The Family Life Cycle

Dr. Karl Darryl R. Tamparia

Objectives:
General Objective:
• To discuss THE FAMILY LIFE CYCLE
Specific objectives:
• Review the meaning of family
• Meaning and importance of Family Life Cycle
• Identify the 2 levels of changes in the family
• Identify different stages of the Family Life Cycle
• Factors that can affect the family
Family Life Cycle
Set of predictable steps or pattern and
developmental tasks
It includes emotional
– Emotional
– Psychosocial
– Physical changes
Family Life Cycle
• The family life cycle is a very important concept essential in
thoroughly understanding the health and illness responses of
patients and their families
• It delineates various developmental stages
• The family projects various identities and roles and fulfilment
• It is a process that involves transition, extensions and overlaps
Family Life Cycle
• Nine-stage cycle
• Eight-stage cycle
• Five-stage cycle
• Six-stage cycle
Family Life Cycle UNATTACHED
YOUNG
ADULT

FAMILY IN NEWLY
LATER YEARS MARRIED
COUPLE

LAUNCHING FAMILY WITH

FAMILY YOUNG
CHILDER

FAMILY WITH
ADOLESCENT
Family Life Cycle
Why do we study family life cycle?
• Provides a predictable, chronologically oriented sequence of events in
family life
• Involves a sequence of stressful CHANGE that requires compensating
or reciprocal readjustment by the family if it is to maintain viability
• Events can be related to clinical events and to health maintenance of
the family.
Two Levels Of Orders Of Magnitude Of Change
First Order Second Order
• Involves increments of mastery and • Involves transformation of an individual’s
status and meaning
adaptations
• “NEED TO BE”
• “NEED TO DO” • Change in the very basic attributes of the
• Don't involve change in the main structure family
of the family • Change in the role and identity of family
members
• Don't involve change in individual identity
• Occurs BETWEEN stages of FAMILY LIFE
and self-image CYCLE
• Task the must be accomplish • Intergeneration connectedness
Family Life Cycle UNATTACHED
YOUNG
ADULT

FAMILY IN NEWLY
LATER YEARS MARRIED
COUPLE

LAUNCHING FAMILY WITH

FAMILY YOUNG
CHILDER

FAMILY WITH
ADOLESCENT
Unattached Young Adults
• The start of the family cycle
• Age 20 - 45
• Short or long
• Straight or tumultuous
• Create self identity
• Healthiest season
• Peak performance
• Intimacy VS. Isolation
• Finding life long partner
• Stable and continuous life structure
• Work and job identity
• Increasing numbers are prolonged at this stage
Unattached Young Adults
Characteristics: Practice milieu
• Poor doctor seeking • Must be seen at least 1 times a year
• Office based support - improved
• Prone to misleading quality of care
information • Good role model
• Feels confident and invincible • Reachable
• Blinded with their dream • Personal-relationship based
• Looks up to a role model practice
Unattached Young Adults - PROACTIVE approach
Biomedical
• Regular Check-Up
– Annual
• Baseline work-ups
– CBC, X-ray, urinalysis, HBsAg
• Immunization
– HepB, MMR, TAT, HPV, Pneumococcal,
flu, meningococcal, travel vaccine
(malaria, typhoid and cholera)
Sexual and Reproductive Health
• Risk and consequence of STDs
Lifestyle Health
• Food fetish and extreme diet
• Obesity VS. Under-nutrition
• Sleep
• Exercise
• physical activities
Psycho-social-spiritual intervention - life-coaching
• Transition to independent living
• Marriage
• Identity and self-esteem
 Unattached Young Adults
Emotional process of First order changes Second order changes Problems Encountered
transition: KEY PRINCIPLE Medical:
•Extend social contact •Differentiation of the 1. Episodic problems
Accepting parent and outside of home self in relation to the 2. Sexually transmitted
offspring separation includes dating, clubs family of origin disease
and recreation 3. Unwanted pregnancy
•Development of
4. Early mortality
•Job employment intimate peer Emotional
•Living accommodation relationships 1. Psychosomatic problems
•Establishment of self 2. Depression
3. Anxieties
in work
4. Mentral disorders
Social
1. Peer group pressure
2. Fiancee pressure
Family Life Cycle UNATTACHED
YOUNG
ADULT

