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Family Lifeline

The Tejero family consists of 6 children, namely Erika Joy, Angel, Ernesto, John Robert,
Jolina and Aubrey Rose. The head and the pillar of the family is the father, Nestor and Joseller
the spouse. The family lives with Rosario and Rolando, the mother and brother of Nestor. In the
year 1994, Nestor and Joseller decided to reside in Pandacan, Manila to start their own family.
The eldest was born in 1995, named Erika. Nestor continues to work in Petron while Joseller
started to be a housewife. Nestor and Joseller had their official marriage in 1998 and Joseller
gave birth to their third child Ernesto, born deaf and mute. In the year 2003, they had their 6th
child, Aubrey Rose and the family experiences financial crisis. When Angel started working in
2014, there was an increase in financial support and the parents’ keeps reminding Angel to
prioritize her family, “Huwag muna mag asawa. Tulong muna sa pamilya.” In 2017, Erika
started to work and this increases the financial family support, the 2 sons, Ernesto and John
decides to stop schooling. Nestor had an asthma and hypertension attack and recovered fast,
since the center is accessible for them.

DATE LIFE EVENT IMPACT/REACTION

1982 Death of Josephine (Sister) Depression and the family undergone

stages of grieving
1994 Nestor cohabits Joseller The couple decides to reside in
Pandacan to start their own family
1995 Joseller gave birth to their first Nestor continues to works in Petron
child(Erika) as a janitor while Joseller started to
be a housewife
1998 Joseller gave birth to their third
child(Ernesto)
Official Marriage of Nestor and
Joseller
2003 Joseller gave birth to their sixth
child, Aubrey Rose
2014 1st work of Angel (daughter) Increase in financial family support
“Huwag muna mag asawa. Tulong
muna sa pamilya.”
2017 Ernesto and John Robert decides John Robert has a sideline in the
to stop schooling school canteen
1st work of Erika Increase in financial family support
Husband – asthma and Family strained: caregiver role (due
hypertension to sudden sickness of husband)
Table 1. Family Lifeline
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Genogram

Tejero family was headed by Mr. Teofilo and Rosario Tejero (parents of Mr. Nelson
Tejero, the husband of the index patient) along with their 4 children. Mr. Teofilo died of asthma
at the age of 72.

On the other hand, Dela Cruz family was headed by Mr. Nicanor and Teresita Dela Cruz
(parents of the index patient, Mrs. Joseller Tejero) along with their 6 children. The last
pregnancy of Mrs. Teresita Dela Cruz gave birth to twins through which both suffered a post-
natal death. Ms. Josephine, their 4th child, suffered from heart disease further aggravated by
yearly pregnancies and was declared dead at age 27 due to disease complications.

The main household is composed of the index patient and/or head of the family – Mrs.
Joseller Tejero along with her husband- Mr. Nelson Tejero. They have 6 children namely (from
oldest to youngest), Erika, Angel, Ernesto, John Robert, Jolina and Aubrey Rose. The family has
been living with Mrs. Rosario Tejero and Mr. Rolando Tejero, the mother and sibling of the
head’s husband, the latter separated to his wife and children. Overall, the whole household is
composed of 10 members.
Mr. Nelson Tejero had acquired asthma from both his mother and father which led to passing it
on to his eldest child Erika. Ernesto, the 4th child on the other hand was born deaf and mute.
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Figure 1. Genogram
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Family Profile

Table 2. Family Profile

Classification of the Family

A. According to Structure: Extended Family
B. According to Residence: Patrilocal
C. According to Family set-up: Democratic

The Tejero family is an extended family with adolescents that is internally matriarchal
and externally patriarchal. It is composed of 8 members. It was on the year 1995 that their first
child was born and they got married on 1998. Tatay Nestor works as a janitor in a nearby
gasoline station while Nanay Josellar is a housewife. The eldest, Erika Joys works as a salesclerk
in Robinson’s Otis. Recently, the second daughter just got her first job as a cashier in National
Bookstore. The first two daughters are currently helping financially.
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The family is currently living with the mother of Tatay Nestor. The lot where their house
was built is owned by the government. The house has 2 floors where for the 1st floor is occupied
by the mother and the brother of Nestor and the 2nd floor is occupied by the family of the index
patient, a total of 8 members in the second floor. They have their own electric and water supply.
Their house is made up of mixed materials (semi-concrete). For their water source, they are
connected to a local water system.

For the garbage disposal in Pandacan, they segregate the biodegradable and non -
biodegradable waste products, it is collected every day in the area.

The Economic Aspect

For the family’s monthly expenditure, the first on the list is food followed by education,
electric bills, water bills, clothing, and health. The resource allotted for health care is the
Philhealth.

Combined monthly family income P 20,000 – P25,000

Nestor (Husband) P 12, 000
Erika ( Daughter) P 6,000
Angel (Daughter) P 5, 000
Other sources of income (livelihood) None
Table 3. Combined Monthly Family income
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Family Mapping

The Tejero Family has a harmonious family relationship towards each other. The eldest
and the youngest, like normal siblings, they encounter misunderstandings.

