The purpose of this paper is to incorporate one family's experience of living with multiple chronic illnesses into the Calgary Family Assessment Model (CFAM) and Rolland's Chronic Health Challenge Framework. CFAM was developed by Dr. Lorraine M. Wright, a professor Emeritus of nursing and by Dr. Maureen Leahey, a manager of a mental health outpatient program both have over 25 years experience while still managing to supervise, teach, consult, write, and maintain a part-time clinical practice in individual, couple, and family therapy (Moxie, 2007). CFAM allows nurses to assess families during interviews. CFAM is a multidimensional framework consisting of three major categories: structural, dimensional and functional. (Wright & Leahey, 2005) Each category has its own subcategories, with the ability to pull out family strengths, weaknesses and roles of possible resources the family has or may need. These topics help the nurse assess the family's perspectives at that particular moment in their lives and allows the nurse to help with any problems or challenges the family may face. The family interviewed was a gentleman living with cystic fibrosis, diabetes, life threatening asthma and metabolic myopathies. For confidentiality, each family members name has been changed. The gentleman living with the chronic illness will be named Bob Jones, Bobs mother will be named Sue Jones, Bobs girlfriend will go by Jane, and the 2 year old daughter will be named Anna.
The structural category of CFAM is broken down into three subcategories: Internal, external and context. Developing questions according the family allows the nurse to develop an idea of who is considered family, what is the connection among family members and those outside the family, and what is the family's context (Wright & Leahey, 2005). Internal consists of family composition, gender, sexual orientation, rank order, subsystems and boundaries. Assessing family composition allows the nurse to discover who is considered family according to the patient, whether they are actual biological members or individuals who have influences the family's life (Perry & Potter, 2006). The Jones consist of Sue who is 47 years old, her son Bob who is 22 years old and has the chronic illnesses, Bobs girlfriend Jane who is 21 years old, and their daughter Anna who is 2 and a half years old. It was noted not to forget their loyal companion Sasha, the family dog or "second child", as Bob puts it. (Personal) Due to the fact that Bob is not Anna's Father, Bob's family would be classified as a step family (Potter & Perry, 2006). Bob, Jane and Anna live at home with Bob's mom Sue. According to Bob, Jane is works long hours throughout the week and being at home with his mother allows him to receive the care he needs socially, mentally and physically; while, acting as another pair of eyes on the very active Anna.
Bob's family does not believe in the gender roles about wives staying home to cook and clean while the men are at work. Sue and Jane take on the responsibility of making sure Bob meets his nutritional requirements as well as their growing daughter Anna's. Being a heterosexual couple, Bob and Jane were open to questions based on sexual orientation in their lives. Bob has done most of the teaching with Anna and due to his illness, he has been teaching her to treat everyone equally even if they are different. Although it is hard to understand such concepts at 2 years old "she is very smart and picks up on things very quickly" (Personal). Bob's mother influenced him to be very open-minded in life, due to his illnesses it was sometime hard to cope with their effects. This open-minded characteristic about Bob allowed him to avoid putting people into genres and creating ideas of what they are meant to do.
There is no specific ranking order, as Bob's illness plays a huge factor in what goes on within the family's decisions and priorities. Anna is the only child present in the family and...
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