SAN BEDA COLLEGE OF MEDICINE Batch 2011

Topic: Family’s Influence on Health

FCM 1
Family Life Cycle
Lecturer: Dr. Mek Solana Nov. 26, 2007

Objectives for this Session

 Learn the effect of families and their
complex relationships to health FAMILY LIFE CYCLE
 Discuss the family life cycle and why we  Provides chronologically oriented sequence
need to study it of events in family life
 Determine the two levels of orders of  View of the stressful changes in the family
magnitude of change  Events in the FLC can be related to clinical
 Learn the stages of the family life cycle, the events and to health maintenance in the
key principles and conflicts in each stages family
 Provide view in terms of intergenerational
Research on Families and Health connectedness in the family
 The family is the primary social context in  Clinicians can view family problems and
which health care issues are addressed strengths
 Most health beliefs and behaviors are  Views symptoms and dysfuntions in relation
developed and maintained within the family to normal functioning over time
 Family members provide most of the health
care for patients  The individual life cycle takes place within
 Family support affects the outcome of most the family life cycle, which is the primary
chronic medical illnesses context of human development. As such, it
is crucial in understanding the emotional
Ex. 3x mortality rate for MI patients with few problems that people develop as they move
or no family support together through life
 Family stress is greatest at transition
 Emotional support is the most important points from one stage to another of the
and influential type of family support family developmental process
 3 types of family support: Instrumental,
Informational and Emotional The Family is a System Moving Through Time
 Families incorporate new members only by
1. Instrumental Support - actual provision of birth, adoption, or marriage, and members
services or care giving by family members can leave only by death
2. Informational Support - involves giving health  Main value in families is in the relationship,
related information and advice which are irreplaceable
3. Emotional Support - provides empathy, love
and care
2 Levels of Orders of Magnitude Change
 Marriage is the most influential family First Order Change
relationship on health o Involve adaptation
o Do not involve change in the main
Married> widowed> divorced/single structure of the family
 Negative, critical or hostile family o Do not involve a change in an
relationships have a stronger influence on individual’s identity and family
health than positive relationships o a “NEED TO DO” something new
 Family psychoeducation is an effective o -Tasks that must be accomplished
intervention for health problems by the family and its members
working within a stage in the FLC
Family Influence Second Order Change
 Genetic Influence o Involve transformation of an
 Family is crucial in child development individual’s status or meaning
 Infectious disease spreads in the family o a “NEED TO BE” something new
 Family factors affect morbidity and mortality o Change in the role and identity of
in adults family members
 Family support is important in recovery from o Change in the very basic attributes
illness of the family system
o Occur between stages in the FLC

1
 SOLANA-VILLAFUERTE FAMILY
I
David Tess
Gracian Remedio
58 55
o s

STAGES OF FAMILY LIFE CYCLE

Amy George Lydia Imelda Elizabet Grace Reggie Jha Bhen
h
31 y 20
Victoria Nene Hearty Mandy22
Julie Mien
Leaving Home: The Unattached 28 28

Young Adult 4 4 6 Lester

Michael

 “Between families” Heart disease

Chai
3

 Start of the family life cycle Diabetes Justin

39
Mek
33
Nanay
Asthma Puring

 Primary task: coming to terms with their Junilyn

Thea
58

HPN 28
2 mos
family of origin Stroke Nov. 25, 2007
 Issues on separation from parents/ family of
origin
 Formulation of personal goals
 Need for self-differentiation
 Alcoholism, smoking, STD’s, unwanted
pregnancies

Newly Married Couple

 The joining of families Family with Adolescents
 Key principle: Commitment to the new  Key principle: increasing flexibility of
subsystem boundaries to includ children independence
 Formation of the marital system  Identity crisis
 Realignment of relationships with extended  Re-focus on midlife, marital and career
families and friends to include the spouse issues
 Establishing home base  Beginning shift towards concern for the
 Money matters older generation
 Demands on new role
 Establishing a satisfying sexual relationship Launching Family
 Interaction with friends and associates in  Begins when the first child leaves home
the community  Longest stage, most problematic of all
 Facing the possibility of children and phases
planning for their coming  Key Principle: accepting a multitude of
entries and exits into the family system
Family with Young Children  Adjustment to new family members
 Pregnancy for the first child to emergence of  Dealing with illness or death of
adolescents parents/grandparents
 Stage when child starts to go to school  Career stagnation vs financial liberation
 Becoming parents  Extramarital affairs vs a restructured marital
 Key principle: Accepting marital system to relationship
make space for children
 Taking on parenting role
 Key principle: Realignment of relationship
with extended family to include parenting &
grand parenting roles
 FLC phase that has the highest rate of
divorce

2
  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

 Women most prone to symptom

S O L A N-VAIL L A F U E
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

I
relationships

G ra c ia n o R e m e d io s

The Family in Later Life

II
 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
M a ngenerational
d in g goals
Am y G e o rg e L y d ia I m e ld a E liza b e th G ra c
SOLANA-VILLAFUERTE FAMILY
I V ic to ria N ene
Gracian
o
82
Remedio
s
65
David
58
Tess
55 J u lie M ie n
II Flow of Anxiety in a Family
Mandin
g
Amy George Lydia Imelda Elizabet Grace Reggie Jha Bhen SYSTEM LEVELS Vertical Stressors
h

III 4 4
31 y 20
Family patterns, myths, legacies
Victoria
- Social, cultural,

6
Nene Julie Mien Hearty Mandy22

M ic h a e
28 28

III 4 4 6 Michael political, economic

Lester

Chai
- Community, work,
Heart disease friends
L e s te r
3

Diabetes Justin
39
Mek
33 - Extended family
Asthma
Junilyn Thea - Nuclear family
HPN 28
- Individual
2 mos

Stroke Nov. 25, 2007

The Changing Family Life Cycle

H e a r t d ise a se Horizontal Stressors
DEVELOPMENTAL- Life cycle transitions
UNPREDICTABLE- Untimely death, chronic illness,

D ia b e t e s
 Due to lower birth rate
accident
 Longer life span/ expectancy
 Changing role of women 2 Types of Stressors J u s tin M
 Increasing divorce and remarriage rate 1. Vertical Stressors – trans generational stressors

A sthm a 3 9 of 3
transmitted down each generation, patterns
relating interactions, attributes, norms, taboos
within family
Role of Women in the FLC J u n ilyn Issue: How each family deals with those
 Central to the functioning of the family factors,taboos etc. T hea
function as wife and motherH PN
 Identities determined primarily by their
28
2 m os
3

S tro ke
2. Horizontal Stressors – come with each cycle
change

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. p3-28.

Transcribers: Ryan S. Marcelo

Yrenne James H. Teodosio, PTRP