Figure 2. Family Map

Psychodynamics

There are several aspects that could affect the family’s health. During the interview, we
have assessed the economic and environmental aspect that has an impact on their health
condition.

First, economically, the husband and daughters of our informant, Nanay Joseller, are
working and have a combined monthly family income of Php.20,000-25,000 which is just
enough for their daily needs and monthly bills. Unfortunately, the family does not have other
sources of income that could help in providing their needs. We have also asked to rank their
priority expenditure and food as being the highest followed by education, electrical bills, water
bills, clothing, and health as being their least priority.
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In relation with health, the family and their community is provided by the health center of
various health programs such as free consultation, immunization, family planning, pre-natal
checkup, well-baby clinic and free dental services. Moreover, they are aided by health insurances
and PhilHealth, which serves as their resources allotted for health care.

Another aspect would be their environment, which can greatly affect their health. The
family lives in a two- floor rent-free house that is located in a government owned land. The
house is made out of mixed materials and it is semi-concrete. They live in the upper portion of
the house and their relatives live under them. Their living, dining and bedroom area is only in
one place since they only have a limited space to use. They have their own bathroom and toilet
facility, which is a water-sealed latrine system. They get their source of water from the local
water system (NAWASA) and electricity from our local electricity provider (MERALCO).
Furthermore, the type of waste disposal that is practiced by the family is garbage collection,
which is done every day. Other environmental aspects would be the family is taking care of a
domesticated cat that has not yet received any vaccination, the main entrance of their house is
near of drainage areas which houses vectors and rodents, and outside their houses are drums of
water that could be a breeding ground for insects.

With these assessment and observations, it is noticeable that some of these aspects can
greatly affect the health of the family. It would be very helpful if they were to undergo seminars
provided by the health centers related to preventive measures or proper hygiene to ensure the
good condition of every family member.
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Assessment of Family Function

I. APGAR

✓
✓
✓

✓
✓
Table 4. APGAR Part I

Table 5. APGAR Part II

Scoring evaluation: Palagi (almost always) = 9/Highly functional

APGAR Scoring: Interpretation:

Palagi - 2 8-10 = highly functional
Paminsan-minsan - 1 4-7 = moderately dysfunctional
Halos hindi - 0 0-3 = severely dysfunctional
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Adaptation
Nanay Joseller stays at home with her deaf and mute child and takes care of his needs. Tatay
Nestor and Nanay Joseller are able to ask for assistance from their two older children whenever
necessary.

Partnership
Tatay Nestor and his two eldest children share the responsibilities in terms of paying for their
household expenses and providing for other needs of the family while Nanay Joseller takes care of the
household chores and attend to the needs of her son, Ernesto, who is deaf and mute. The family
ensures that they work hand in hand in coming up with a decision, making sure that each voice is
heard. Each family member always tries to give their best in their respective duties in order to help
the family.

Growth
The parents are supportive of their children especially when it comes to their decision. Just take
in for example, when their two older children decided to stop studying and start working for the
family. Each member is able to find the support system that they need within the family.

Affection
Although misunderstandings may arise between family members, they don’t waste time and they
try to fix it as soon as possible. Tatay Nestor and Nanay Joseller never forgets to give timely and
valuable advices to their children. Each of the family members express their love by showing their
support for one another, most especially in difficult times. They are also able to find comfort in each
other’s arms.

Resolve
Conflict is inevitable among families that is why the Tejero family makes sure that they are able
to resolve things by spending some quality time by communicating with each other and sharing their
experiences while having their dinner. Also, on Sundays, they go to church together and stroll along
the park.
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II. SCREEM
In determining the assigned family’s capability to provide health care, the SCREEM
Method was used. The tool is used to assess for extra-familial resources that may be tapped that
will help the family.
Subscales and scores are as follows:
• Social: 5
• Cultural: 4
• Religious: 5
• Economic: 4
• Educational: 6
• Medical: 5
Total: 29

Interpretations of scores are as follows:

For each domain subscales: Total SCREEM-RES scores:
Severely inadequate - 0 to 2 Severely inadequate - 0 to 12
Moderately inadequate - 3 to 4 Moderately inadequate - 13 to 24
Adequate - 5 to 6 Adequate - 25 to 36

Resources
Social The family has a balanced communication within
the family and with their extra-familial social groups
and other community organizations.

Cultural Culture serves to strengthen family integrity.

Community’s culture of helpfulness serves as a
support for the family.
Religious The family has satisfying spiritual experience.

Economic The source of income of the family is from three

members of the family. The family income is just
exact to meet their needs.
Educational Family considers their educational background
enough and adequate in understanding the illness
and patient care.
Medical Medical care is available through channels that are
easily established and have previously been
experienced to be satisfactory.
Table 6. SCREEM
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Impact of Illness

Stage I Onset of Illness

Stage II Reactions to Diagnosis (Impact Phase)

Stage III Major Therapeutic efforts

Stage IV Early adjustment to outcome (Recovery)

Stage V Adjustment to the Permanency of Outcome

Table 7. Impact of Illness

The patient and the family tries to self-medicate first when symptoms arise and when it
persists after a day or two that is the time they decide to seek consultation from (1) doctors in a
private clinic or in the barangay.

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