FAMILY IN NEWLY
LATER YEARS MARRIED
COUPLE

LAUNCHING FAMILY WITH

FAMILY YOUNG
CHILDER

FAMILY WITH
ADOLESCENT
Newly Married Couple
• The joining of families through
marriage
• Transition stage as an individual to a
couple
• Married and unmarried life effect to
Health
Practice Milieu
• Prefers morning consult
• Modern equipment
• Privacy - chance to talk and ask
Stages of Marriage
Stages Emotional Issues Stage Critical Tasks

HONEYMOON STAGE Commitment to marriage a) Differentiation from family

(0-2 years) origin
b) Making room for spouse
with family and friends
c) Adjusting career demands

EARLY MARRIAGE Maturing of relationship a) Keeping romance in the

STAGE marriage
( 2 – 10 years) b) Balancing separateness and
togetherness
c) Renewing marriage
commitment
 Stages of Marriage
Stages Emotional Issues Stage Critical Tasks

MIDDLE MARRIAGE Post care review a) Adjusting to mid life changes

STAGE b) Renegotiating relationship
( 10 - 25 year) c) Renewing marriage
commitment

LONG TERM MARRIAGE Farewell and planning a) Maintaining couple

STAGE functioning
( 25 years and more) b) Closing and adapting family
home
c) Coping with death of spouse
Newly Married Couple- PROACTIVE approach
Biomedical Psycho-social-spiritual
• Baseline work-ups • Communication
– Fecalysis, urinalysis • Finances
– AIDS test, HBsAg, Complete STD work-up • Intimacy
– hereditary disease • Family planning and parenting
– ABO RH typing • Fidelity
– Baseline fertility test • Roles
• Screening for lifestyle related diseases
• Family planning
• Gyne problems
• Physical barriers to sexual fulfilment
 Newly Married Couple
Emotional process of First order changes
transition: KEY PRINCIPLE •Establishing a home base
•Establishment of:
Commitment of the new 1. Mutually satisfying system
system 2. Acceptable patterns
3. Mutually satisfying sexual
relationship
4. Intellectual and emotional
communication
5. Workable relationship
with relatives
6. Ways to interacting with
friends and community
7. Facing possible children
and planning for their
coming
Second order changes Problems Encountered
Medical:
•Formation of marital 1. Episodic problems
system 2. Early pregnancy
•Realignment of 3. Sexually transmitted disease
4. Job-related physical
relationship with examination
extended families and 5. Gynecologic problems
6. Infertility
friends to include
Emotional and Social:
spouse 1. Depression
2. Jealousy
3. Problems to new role as a
spouse, in-laws, peers,
friends and money
4. Demand of new role
5. Office and work
Family Life Cycle UNATTACHED
YOUNG
ADULT

