The home health nurse was unable to access the family unit as a whole. The family assessment should have included consideration of education levels, health issues, family demographics, and psychosocial issues (T. O'Hara, personal communication, August 2015). The nurse simply thought that Mrs. H was able to help her with the wound. Although her diabetes and ill appearance were noted, the home health nurse failed to access whether Mrs. H's health problems prevented her from providing adequate care to her husband. Additionally, the nurse never observed Mrs. H performing Mr. H's wound and did not know that she was performing wound care correctly. Mr. and Mrs. H also have a mentally handicapped son and there is no mention of his level of functioning and how much care he requires. Perhaps Mr. H was so consumed with his son's needs that he failed to understand that he, too, needed help. It is this writer's belief that both the nurse and the family doctor saw the dysfunction of the H family and did not investigate why they were dysfunctional. Although the family has shown signs of dysfunction discussed in the conference, such as noncompliance and resistance to making necessary changes, nothing is done to help the family overcome any obstacles to Mr. H receiving the care he needs (T. O 'Hara, personal communication, August 2015). Furthermore, the nurse did not provide any teaching to Ms. H, who Mr. H had appointed as a caregiver, nor did she have access to her ability to perform the necessary wound care. The nurse also had access to roles within the family. Diet is an important factor in maintaining Mr. H's health, but the nurse failed to find out who was responsible for preparing the food and shopping for it. For example, teaching Mr. H about nutrition isn't very effective if he doesn't do the preparation