Family Genogram

The completed genogram for this project is for a client named Michelle Wolf and her immediate and extended family members. Michelle is married and has fraternal twins. She has two brothers, two sisters, and her parents are still alive. Her maternal grandmother and paternal grandfather are still alive. She also has several aunts and uncles on both sides of her family. Overall, Michelle is generally healthy, but she was diagnosed with hypertension when she was in her early thirties. She controls her blood pressure with medications. Michelle stays in shape by eating a balanced diet, limiting her sodium intake, and exercises regularly. Most of the members of her maternal and paternal families are healthy; however, hypertension does run in her family on both sides. Michelle’s father, her maternal and paternal grandfathers, her sister, an aunt and some of her uncles all have hypertension, and her maternal grandfather died of a heart attack. Both of her grandmothers and her maternal aunt were diagnosed with Alzheimer’s disease. 

With the extensive history of hypertension in Michelle’s immediate and extended family members, there is a higher risk of them developing heart disease. Michelle’s body mass index (BMI) measures at 21.49, which is within the normal healthy range (“Calculate Your Body Mass Index,” n.d.). This is an opportunity for patient education as Michelle is taking all of the correct steps to control her blood pressure, maintain an appropriate weight, and stay fit; her medical provider will want to ensure that she maintains her same health routine to reduce her risk of heart disease. There is also an educational opportunity for Michelle and her family with regards to the correlation between their shared history of hypertension and heart disease (“How High Blood Pressure Can Lead to Heart Failure,” 2017). Keeping their hypertension under control with medications, dietary changes, and a regular physical fitness routine can help reduce the risk of developing heart disease (“How High Blood Pressure Can Lead to Heart Failure,” 2017).

The second disease that runs in Michelle’s family is Alzheimer’s disease. Both of her grandmothers and her paternal aunt were diagnosed with the condition. The cause of Alzheimer’s has yet to be identified, but researchers believe that it is a combination of environmental factors, genetics, and lifestyle factors (“Alzheimer's Disease Fact Sheet,” 2016). It is hard to determine if Michelle or anyone else in her family will develop the disease later in life, but the fact that three members of her extended family were diagnosed with Alzheimer’s could mean that there is a higher risk of developing the disease later in life. Because there is so much about Alzheimer’s disease that are unknown, it is hard to identify specific risk factors that may make Michelle and her relatives susceptible to the condition. Research studies have shown a correlation between Alzheimer’s disease and other medical conditions such as diabetes, hypertension, obesity, heart disease and stroke (“Alzheimer's Disease Fact Sheet,” 2016). According to the National Institute of Health’s Alzheimer's Disease Fact Sheet, following a nutritionally balanced diet, being physically active and socially engaged can help to reduce the risk factors for developing Alzheimer’s (2016). 

Having a family history of Alzheimer’s is also an opportunity for educating Michelle and her family. Since Alzheimer’s disease runs in her family, Michelle and her relatives may want to consider entering clinical trials (such as the Nivolumab trial for the disease that can help identify the genetic risk factors for families. Additional information regarding the lifestyles of Michelle’s grandmothers and aunt may offer some insight as to why they developed Alzheimer’s disease, and identify possible commonalities that they shared, such as living in the same or similar environment; ingesting a certain type of food or beverage; or possible exposure to a particular chemical or element. The many unknowns regarding Alzheimer’s disease makes it a very difficult condition to pinpoint and successfully avert, but healthy lifestyle choices may be beneficial in lowering the risk of developing the disease.

References

“Alzheimer's Disease Fact Sheet.” (2016). NIH. Retrieved from: https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet#causes

“Calculate Your Body Mass Index.” (n.d.). NIH. Retrieved from: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm?source=quickfitnesssolutions

“How High Blood Pressure Can Lead to Heart Failure.” (2017). American Heart Association. Retrieved from: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/LearnHowHBPHarmsYourHealth/How-High-Blood-Pressure-Can-Lead-to-Heart-Failure_UCM_490534_Article.jsp#.WzCAtoWcGP8