The Family (Development Throughout the Life Cycle) (Nursing) Part 1

Learning Objectives

1.??? Identify universal characteristics of families.

2.??? Discuss the importance of parent-child and sibling relationships.

3.??? List the functions and tasks of families.

4.??? Describe various types of family structure.

5.??? Explain the influences of culture, ethnicity, and religion on the family.

6.??? Discuss the stages of the family life cycle and important milestones and tasks of these stages.

7.??? Identify common stressors on today?s family.

8.??? Differentiate between effective and ineffective family coping patterns.

IMPORTANT TERMINOLOGY
binuclear family	dysfunctional family	gay or lesbian family	single-adult household
cohabitation	extended family	nuclear dyad	single-parent family
communal family	family	nuclear family
commuter family	foster family	reconstituted family
dual-career/dual-worker family	functional family	siblings

The family has traditionally been a central focus of nursing. As the basic unit of society, the family profoundly influences its individual members. All nursing care should involve the family. When giving care, nurses must consider the particular needs, circumstances, goals, and priorities of each family and the members within it.

Key Concept Understanding concepts related to the family and its influence over individuals is essential for providing appropriate nursing care.

CHARACTERISTICS OF THE FAMILY

What is a family? This question may seem simple, but the answer constantly evolves, reflecting changes that occur within society. The names of the types of families may be different, too, depending on the reference. However, a family basically can be thought of as a group of two or more individuals who are related to each other by blood, marriage, or adoption and who usually live together. Historically, the meaning of family centers around childbearing and childrearing. These activities now encompass less than half of an adult?s life prior to old age. Changing birth rates, longer life expectancy, the evolving role of women, divorce, and alternative lifestyles and living arrangements have influenced modern society?s perceptions of family. A broader definition, which reflects societal changes of the 21st century, is that a family consists of two or more people who are joined together by bonds of sharing and emotional closeness, and who identify themselves as being part of that family.

Key Concept A client?s family includes any person that he or she identifies as a family member.

Although every family is unique, families share five universal characteristics:

1.??? A family is a small social system.

2.??? A family performs certain basic functions.

3.??? A family has structure.

4.??? A family has its own cultural values and rules.

5.??? A family moves through stages in its life cycle.

The Family as a Social System

The family is a living social system. Although it is a basic unit of society, it is also complex. The family is a group of individuals who are interdependent; the choices and actions of one family member often influence other family members. For example, when one family member is ill, the entire family is affected. In another example, when a mother returns to full-time outside employment after several years of staying at home to care for children, ramifications abound for all members of the immediate, and perhaps the extended, family.

The roles people play within a family may be many and varied. One major relationship played out in a family is that of the parent-child relationship. Another is the relationship between siblings.

Parenting

Parenting is the ability of one or more people to help a child meet his or her needs and to guide that young person through developmental tasks. Parenting styles differ in each family. Some families are strict in discipline, whereas others are lenient or even indifferent. A person?s own upbringing may guide his or her parenting style. Other parents learn their styles by watching role models or by following moral or religious teachings.

Parenting is an enormous responsibility and brings rewards and challenges. Although essential parental tasks include providing children with food, shelter, and safety, the ability to help children develop their own identity, self-confidence, and creativity is also of fundamental importance. You will often need to communicate to parents and other family caregivers the importance of encouraging their children and helping them to meet their needs. In Practice: Educating the Client 9-1 summarizes suggestions for helping families to build their children?s self-esteem and independence.

Key Concept The lack of adequate self esteem may play a role in the development of problems later in life, including chemical dependency eating disorders, and depression.

Siblings

Because of continued interaction over many years, siblings (brothers and sisters) exert powerful influences on one another. The sibling relationship is the first peer relationship that many people experience. It is long-standing, often lasting for six decades or more.

IN PRACTICE : EDUCATING THE CLIENT 9-1

WAYS TO PROMOTE CHILDREN?S SELF-ESTEEM AND INDEPENDENCE

???? Spend quality time with children, including playtime and instruction.

???? Communicate with children, using eye contact and listening attentively to their questions and responses.

???? Establish and maintain routines.