FAMILY IN NEWLY
LATER YEARS MARRIED
COUPLE

LAUNCHING FAMILY WITH

FAMILY YOUNG
CHILDER

FAMILY WITH
ADOLESCENT
Family With Young Children
• Starts with pregnancy for the first child to
emergence of adolescents
• First significant contact with people outside
the family
• Conflict with practices in home and school
regulations
• Dynamic and difficult stage
• It is the foundation of physical, mental,
and spiritual development
Practice Milieu
• Must invite all family members
Family with Young Children - PROACTIVE approach
Biomedical Psycho-social-spiritual
• Immunization • Insight about parenting and child
• Safety development
• Lifestyle health • Nurturing and attachment
– Good play
• Parental resilience
– Regulate gadgets • Social connectedness
– Motivate physical activities • Concrete support in times of need
– Breast feeding and healthy meals Emotional health
• Dental health Personality and gender development
• Mental and developmental health Bonds and relationship
– Mental disabilities
 Family With Young Children
First order changes
• Supplying adequate space
facilities and equipment
• Meeting predictable and
unexpected cost of family life
• Sharing responsibilities
• Maintaining mutually
satisfactory sexual relationship
and planning for future children
• Creating and maintaining
effective communication
• Cultivating the full potential of
relation with relatives
• Tapping resources, serving
needs and enjoying contracts
outside the family
• Facing dilemmas and reworking
phisophies
Second order changes Problems Encountered
• Accepting marital Parents
Medical
system to make space 1. Episodic medical problems
for children 2. OB-Gyne problems
• Taking on parenting 3. Family planning
4. Annual PE in the job
role 5. Sexually transmitted disease
• Realignment of Emotional and Social:
1. Peer pressure
relationship with 2. Sexual inadequacy
extended family 3. Spouse abuse
4. Problems rearing a child
5. Communication problems
6. In-laws problems
7. Taking care of the sick and
old parents or in-laws
8. Financial difficulties
Problems Encountered
Children
Medical:
1. Episodic problems
2. Accidents
3. Mental retardation
4. Congenital defects
5. Poisoning
Emotional and social:
1. Learning deficiencies
2. Child abuse and neglect
Grandparents:
Medical:
1. episodic problems
2. Degenerative disease
3. Chronic debilitating diseases
Emotional and Social
1. Psychosomatic problems
Family Life Cycle UNATTACHED
YOUNG
ADULT

FAMILY IN NEWLY
LATER YEARS MARRIED
COUPLE

LAUNCHING FAMILY WITH

FAMILY YOUNG
CHILDER

FAMILY WITH
ADOLESCENT
Family With Adolescent
• Parents are approaching middle life stage and
grandparents in the later stage
• Identity VS. Role Confusion
– For adolescent
– Identity crisis
• Generativity VS. Stagnation
– For parents
• Emancipation to family of origin
• The transition of dependent childhood to
independent adult
• Time of great physical, intellectual, emotional,
and sexual
• SANDWICH GENERATION - the parents
 Family With Adolescent
Emotional process of
transition: KEY PRINCIPLE
Increasing flexibility of
boundaries to include children
independence
First order changes Second order changes
•Providing facilities for widely • Permit the adolescent to permit
different needs the adolescent to move in and out
•Working out money matters in the of the system
family • Refocus on mid-life, marital and
career issues
•Sharing the tasks of responsibilities • Beginning shift towards concern
of family living for the older generation
•Putting marriage relationship into
focus
 Family With adolescent
Problems Encountered
Adolescent
Medical:
1. Drugs and other substance abuse
disorder
2. Sexually transmitted disease
3. Acne, bad odor
4. Gynecologic problems
5. Menstrual problems
6. Allergies and other skin disease
7. Circumcision
Problems Encountered
Emotional and social:
1. Sexual experimentation
2. Homosexuality
3. Conflicts with parents
4. Juvenile delinquency
5. Depression secondary to peer
pressure, identity crisis and
secondary sex
6. Child prostitution
7. Suicidal tendencies
Problems Encountered
Parents
Medical:
1. Common medical problems
2. OB-Gyne problems
3. Pre-menopausal symptoms
4. Alcoholism and other vices
Emotional and social:
1. Middle life crisis - CRISIS LIMITS
2. Male climacteric
3. Extra-marital affairs
4. Insecurities secondary to changing to
changing appearance
Family Life Cycle UNATTACHED
YOUNG
ADULT

