Instructions: Read the attached Perez Family Case Study and review what has happened to the family system since Ramon, the grandfather has died. After reading the case study, answer the questions that follow. Your entry will be evaluated for clarity, integration of information from the text and scholarly literature, and for evidence of proofreading.

We were introduced to the concept of Transitions and Trajectories in Chapter 10. And, as we have leaned from reading chapter ten, for better or worse, people experience challenges and changes that initiate and influence transitions that can be life altering. These life altering changes can initiate behavioral changes as well.

In Chapter 16, we are introduced to Elizabeth Kübler-Ross’ “5 Stages of accepting impending death”.

Elisabeth Kübler-Ross, (born July 8, 1926, Zürich (Links to an external site.)Links to an external site., Switz.—died Aug. 24, 2004, Scottsdale (Links to an external site.)Links to an external site., Ariz.), Swiss-born American psychiatrist and author who was a pioneer in the study of death (Links to an external site.)Links to an external site. and dying whose work helped revolutionize the care of the terminally ill and helped change attitudes toward pain control and death itself. She was especially known for having identified five stages of grief experienced by the dying: denial, anger, bargaining, depression, and acceptance. Kübler-Ross, one of identical triplets whose survival was at first doubtful, knew at a young age that she wanted to be a doctor and defied her father’s plans for her to be his secretary in the business he managed. Instead, she worked at a variety of jobs and, when World War II (Links to an external site.)Links to an external site. ended, did volunteer relief work in Poland before studying at the University of Zürich, from which she received her medical degree in 1957. She moved to the U.S. the following year and was disturbed to discover the medical community’s tendency to refuse to acknowledge the reality of death to terminally ill patients and therefore to deny those patients the help they needed for dealing with it. In the early 1960s, as a teaching fellow at the University of Colorado’s medical school, Kübler-Ross began to try to enlighten (Links to an external site.)Links to an external site. her students on the subject, and while working in Chicago, she held seminars in which the terminally ill were interviewed and allowed to express themselves. It was from these interviews that she developed her description of the five stages of accepting death.

https://www.britannica.com/biography/Elisabeth-Kubler-Ross (Links to an external site.)Links to an external site.

Far too often, our assumptions about people are based on our own previous experiences, and often what we see at surface level. This means that important details are hidden from sight during the initial impressions. Unfortunately, just about everyone has made a snap decision based on these incomplete impressions. We profile people based on whether or not they wear their hair a certain way, or if their shirt is tucked in or loose, or sometimes even if they are wearing a tie or a t-shirt. A person’s actions, or reactions, and or how we treat people are often influenced by simplistic and often inaccurate first impressions. We need to be mindful of the word “cope”, and the presence or absence of coping skills, as well as the presence of positive and negative behaviors that accompany coping abilities. Be mindful that coping is a verb that relates to how effectively someone or something deals with a difficult situation.

If a rather disheveled, and foul-smelling person that reeked of alcohol entered your office, it would be easy to assume that they are not a successful functioning member of society. In doing so, you have failed to turn the page, and discover the story that lies within. A skill to master is to learn the importance of how to place judgmental glasses aside, and view a person through the lens of empathy and understanding

To empathize means to be capable of identifying and understanding another person’s feelings, without experiencing them for yourself at that particular moment. It is the ability to literally experience the world from another person’s perspective; to walk in their shoes, to view life from their living conditions and to feel what it feels like to be that person.

What have they experienced? Do they have any positive coping skills? Do they have a good support system? Are they aware that they have strengths? Is their behavior reactionary?

These are only a few examples of questions that can help you understand a person from a holistic, or multidimensional perspective. As we know, a multi-dimensional perspective includes

physical, emotional, mental and spiritual aspects, along with conscious and subconscious aspects, as well as rational and irrational aspects.

INSTRUCTIONS:

After reading the Perez Case Study, you are to address the following aspects and how they relate to this case. You are required to provide depth and thought in this assignment. If your submission lacks effort, deductions will occur. Always be proud of your work!

a). List and explain the major transitions and trajectories for the following family members. Carmen (2 points), Luis (2 points), Ramon (2 points) Rolando (2 points).

b). Apply Kübler-Ross Model of the Grieving Process to Carmen’s situation. Explain each of the 5 stages and how they relate to Carmen. Provide examples for each. (2 points).

Case Study: Perez Family

Luis, 41, and Maria, 40, Perez have immigrated to the US from Argentina with their seven children. Rolando is 19, the eldest and only son in the family. Lupe, 17, Anna, 15, Roselina 13, Gracelia, 10, Yesenia, 8, Gariella, 6 and Maritza, 3, have looked forward to the move to the U.S.

Luis’ elderly parents, Ramon, 81, and Carmen, 79, have also come with the family, leaving behind most of their belongings and two dogs that Carmen raised since they were four-week-old puppies.

The family was successful in Argentina but decided to immigrate because Luis felt there would be more opportunities for his children. The family was able to purchase a small piece of land in a rural community in the western part of the U. S. with the intention of producing grapes to market to a winery.

Luis and the children are quite fluent in English although Spanish is the first language used in the home. Maria knows some English but lacks confidence in her ability to speak the language. Ramon and Carmen do not know English at all, have no interest in learning the language, and are committed to keeping tradition alive within the family.

