 

The development tasks for the third life cycle of Tom have been met. This is because the personal development of Tom is contributed by both Ivy, Derrick, and Maria. Ivy supports the family both financially, mentally, emotionally, and physically. While Maria, Tom’s mother, does not work, she provides emotional and physical support for Tom. Derrick provides mental and emotional support for Tom. Tom feels that he should fight his pulmonary cancer because he needs to be with his son as he grows. The presence of the three support groups has enabled Tom to become hopeful despite his difficult situation. Tom and his mother are often at home and a strong and caring relationship has developed between the two. 

Watson’s theory on how Caring is enacted by Family Members 

Watson’s theory describes caring as a process where the ethical and moral ideals of nursing interact with humanistic qualities and interpersonal skills. It would involve development of knowledge, expertise, and skills regarding communication, interpersonal skills, empathy, and clinical competence (Sitzman, 2018). Caring is enacted by the family members as they show empathy and proper communication skills to Tom. Tom has developed strong communication and interpersonal skills with the members of his family as they tackle various difficulties brought about by cancer. 

Family Functional Status 

The functional assessment is used to identify how different individuals behave towards each other in the family. It can also indicate how the illness has affected the relationship of different members of the families (Boterhoven de Haan et al., 2014). 

Emotional communication 

The illness of Tom has caused him much grief and sadness. He mostly expresses his emotions of sadness and disappointment because his illness has left him somewhat inactive. He mostly states that he finds his illness emotionally draining because he cannot be involved in the active life of Ivy. Ivy is affectionate of her husband and is supportive during his illness. Ivy sometimes cries as she sees Tom through pain and difficulties with the chronic pulmonary cancer. 

Verbal communication 

Tom and Ivy communicate verbally quite often. The verbal communication builds the relationship and bonding between the two. The communication is important for Tom to find help when needed. Tom also communicates how he is progressing with his health. 

Non-verbal communication 

Non-verbal communication occurs when Tom and Ivy communicate through their facial expressions. When Tom is in pain, he shows this through a facial expression indicating that he is in a distraught condition. 

Circular communication 

The different members of the family communicate in a circular manner making various decisions. For instance, circular communication is enhanced as Tom, Ivy, and Maria communicate on nutrition plans and the medication. 

Problem-solving 

The family makes use of the pro-active problem-solving technique to solve their problems. Tom is skilled in problem-solving and assists the family in making decisions. Even though the diagnosis of cancer caught Tom by surprise, he has managed to cope up with the situation and solve various challenges that came up. He initially had a comprehensive health care insurance plan and had sufficient emergency savings. The family has prepared for future complications that could arise in case of any further problems. 

Family Member Roles 

The roles of family members are not well defined. Both Tom and Ivy share roles and responsibilities for different duties. Both Tom and Ivy provide financial support for the family. Tom is on sick leave due to his chronic pulmonary cancer and is still under pay from his job. Ivy works in the fashion industry and earns a good income to provide financial support for the family. Derrick, their son, participates in small household chores such as washing the dishes and keeping his items such as his toys clean. Tom also participates in various household chores when he feels that he is energetic enough. 

Influence and power 

The decision-making process does not come from one source. Instead, the key members of the family participate in the decision-making process. Tom and Ivy are the key decision makers in the home. They can take the advice from Maria, Tom’s mother, regarding various issues. Therefore, for critical decisions, the three key family members have to take part in the decision making process. 

Beliefs about health and illness 

The family has a strong religious background and their beliefs about health and illness are shaped from a religious perspective. They believe that God protects them from harm. Their take on Tom’s chronic condition is that God can provide healing and comfort through the difficult times. They believe that God can use chemotherapy and various treatment options to provide healing for Tom. 

Alliances and coalitions 

Tom and Ivy have maintained their relationship by having a strong financial alliance and coalition. They have pulled in their resources together to enable Tom to go through his difficult moments with the chronic pulmonary cancer. The extended maternal family is quite close to the family and provides the necessary emotional support for the family. Kennedy, Tom’s cousin, is a close and loving friend to Tom. He knows his situation, calls him and visits him quite frequently to know and understand how his condition is progressing. 

Diagnosis 

Tom was diagnosed with chronic pulmonary cancer and has since faced emotional challenges. He has been stressed and has undergone a difficult time due to the ordeal. The emotional difficulty has been made better through the help and support he has received from his close family. 

Intervention 

Tom has the support of Ivy, his wife, that supports him both financially and emotionally. Ivy ensures that Tom undergoes various interventions such as chemotherapy according to the stated plan and follows his medication correctly. Tom is undergoing chemotherapy and is willing to follow the required medication to realize recovery. 

Desired Results 

The family has taken the serious condition faced by Tom positively. The family desires that Tom should attain full recovery in the next few months. They are willing to dig deep into their pockets to ensure that Tom fully recovers from the condition. 

Conclusion 

The assessment of Tom, a 40-year-old father, who is undergoing treatment due to chronic pulmonary cancer shows that he has adequate support from various members of the family. His main source of support is Ivy, his wife who provides financial and emotional support to Tom. Tom lives with his mother, wife, and son who understand his situation and are willing to offer help and support. Tom has an extended family that provides all the help and support he needs. The family is young and is at the third stage of the family life cycle and pulmonary cancer hit them by surprise. However, through proper communication and problem-solving skills, proper division of roles, and an effective power-sharing and influence in the family, they have managed to go through the process with much ease. 

References 

Boterhoven de Haan, K., Hafekost, J., Lawrence, D., Sawyer, M. and Zubrick, S. (2014). Reliability and Validity of a Short Version of the General Functioning Subscale of the McMaster Family Assessment Device.  Family Process , 54(1), pp.116-123. 

McGoldrick, M., Carter, B., & Garcia-Preto, N. (2011). The expanded family life cycle: Individual, family, and social perspectives.  Boston: Allyn and Bacon . 

Sitzman, K. (2018).  Caring science, mindful practice: Implementing Watson’s human caring theory . Springer Publishing Company. 

Wright, L. M., & Leahey, M. (2012).  Nurses and families: A guide to family assessment and intervention . FA Davis.