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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
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.), Switz.—died Aug. 24, 2004, Scottsdale (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.)
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.)
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.)
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.
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
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
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
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 12th
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
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
Ramon has been working with Luis. One afternoon, Ramon complains of a
headache from “too much sun,” collapses and dies en route to the
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
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
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.