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California State University, San Marcos N480

Meet the Bregstien/Hanson Family ●

Grace and Frankie were completely shocked when their husbands, Robert and Sol (business partners at a law firm), reveal they had been having an affair with each other for the last 20 years. Grace and Frankie, initially foes, divorce their husbands and move into a beach house in San Diego that both families co-owned, while their husbands get married and start their life together. Grace and Frankie eventually become best friends and business partners as they learn to cope with their difficult situation and adapt to their new lives, as well as the complications of aging. Grace and Frankie each have two adult children, whom they are very close with. Both women remain close with their ex-husbands as well. The Bergstien and Hanson Families were once both traditional nuclear families, however, with the marriage of Robert and Sol, the Bergstien/ Hanson Family becomes a same-sex, blended family. Every member of this family is caring and supportive of one and other.

Stage of development ●

The Bregstien/Hanson Family is in the “aging family” stage of development. Family development tasks include, “adjusting to retirement, grandparent roles...and living alone” (Kaakinen et al., 2015). Due to the unconventionality of the Bregstien/Hanson Family, the “married couple” stage applies to Sol and Roberts relationship. There developmental takes include: “establishing relationship as a married couple...blending of individual needs, developing conflict-and-resolution approaches, communication patterns, and intimacy patterns” (Kaakinen et al., 2015).

Introduction: Frances "Frankie" Bergstein: Hippie art teacher. Divorced from Sol, adoptive mother of Coyote and Bud. Currently lives in a beach house in San Diego with Grace, who is her best friend and business partner. Frankie is very spiritually, open minded, and quirky. She marches to the beat of her one drum and is unapologetic about it. She is a fan of marijuana and hip hop music. She is open and honest about her sexuality and love life; she is also currently dating a yam farmer named Jacob. Frankie is also a member of PETA and claims to be vegan. Age: 74

Grace Hanson: Retired cosmetics mogul of Say Grace. Dioveried from Robert Hanson, mother of two daughter, and grandmother of four. Currently lives in a beach house in San Diego with Frankie, who is her best friend and business partner. Grace and Frankie frequently do not see eye to eye. She is use to a upper-class lifestyle. Grace is conservative, plays by the book, and cares what others think of her. Age: 73

Robert Hanson: Ex-husband of Grace, current husband of Sol. Father of Brianna and Mallory. Successful lawyer. Initially shameful of his homosexuality and wants to hide his relationship with Sol. Manly man attitude. Loves theater (member of a queer theater group). Age: mid-70s

Sol Bergstein: Ex-husband of Frankie, current husband of Sol. Adoptive father of Coyote and Bud. Successful lawyer. Can’t stand to make anyone unhappy, very shameful that he cheated on his wife. Sensitive man. Very happy and in love with Robert. Age: mid-70s

Brianna Hanson: Daughter of Grace and Robert. Current CEO of Say Grace. Determined and motivated in her work, but unsure in her dating life. Worries about missing her chances to have kids. Age: 36

Coyote Bergstein: Adopted son of Sol and Frankie. Recovering alcoholic and drug addict. Spent 5 years in rehab. Currently a substitute teacher. Had a former romantic relationship with Mallory Hanson. Age: 32

Mallory Hanson: Youngest daughter of Grace and Robert. Mother of four children. Currently a stay-at-home mom. Married, but unhappy. Very uptight rule follower. Age: 31

Nwabudike "Bud" Bergstein: Adopted son of Sol and Frankie. Works as a lawyer for Robert and his father’s law firm. Momma’s boy. Age: 33

Frankie’s Trans-ischemic attack ●

While driving one day, Frankie experienced stroke-like symptoms including right-sided facial droop and the inability to speak It was later discovered that she had trans-ischemic attack, or a mini stroke. Also, according to her brain CT, it was discovered that Frankie had experienced a far larger stroke about 10 years ago. The concern now is that because of Frankie’s age, she is very suspitle to experience another stroke in the future. Frankie has been advised to change her lifestyle in order to prevent another stroke; her family is supportive of a health change, but Frankie is very resistant.

Transient ischemic attacks (TIAs): Also referred to as a mini-stroke, these occur after blood flow fails to reach part of the brain. Normal blood flow resumes after a short amount of time, and symptoms cease (McIntosh, 2017). Causes: ● ● ● ● ●

being overweight 55 years or older a personal or family history of stroke an inactive lifestyle a tendency to drink heavily, smoke, or use illicit drugs (McIntosh, 2017).

