L02 - Lifespan changes and families

L02 - Lifespan changes and families

1. Family/Household and Family Function

   • What is a family?
     • Married or co-habiting adults, couple or a single adult
       • With or without children
       • Includes childless couples
       • Includes lone parent
     • Grandparents with grandchildren (no parents)
     • A functional, economic unit of people, where the adults are responsible for the upbringing of the children
     • Family Types
       • Lone parent
       • Nuclear Traditional
       • Nuclear adopted
       • Nuclear same sex
       • Extended
       • Reconstituted/blended (children from several marriages)
   • What is a household?
     • Group of people sharing accommodation
     • Not the same as family
     • Spatial and temporal relations
     • Different interactions between householders and families
   • Changing family structure
     • More people cohabiting
     • More lone parents
     • Women having children at older age
     • Decreased divorces
     • More people living alone
       • Isolation
       • Mental health
     • Fewer households have children
     • Households have fewer children
     • More likely to live alone in old age - when they need help the most
   • Family function
     • Facilitates procreation of children
     • Provides social control and socialisation of children
     • Dictates the social placement of children and adults
     • Physically looks after its members
   • Feminist perspective
     • Family as a source of exploitation/inequality
       • Domestic division of labour
       • Unequal power relationships

2. Families and Health

   • Family's role in health
     • Transmission of health risks (inherited disease)
     • Healthy/Unhealthy behaviour
     • Attitudes
       • To health and illness
       • To HC professionals
       • HC-seeking behaviour
     • Body Image
     • Diagnosis of symptoms
     • Management of symptoms
     • Effect of illness on family functioning
     • Provision of HC
   • When does the family become relevant to a doctor?
     • Family fails in its patient care function
     • Family member has a physical or psychological breakdown
     • Non-compliance and friction between the patient, family and doctor that interfere with case management

3. Family Lifecycle

4. Family Reactions to Illness

   • Sudden Illness
     • Daily pattern of family life disturbed
       • Families tend to pull together and become more cohesive and integrated
         • Ill person recovers
           • Family returns to normal
         • Illness becomes chronic
           • Family remains tightly bound
             • Family life organised around illness
             • Illness ignored as far as possible
             • Family avoids involvement with community to avoid confrontation with the effect of the handicap
           • Family pulls apart
             • One parent can't stand the strain - martial disruption - divorce
             • Attention devoted to ill person
               • Rest of family neglected
                 • Social deviance
             • Exclude ill person from family - family returns to normal
   • Family dysfunction and HC implications
     • Centripetal family
       • External world perceived as threat
         • Causes dusruption
       • Gratification from within the family
       • Negative or hostile feelings are hidden/denied
       • Distrust medical advice
       • Outlook may be amplified by illness
       • Autonomy at risk
       • Illness offers excuse
     • Centrifugal family
       • Gratification outside the family
       • Distance between members - little communication
       • Members comfortable for negative/hostile feelings
       • Members uncomfortable with warmth/caring
       • May not offer patient the support they need
       • Lack of understanding by family members
       • Resentment towards ill family member

5. Families and Informal Carers

   • Tasks carried out by carers
     • Cooking, shopping, ensuring appointments are kept
     • Dealing with medical staff, organising transport
     • Managing medicines
     • Managing money
     • Managing housing/DSS
     • Lifting/motility aid
     • Verbal, physical and mental abuse
   • Effects on health of carers
     • Stress/nervous tension
     • Depression
     • Anxiety
     • Back Injury
     • High BP
   • Young Carers
     • Long terms psychological effects
       • Social isolation
       • Difficulty acting as a child
     • Mental health problems

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