FAMILY IN NEWLY
LATER YEARS MARRIED
COUPLE

LAUNCHING FAMILY WITH

FAMILY YOUNG
CHILDER

FAMILY WITH
ADOLESCENT
Launching Family
• Begins when the first child leaves
home and ends when the last child
leaves home
• Launched children start their own
family life cycle
• EMPTY NEST SYNDROME
• Co-residence
• Custodial parenting
• SANDWICH GENERATION
• Retirement
 Launching Family
Emotional process of First order changes Second order changes
transition: KEY PRINCIPLE •Adjusting to physiologic changes of • Renegotiating of marital system
middle age
Accepting a multitude of •Discovering new satisfaction with spouse • Development of adult and adult
entries and exits into the •Setting up a comfortable home for relationship between and grown-
themselves up to children and their parents
family system
•Helping their adolescent children to free • Realignment of relation to include
themselves and become responsible and
happy adults in-laws and grandchildren
•Re-examining their living arrangement • Dealing with disabilities and
with their own parents
•Adjusting to the reality of their own work
deaths of parents and
situation grandparents
•Assuring security for later years
•Participation in community life
•Reaffirming values of life
•Sexual relationship with spouse
Launching Family
Problems Encountered
Parents
Medical:
1. Episodic medical problems
2. OB-Gyne problem problems
3. Degenerative diseases
Emotional and Social:
Depression
1. Career stagnation
2. Emptiness syndrome
3. Over-dependent married children
4. Early retirement
5. Extra-marital affairs
6. Taking care of the sick
7. Adjustment of new member of the
family through marriage
Problems Encountered
Children
Medical:
1. Episodic medical problem
2. OB-Gyne problems
3. Medical problems of adolescents
Emotional and Social:
1. Independence Vs. Dependency
2. Juvenile delinquency
3. Peer group pressure
4. Problems of old relatives
5. Conflicts with parents
6. Adjustment to married life
Family Life Cycle UNATTACHED
YOUNG
ADULT

FAMILY IN NEWLY
LATER YEARS MARRIED
COUPLE

LAUNCHING FAMILY WITH

FAMILY YOUNG
CHILDER

FAMILY WITH
ADOLESCENT
Family In Later Years
• Begins with departure of the last
child and continues through
retirement of one or both couple
• Ends when both are dead
• Filipino family has traditional
built-in system of old age support
• Longer life expectancy indicator
of improvements of health
 Family In Later Years
Emotional process of First order changes
transition: KEY PRINCIPLE •Adjusting to physiologic changes of
Accepting the shifting of middle age
generational goals •Re-examining their living
arrangement
•Participating in-group activities
•Maintaining contact with younger
generations
Second order changes
• Maintaining own and or couple
functioning and interest in the
face of physiologic decline
• Exploration of new familial and
social options
• Support for more central role for
middle generations
• Making room in the system for
the wisdom and experience of the
elderly generations
• Dealing with loss of spouse,
siblings and other peers and
preparation of own death
• Life review and integration
Family In Later Years
Problems Encountered Problems Encountered
Parents
Children
Medical:
1. Degenerative diseases Medical:
2. Episodic medical problems 1. Episodic medical problem
3. Gynecologic problems 2. OB-Gyne problems
4. Urologic problems 3. Menopausal problems
Emotional and Social:
1. Depression due to death of spouse
and sickness
2. Psychosomatic problems secondary
to children leaving home
3. Loneliness
4. Financial adjustment
Family In Later Years Functional impairments and categories of medical
conditions causing difficulties to elderly subjects
Other problems Difficulty of walking
Difficulty of chewing
• Medication Somatic symptoms
Alcohol drinking
• Caregivers Smoking
Visual impairment
• Functional decline Hearing impairment

• Frailty Neurologic problems

Cardiovascular problems

• Mortality Musculoskeletal problems

Symptoms of anxiety and
depression
Foot problems
incontinence
Comprehensive Geriatric Assessment
Medical history
Physical examination
Neurologic examination
Structured psychiatric interview
Suggested intervention for families with
Review:
a frail older member
• Medications
F Functional independence
• Immunization
R Restoration of muscle size and strength
• Nutritional intake
A Adequate nutrition
Screening
I Instability management and prevention
• Osteoporosis
L Loneliness and depression prevention
• Malnutrition
T Testosterone, thyroid and other endocrine checks
• Depression and mental state
Y Yearly comprehensive geriatric assessment
Family Life Cycle

Thank you for listening!