SESSION 5:FAMILY CRISIS AND DISRUPTION

MDOC1513
 Overview

• Composition of families/family structure.

• Family Stress.

• Family Disorganization.

• Relationship between marriage, family and disease.

• Impact of disease on the family.

• Factors to consider as a doctor regarding family experience.

 Composition of families (types of family structure)

• Nuclear family : two generations (husband + wife + children). Ideal typical family structure.

• Extended family: three generations (grandparents + parents + children). Common in more

traditional and poorer societies.
 Family Stress and Family Crises

• Family stress: state of tension that arises when demands test, or tax, a family’ capabilities.

• Family crises: situation in which the usual behaviour patterns are ineffective and new ones are
called for immediately.
 Family Stress and Family Crises cont’d

• Addition of a family member: through birth, adoption, marriage, remarriage or cohabitation-

shifting of borders.

• Loss of a family member: through death-loss of role.

• Ambiguous loss: through divorce, disappear or alcoholism-unsure of how to act.

• Sudden, unexpected change: income/social status/economic recession.

• Ongoing family conflict: underlying conflict not resolved-children.

 Family Stress and Family Crises cont’d

• Care for the disabled or ill family member: medical technology-more person surviving-HIV/AIDS.

• Demoralizing events: loss of family morale, loss of status (linked to behaviour that transgresses
norms), bankrupt, prison, unmarried parenthood.

• Daily Family Hassles: daily life (working parents, economic pressure, violence, types of families).
 Family Stress and Family Crises cont’d

• Crises could be one major stressful event or stressor “pile up”.

• Stressor overload creep up on people without realizing it.

• Vulnerable families/resilient families.

 Family Stress and Family Crises cont’d
Period of disorganization
• Declines from initial level

• Roles – habits – become confused/not so clear

• Less enthusiastic

• May even come to a standstill

• Expressive relationships change

• Relationships with outside members affected

• Nadir (rock bottom) – the way forward

• Members cope with “anger” caused by crisis

 Relationship between marriage, family and disease

• Family relationships influence the

• Development of certain diseases (i.e. substance dependency, mental illness).
• The course of disease (resources available, coping mechanisms).
• The outcome of disease.

• Family is the main caretaker of chronic patients

• Physical disabilities.
• Chronic diseases.
• Mental health problems.

• Diagnosis of a serious illness or disease in the family

• Described as arriving ‘unprepared in an alien country’
 Impact of disease on the family

Lifestyle
constraints

Psychological Financial
impact implications

Impact

Family Future
prospects of the
relationships family
 Relationship between marriage, family and disease : what you should know as a doctor about the
family’s experience
•Psychological impact
• Guilt, disbelief, shock
• Becoming engulfed by this ‘monster’ and there is no way out
• “I don’t want this, we do not deserve this…”

• Psychological impacts:
• Family members feel:
• Vulnerable
• Scared
• Confused
• Exhausted
• Helpless
 Relationship between marriage, family and disease : what you should know as a doctor about the
family’s experience cont’d
• Family relationships:
• Roles have to be renegotiated
• Often “unwritten rules” to cope
• “Just get by”
• “take it one day at a time”
• “don’t rock the boat”
• “disappear”

• Financial constraints
• Financial support is a constant struggle.
• One or more family members sacrifices time to take care of sick family member – family
responsibility leave; unpaid leave; job loss.
• Medical aid becomes depleted.
 Relationship between marriage, family and disease : what you should know as a doctor about the
family’s experience cont’d

• Future prospects
• Familyrelationships may deteriorate and family may disintegrate.
• Expectations for future education in the face of financial constraints.
• Expectations for a ‘normal’ development trajectory become unrealistic.

• Lifestyleconstraints
• Participating in everyday events become a challenge to negotiate
• Transport
• Accessibility
• Finances
 Relationship between marriage, family and disease : what you should know as a
doctor about the family’s experience cont’d

• Negotiating the medical environment is extremely stressful for patients and their families
• Multiple visits to medical practitioners.
• Translating medical jargon.
• Waiting for consultations.

• Constantly being disappointed by prospects for recovery

• Breaking bad news to family members.
• Empathy and sympathy.
• Honesty.
THE END!!!!