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Original Question

Janelle is a 42-year-old grandmother currently parenting her 4-year-old grandson, Jacob. Janelle has been divorced for 7 years from her physically and emotionally abusive husband. Her 20- year-old daughter, Danielle, lost custody of her son after an incidence of domestic violence where her live-in partner threatened her with a gun. Jacob witnessed this episode, and the Child Welfare Services learned that Jacob was a witness to numerous occasions of violence, including his mother’s partner hitting, kicking, strangling, and threatening his mother, resulting in two emergency department visits. The court determined that Danielle could not adequately protect her son from danger. She asked her mother to care for her son until she could obtain needed counseling, alcohol abuse treatment, and job training. Janelle agreed to parent her grandson. She feels partially responsible for her daughter’s difficulties, because her daughter suffers from attention-deficit disorder (ADD) and a learning disability that affected her academic success and peer relationships. She was also very upset during the divorce of her parents and witnessed physical abuse of her mother by her father. She dropped out of high school at age 15 and drifted from partner to partner, experimenting with drugs and violence. She became pregnant at 16, and her mother kicked her out at that point, hoping her actions would result in Danielle reevaluating her life and resuming school and sobriety. The result was the opposite. Janelle watched her daughter choose dangerous men to live with, and her struggle with alcohol and drugs increased. Danielle is finally receiving the counseling and job training she needs but at the expense of her son suffering from severe post- traumatic stress disorder, with symptoms of poor attention, anxiety with sleep disturbances, and difficulty stabilizing emotions. His grandmother obtains training and support through the Child Welfare Services caseworker. Case Study Discussion Questions 1. How does this family compare to current demographic trends seen across the United States? 2. Why is this family at risk for poverty? 3. What other economic trends may affect this family? 4. What are two nursing interventions that may help change risk factors for this family, based on the Healthy People 2020 criteria?

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