Cultural/Religious Traditions ●

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Frankie is buddhist. She uses alternative medicine, practices energy healing and meditation. She is very against traditional medicine. Grace and Robert Identify as Catholic, but do not practice the religion. However, they both seem to turn to it during times of crisis. Sol identifies as Jewish. Frankie and Grace’s children do not affiliate with any religion. However this disagree with Frankie’s resistance to traditional western medicine. Although the families viewpoints differ, there is no animosity about religion.

Family Communication Each individual in the Bregstien/Hanson Family has a different style of communication. Frankie often communicates abstractly through the use of analogy, metaphors, and “performance art.” She frequently avoids unpleasant or confrontational topics. Grace prefers to communicate directly and work out conflicts diplomatically. Bud and Coyote both have a passive way of communicating; they, like their mother, prefer to avoid conflict. Mallory and Brianna, on the other hand, take after their mother and communicate directly and do not “beat around the bush” with topics that may cause conflict. Sol is the most adverse to conflict; he does not like to unset people and frequently hides from the truth. Robert is opposite in that sense; he communicates very methodically and thoughtfully. Nonverbal communication is relatively universal throughout the family; all members use facial expressions that line up with their emotion (smile, frulling eyebrows, crying). Conflict arises in the family often due to half the family members having a direct communication style and half having a passive, conflict avoiding communication style. However, when conflicts arise, the family communication and intention come from a supportive and loving place. Family communication is “continuous in that it defines their present reality and constructs family relationships” (Kaakinen et al., 2015).

Strengths ● ●

The family is tight-nit There is strong trust between Grace and Frankie Each family member takes care of one and other. Each family member is reliable

Challenges ●

Frankie and Grace is very stubborn, strong willed, and easily swayed. Each family member has a different communication style. There is still distrust between Grace and Frankie and Robert and Sol (for the 20 year affair). Each family member feels like they know what’s best, which leads them to conflict often

Chronic Illness Framework Theory This framework was proposed to understand the effects of chronic illness on the family and it focus on three main categories: illness type, time phases of the illness, family functioning (Kaakinen et al., 2015). ●

Illness Type: Frankie experienced an acute onset to a chronic disorder. With an acute onset the family has a “rapid mobilization of crisis mode strategies to manage the situation” (Kaakinen et al., 2015). After the initial acute onset, the family adapts to the the grandal nature of the condition. Frankie’s course of illness is episodic, which causes stress to the family do to the uncertainty and unpredictability of another stroke. The outcome of the illness was non-incapacitating and non-fatal. Time phases of the illness: The Bregstien/Hanson Family is in the initial/crisis phase of illness and the family must: “(1) establish a positive working relationship with health care providers (2) gather information about the diagnosis (3) accept the diagnosis” (Kaakinen et al., 2015). Family functioning: The the main concern for the family nurse is to help foster family adaptation to life with a chronic illness (Kaakinen et al., 2015). The Bregstien/Hanson Family is very willing to help and support Frankie with her lifestyle change and illness management.

Interventions/Outcomes 1.


Assess the family members mood and feelings and encourage them to express their emotions regarding Frankie’s condition. ○ Rationale: It is important to have the family reflect on their feelings to “continue to provide care and empower them to maintain their own health and well-being” (Corry, While, Neenan & Smith, 2015). ○ Outcome: All family members will expect their emotions and move forward as active caregivers for Frankie. Educate the family about the pathology as well as sign and symptoms of a stroke ○ Rationale: This is ensure that all family members understand what is going on with Frankie. Also, if every family member is on the same page, they will be more effective in the prevention of another stroke (Corry, While, Neenan & Smith, 2015). ○ Outcome: The family will recognize and verbalize their understanding of stroke signs and be able to intervene quickly if a sign presents itself.

3. Educate and encourage the family to all make the same lifestyle change as Frankie. This includes diet change, smoking cessation, and increase in exercise. ○ Rationale: It has been proven that cohesive family lifestyle changes increase adherence to the change (Kaakinen et al., 2015). ○ Outcome: Frankie and the family will successful change their lifestyles and family support.

References Corry M., While A., Neenan K. & Smith V. (2015) A systematic review of systematic reviews on interventions for caregivers of people with chronic conditions. Journal of Advanced Nursing 71(4), 718–734. doi: 10.1111/jan.12523 Kaakinen, J., Duff-Gedaly, V., Hanson, S. & Coelho, D. (2015) Family health Care nursing: Theory, practice and research (5th ed.). F.A. Davis: Philadelphia. McIntosh, J. (2017, November). Everything you need to know about stroke. In Medical News Today. Retrieved March 7, 2018, from Pictures From: Grace & Frankie. (n.d.). In Tumblr . Retrieved March 8, 2018, from Grace And Frankie Pictures and Images. (n.d.). In Getty Images. Retrieved March 8, 2018, from

480 family nursing project  
480 family nursing project