Problem

1- Excellent point you brought about with mother moving into daughters home and there being roll confusion as to who will be the leader. Clear communication and boundaries need to be in place within this family. This family will need to learn their remaining and new roles in order to properly function. The grandmother should still have decision making roles when it comes to some aspects of her personal life. This will give her a sense of control and keep her active in her own care. Decisions rega the childre, their roles and discipline should be between the husband and wife.

2- You mention goals. This is crucial. I have seen many families make decisions that they would not have made if they fully understood the impact of those decisions. "If only we had known that it would be like this.". Of course, not all situations can be clearly defined or predicted, but reviewing in depth the available information and helping families to understand the process and what to expect is critical to good family function through difficult health situations.

3- Anticipatory strategies should be incorporated into family education. These range from installing equipment (such as a handle in the shower) that may help Ms. Jones with activities of daily living to a living will and an advanced directive for medical care. Anticipatory strategies tie in to the risk factor assessment from last week. What is the family at risk for and what could be implemented to prevent the identified problem from occurring?