???? Encourage children in their endeavors, and express pleasure, enthusiasm, and interest over their achievements and activities.

???? Offer constructive criticism when necessary

???? Recognize the difference between normal incidents of misbehavior and continued patterns of behavioral problems.

???? Adapt expectations to children?s level of maturity and age group.

???? Give children room to make their own decisions, while providing supportive guidance.

???? Act as a role model for appropriate behaviors.

???? Use discipline with logic and consistency.

???? Apologize for mistakes, but never apologize for fair punishments.

???? Read to children.

???? Tell children that they are loved and special, and reinforce these words with actions.

Siblings can fulfill many roles for each other: protector, supporter, comforter, teacher, social planner, friend, and disciplinarian (Fig. 9-1). Although siblings share many experiences, each one has a different perspective on those experiences. Birth order often plays a large role in shaping the experiences of siblings. For example, the firstborn in a family usually recalls experiences differently than the youngest child. Many other factors, including the time between each child?s birth, are as influential on sibling relationships as birth position.

FIGURE 9-1 ? The sibling relationship is extremely influential. Siblings fulfill many roles for one another; including companion, teacher; and friend. They also like to compete in games and for the affection of their parents.

Family Functions and Tasks

The family is organized as a unit for the achievement of certain functions. Five basic family functions can be identified:

1.??? Providing for physical health

2.??? Providing for mental and spiritual health

3.??? Socializing members

4.??? Reproducing

5.??? Providing economic well-being

The reproductive function is obviously significant for society because it is necessary for maintaining human life on earth. Supporting individuals in their physical, emotional, economic, and social growth, however, is also vital to family and societal well-being.

The family performs many tasks that encompass these five functions and that are critical for survival and continuity. Notice how the essential family tasks relate to Maslow?s hierarchy of basic human needs discussed:

Provision for physical needs: Food, shelter, clothing, safety, healthcare

Allocation of resources: Careful planning and use of family money, material goods, space, and abilities Division of labor: Assigning the workload, including responsibility for household income and household management Socialization: Guiding toward acceptable standards of elimination, food intake, sexual drive, respect for others and their possessions, sense of spirituality Reproduction, recruitment, and release: Bearing or adopting children, adding new members by marriage, and allowing members to leave Maintenance of order: Providing interaction and communication opportunities, discipline, affection, sexual expression Assistance with fitting into the larger society: Community, school, spiritual center, organizations Maintenance of motivation and morale: Recognition, affection, encouragement, family loyalty, help in meeting crises, philosophy of life, spirituality

NCLEX Alert Clinical situations on an NCLEX could discuss a variety of family healthcare issues. You need to consider what issues are being disclosed. The correct option could relate to multiple concerns including preventative care, topics that need be taught to family members, cultural issues, or socioeconomic concerns. The correct response will be realistic and within the Nurse Practice Act of your license.

FAMILY STRUCTURE

Many different types of families exist in today?s society, which is more tolerant of change than past generations. When working with clients, nurses will encounter many of these variations. No type of family structure is inherently better than another. Rather, it is the quality of interactions among individuals that dictates the family?s ability to cope, adapt, and thrive. Although the family structures of clients may differ from the nurse?s own personal experience, understanding and appreciating various family forms is critical for providing nonjudgmental and informed nursing care.

Many adults live alone in apartments or houses with no children involved. This is called a single-adult household. This scenario is common for young adults before entering into other types of family structures, or for older individuals who have lost a partner through separation, divorce, or death. Some people also make a lifetime commitment not to marry or to have children. Many single adults have extensive networks of friends and relatives on whom they rely for support and social interaction.

Nuclear Families

The most familiar family form is the nuclear family: a two-generation unit consisting of a husband, wife, and their immediate children?biological, adopted, or both?living within one household (Fig. 9-2). While the traditional view of the nuclear family has the father working outside the home and the mother staying home to take care of the children and household, the reality in American society is often different. Very often both parents work outside the home, or the father may be the parent who stays home with the children.