Luis is the youngest son of Ramon and Carmen and was brought up in a strict Catholic home, educated by nuns through 12^th grade. Luis has always been in good health and is unusually physically strong. Luis married his childhood sweetheart, Maria, at age 20.

Maria has known Luis her entire life and married Luis at age 19, straight from a convent all-girls’ school. Any time they spent together prior to their marriage was chaperoned by a great aunt. Maria’s parents died in an accident when she was young. Maria is an only child. Luis’ family is now her only family. The marriage is very traditional in roles.

Carmen and Maria had always started their day with mass but can no longer attend church because the closest church is now over 15 miles away and neither of the women know how to drive.

Rolando is the first born and only son of Luis and Maria and the hope of their family name. Luis has plans for Rolando to go into this new family business and looks forward to the many grandchildren that Rolando will give to the family. Rolando has great respect for his parents, family and tradition and always wants to please everyone. Rolando wants to attend college and is struggling with his identity.

Lupe is very outgoing and has already adjusted to this community. Lupe has already made a lot of friends in her new school situation and is looking forward to going away to college to be away from the rigidness she perceives in her family.

Anna is very shy. She has not been able to make friends and every day is a struggle to attend school. Anna spends her time with her mother or grandmother. If she is not with them, she retreats to her room. Anna’s schoolwork is suffering and she is withdrawing more and more from everyone. Anna wants to be anywhere else but right here and feels tired and empty. Anna has started to wear loose clothing and long sleeves even on warm days.

Roselina is much like Lupe in making friends immediately. She is an honor student and very athletic. She has found a new pastime going to the mall with her friends. Roselina has been late for dinner and not always remembering to do her chores around the house. Roselina is not the least bit interested in “family stories” as she puts it. Roselina was close to Anna but now would rather be with her new friends.

Gracelia has been working very hard in school, making some new friends and is quiet and an avid reader.

Yesenia and Gariella are excited with their new house and new school; they love their teachers and have been begging for a puppy.

Maritza is always by her mother’s side. When they moved to the States, Maritza had been out of diapers for quite awhile but now seems to be experiencing quite a few accidents as well as regressing in her use of vocabulary words.

Luis has begun to feel unusually fatigued and has had some moments of feeling unsteady when he is working in the vineyard. He has had some moments of numbness and blurred vision but attributes them to the long hours.

Ramon has been working with Luis. One afternoon, Ramon complains of a headache from “too much sun,” collapses and dies en route to the hospital.

Carmen has known no other life than the sixty years they had been married. Ramon had made all the major family decisions, took care of finances. During their years of marriage, they had to bury two infant sons and lost an adult son to cancer. Luis is their only surviving child. Carmen had always derived her comfort from her priest. Church now for Carmen is just a place to attend mass since it is a rural community, the priest changes weekly. Carmen finds herself very angry with the entire situation and feels totally alone.

Luis tries to plan a funeral for his father but his mother does not want to make decisions. Luis’ stress level is high and continues to feel “off balance.” Luis is feeling financial stress and pushing Rolando to postpone going to college to be more help in the fields. Luis continues to drive the point home that Rolando must carry on the family name and take his place within the family business. As Luis is encouraging Rolando to be more involved, he feels guilty about placing this on Rolando because education was the very reason they had immigrated to this country.

Rolando wants to please his father and continues to work in the vineyard but wants to go to college. Rolando is starting to show signs of depression because Rolando is finally willing to admit to himself that he is gay but does not want his parents to know. He feels tremendous guilt for he knows the shame he will bring the family. Fear and shame is a constant in Rolando’s life now and each day he feels more and more hopeless.

Carmen has stopped helping with the children and is no longer interested in doing family activities or even going to church on Sunday. Maria is feeling the strain of not having help and has no energy. Maria feels that she is starting menopause and these are simply the symptoms.

The younger children continue to enjoy their time with each other and their new friends. Graciela has liked school, especially math. The teacher has been calling on Graciela regularly to read out loud in class. Graciela has been complaining of stomachaches each morning and asking her mother to allow her to stay home.

Maria eventually learns that she is pregnant and is fearful to let Luis know because of the strain he has been under. Normally, she would go to Carmen for advice but Carmen continues to move further and further away from the family.

Luis continues to work long hours in the vineyard, meeting with local winemakers and marketing his product. There have been some extra financial burdens since the death of his father, such as some medical bills.

Luis falls one day, having total numbness in his lower back and legs. For this reason, he was brought to the hospital for tests. The family feels it is the strain of what he has been under but the MRI reveals that Luis has multiple sclerosis that seems to be progressing rather rapidly. Luis is admitted to the hospital with plans to have him participate in rehabilitation.

Rolando is starting to feel an enormous burden because his mother has told him that he is now the “man of the family” and needs to fill his father’s role while he is ill. Rolando’s grandmother tells him the pride that both his now deceased grandfather and father have in his ability to run the vineyard.

Rolando works each day and goes straight to his room. He has mostly stopped eating and communicates very little. Carmen is now praying openly for the family and cries all of the time but continues to isolate herself from her family and church.

Maria is now overwhelmed with a new baby on the way and with a husband who is ill with a progressive disease. Maria does not understand what has happened to her life.

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