The Family Life Cycle

MEK VILLAFUERTE-SOLANA, MD SAN BEDA COLLEGE OF MEDICINE FCH 1 SEPT 8, 2009

Objectives for this Session

Learn the effect of families and their complex relationships to health Discuss the family life cycle and why we need to study it Determine the two levels of orders of magnitude of change Learn the stages of the family life cycle, the key principles and conflicts in each stages

Research on Families and Health

The family is the primary social context in which health care issues are addressed Most health beliefs and behaviors are developed and maintained within the family Family members provide most of the health care for patients

Research on Families and Health

Family support affects the outcome of most chronic medical illnesses Ex. 3x mortality rate for MI patients with few or no family support Emotional support is the most important and influential type of family support

Familys Influence on Health

Genetic Influence Family crucial in child development Infectious disease spreads in the family Family factors affect morbidity and mortality in adults Family is important in recovery from illness

Families go through different stages for which specific developmental tasks must be accomplished.

Families who are not able to accomplish these tasks may develop difficulties with subsequent family development.

FAMILY LIFE CYCLE

Provides chronologically oriented sequence of events in family life View of the stressful changes in the family Events in the FLC can be related to clinical events and to health maintenance in the family

FAMILY LIFE CYCLE

The individual life cycle takes place within the family life cycle, which is the primary context of human development Family stress is greatest at transition points from one stage to another of the family developmental process

The FAMILY as a SYSTEM moving through time:

Boundaries will shift Psychological distance among members may

change Roles within and between subsytems may be redefined

Norris

& Tindale 1994 Cicirelli, 1995

The Family is a System Moving Through Time

Families incorporate new members only

by birth, adoption, or marriage, and members can leave only by death Main value in families is in the relationship, which are irreplaceable

Flow of Anxiety in a Family

SYSTEM LEVELS
1. 2. 3. Social, cultural, political, economic Community, work, friends Extended family

Vertical Stressors Family patterns, myths, legacies

4.
5.

Nuclear family
Individual

Horizontal Stressors 1. DEVELOPMENTAL- Life cycle transitions 2. UNPREDICTABLE- Untimely death, chronic illness, accident

2 Levels of Orders of Magnitude Change

First Order Change - Involve adaptation - Do not involve change in the main structure of the family - Do not involve a change in an individuals identity and family - A NEED TO DO something new -Tasks that must be accomplished by the family and its members working within a stage in the FLC

2 Levels of Orders of Magnitude Change

Second Order Change - Involve transformation of an individuals status or meaning - a NEED TO BE something new - Change in the role and identity of family members - Change in the very basic attributes of the family system - Occur between stages in the FLC

Stages of the Family Life Cycle Unattached Young Adult Newly Married Couple Family with Young Children Family with Adolescents Launching Family Family in Later Years

Leaving Home: The Unattached Young Adult

Start of the family life cycle Primary task: coming to terms

with their family of origin Issues on separation from parents/ family of origin Formulation of personal goals Need for self-differentiation Alcoholism, smoking, STDs, unwanted pregnancies

Unattached Young Adult

Differentiation of self in relation to

family of origin Development of intimate peer relationships Establishment of self in respect to work and financial independence

Newly Married Couple

The joining of families

Key principle: Commitment to the new

subsystem Formation of the marital system Realignment of relationships with extended families and friends to include the spouse Establishing home base Money matters Demands on new role

Newly Married Couple

Establishing a satisfying

sexual relationship Interaction with friends and associates in the community Facing the possibility of children and planning for their coming

Newly Married Couple

Marital adjustment

Family planning and

fertility management
Family planning
Pregnancy and pre-

natal care Labor and delivery Post partum care

The quality of a marriage has a particularly strong influence on over all health.

Family with Young Children

Pregnancy for the first child to

emergence of adolescents Stage when child starts to go to school Becoming parents Key principle: Accepting marital system to make space for children

Family with Young Children

Taking on parenting role
Key principle: Realignment

of relationship with extended family to include parenting and grand parenting roles FLC phase that has the highest rate of divorce

Family with young children

Child care Parenting and child

rearing Discipline

SOLANA-VILLAFUERTE FAMILY
I
Graciano 82 Remedios 65 David 58 Tess 55

II
Manding Amy Nene George Lydia Imelda Elizabeth Grace Reggie Jhay Hearty 28 Mandy 28 Bhen

Victoria

31
Julie Mien

22

20

III 4

Michael Lester Chai

Heart disease Diabetes Asthma HPN Stroke P Provider C Caregiver

Junilyn 28

P
Justin 39 Thea 2 mos

P
Mek 33 Nanay Puring 58

Nov. 25, 2007

Family with Adolescents

Key principle: increasing

flexibility of boundaries to include children independence Identity crisis Re-focus on midlife, marital and career issues Beginning shift towards concern for the older generation

Family with Adolescents

Adolescent care Adolescence
Identity Autonomy sexuality

Injury prevention
STD Teen age pregnancy Drug use and abuse

Midlife
Art of negotiation

Launching Family
Begins when the first child leaves home Longest stage, most problematic of all phases Key Principle: accepting a multitude of entries and

exits into the family system Adjustment to new family members Dealing with illness or death of parents/grandparents Career stagnation vs financial liberation Extramarital affairs vs a restructured marital relationship

Launching Family
Physiologic decline

Letting go

Diseases of

middle age

Midlife crisis

Launching Children and Moving on

Development of adult to adult

relationships between parents and their grown children re-alignment of relationships to include inlaws and grandchildren Dealing with disabilities and deaths of parents

SOLANA-VILLAFUERTE FAMILY
I
Graciano Remedios David 58 Tess 55

II
Manding Amy Nene George Lydia Imelda Elizabeth Grace Reggie Jhay Hearty 28 Mandy 28 Bhen

Victoria

31
Julie Mien

22

20

III

Michael Lester Chai 3 Justin 39 Junilyn Thea 2 mos Mek 33

Heart disease Diabetes Asthma HPN Stroke

28

Nanay Puring 58

Nov. 25, 2007

The Family in Later Life

Begins with departure of last child

and continues through retirement and death Old age and disease Financial/ retirement adjustments Death of spouse Empty nest syndrome Key process: accepting the shifting of generational goals

SOLANA-VILLAFUERTE FAMILY
I
Graciano 82 Remedios 65 David 58 Tess 55

II
Manding Amy Nene George Lydia Imelda Elizabeth Grace Reggie Jhay Hearty 28 Mandy 28 Bhen

Victoria

31
Julie Mien

22

20

III

Michael Lester Chai 3 Justin 39 Junilyn Thea 2 mos Mek 33

Heart disease Diabetes Asthma HPN Stroke

28

Nov. 25, 2007

The Changing Family Life Cycle

Due to lower birth rate

Longer life span/ expectancy

Changing role of women

Increasing divorce and remarriage rate

Role of Women in the FLC

Central to the functioning of the family Identities determined primarily by their

function as wife and mother Life cycle phases linked almost exclusively to child rearing activities A woman who choose a primary role as mother and homemaker will have to face an empty nest phase later on in life

Role of Women in the FLC

Women most prone to symptom

development at life cycle transitions The goals of career and family present severe dilemma Likely to be depressed at childbirth Seek help during the child-rearing years Responsible for older relatives Bear emotional responsibility for all family relationships

References: Isabelita Samanego, MD. Proceedings of the Orientation Course in Family Medicine. PAFP, Inc. Carter, B. and McGoldrick, M. The Changing Family Life Cycle, A Framework for Family Therapy, 2nd ed. 1989. p328.