Outside employment for both partners in a family may necessitate careful structuring of household tasks. Nuclear families in which both parents work outside the home are referred to as dual-career or dual-worker families. Childcare arrangements often become a major issue for working parents. Couples with children may work different shifts or may stagger their work hours so that one parent is at home at all times to care for children. A common option for the dualworking family is to use daycare services.

A married couple that lives together without children is a nuclear dyad. Couples with no children, or couples with children who reside elsewhere, are examples of nuclear dyads.

In the commuter family, both adults are usually professionals. Often one has been transferred to another city, but the other prefers to remain with the present employment. Partners must commute a long distance, usually on weekends, to be together.

FIGURE 9-2 ? The nuclear family consists of a married couple with one or more children, living together in one household.

Extended Families

The extended family consists of the nuclear family and other related people, such as grandparents, aunts, uncles, and cousins. These family members may live together in one house, or in close proximity to one another. This type of family is also called a kin network or a three-generation family. Various members may share babysitting and disciplining of children. Members of the extended family may also influence parental decisions regarding childrearing.

The family in which grandparents assume responsibility for raising children is becoming increasingly common for a number of reasons. An adolescent parent who is in school or work during the day may need the help of a parent. Some parents are unable to care for their children because of divorce, drug abuse, mental illness, or imprisonment. Although family involvement is an asset, older grandparents may have difficulties meeting basic needs for the family because of financial difficulties or illness.

Single-Parent Families

The single-parent family involves an adult head of the house with dependent children. The adult may be single as a result of separation, divorce, death, or never being married. Divorce and births to unmarried women have contributed to the continual shifts from the two-parent family to the singleparent family.

Binuclear and Reconstituted Families

Divorce has contributed greatly to changes in common family situations. A binuclear family is one in which a separation or divorce of the adult partners occurs, but both parents continue to assume a high level of childrearing responsibilities. Joint custody arrangements are especially useful for binu-clear families in which separated parents continue to live in close proximity to one another. Other custodial arrangements following a separation or divorce may require children to alternate households regularly or to live with a noncustodial parent on weekends or over summer vacations. Adults who live without their children for extended periods often find that continually resuming and letting go of their hands-on parental role is especially challenging.

Many divorced adults remarry. If the newly married man and woman both have custody of their children from previous relationships, the two sets of children are placed together at a later stage in their lives, rather than being born into the situation. Such families are called blended or reconstituted families. These families may also include infants born into such an arrangement.

Alternative Families

The term cohabitation refers to unmarried individuals in a committed partnership living together, with or without children. People may live in cohabitation arrangements before, in between, or as an alternative to marriage.

Intimate partners of the same sex may live together or own property together. In this gay or lesbian family, one of the partners may have children from a previous relationship, or the couple may adopt children together. Artificial insemination is an option for lesbian couples who wish to bear and raise children.

In a communal family, several people live together. They often strive to be self-sufficient and minimize contact with the outside society. Members share financial resources, work, and childcare responsibilities.

In a foster family, children live in temporary arrangements with paid caregivers. Theoretically, these children are meant to return to their family of origin when conditions permit, or otherwise to be placed for adoption. In some cases, the children remain in the foster home until adulthood.

INFLUENCE OF CULTURE, ETHNICITY, AND RELIGION

Families develop an internal culture. Members use their accumulated knowledge to interpret experiences and to define acceptable behaviors and actions. The actions of one family member may have significant effects on the family structure.

Each culture or ethnic group sets standards for its members and people in general tend to live in communities of like-minded people or people of similar ethnic background. This network gives its members support and helps them maintain their ethnic ideals. Families may move outside the ethnic community by geographic relocation, or younger members may move to attend a school or college. As these changes occur, some individuals? ethnic ideals may evolve.

Traditionally, families married within their own ethnic, racial, or religious groups. Today, families with partners from different ethnic groups and racial heritages are common. A family may represent two very different religious or spiritual groups. Each person brings into the family cultural factors reflecting his or her background. Adjustments must be made to acknowledge and accept each other?s differences. Box 9-1 lists various examples of cultural factors related to family.

Source: http://what-when-how.com/nursing/the-family-development-throughout-the-life-cycle-nursing-part-1/

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