Week Family: 5 Objectives (WebCT) Explore influences on families Define and describe key concepts related to family ** Study from objectives!!!** What is a "Family"? What is your definition of family? Write 4 words that come to your mind when you think of family o Safety, strength, friendship, loving, caring, trust, responsibility, respect, reliability Write 3 defining features of family What has influenced your words and features? Changing Influences over Time Family structure or form over time? o Economics Moving where the money is o Care giving Women moving out of occupations where jobs are home based o Employment and role changes o Longevity People living longer than they used to o Politics and globalization o Technology o Societal "norms" of relationships o Geographically Ways of Understanding families According to structure and function: o People who are connected and serve a function o Who they say they are (Wright and Leahey) o Principle sociocultural system in which behaviour patterns are learned, adapted or altered (de La Cruz 2006) According to developmental theory system moving through time (Duvall) Another definition
Socioenvironmental approach: Dynamic and adaptive system a complex set of environmental, psychopolitical and developmental processes to which the member attributes specific meanings, whether individually or collectively Socioenvironmental - society, environment around the person Responds and adapts to change Psychopolitical power relationships Developmental evolving experiences All related to culture! Individually/ collectively family rarely thinks as a unit, usually as individuals, but have to bring all perspectives together to make a decision that the entire family can live with Discuss the following sayings/ images about families You can choose your friends but you can't choose your family Blood is thicker than water The apple doesn't fall from the tree There's no place like home Step=mothers in fairy tales (Cinderella) Mother-in-law jokes What did you know about families when you were: 4 years old o Sent to school o Your entire world is in this family bubble o Assume that all families are the same o Thought you parents were perfect At the end of public school o Realized that families are different o Comparisons At the end of high school o Your family has definitely changed from when you were little o People around the dinner table have changed 25 years old By the end of your marriage/common-law relationship Through the eyes of your grandmother Structural Diversity What are all the different ways you can think of for a group of people to live under one "roof"? Are all of these groups families? Why? Or why not? Using Genograms
Pictorial representation of the family structure Ease of communication to other caregivers Involves family in assessment Often yields additional relevant info WebCT for rest of notes!!!! Perspective on Family in Nursing Family as context Family as client o Often doesn't happen, mainly in Palliative Care Family as way to promote health Family as system o Reference Leahy & Wright 2000 Family as system concept 1 A family system is part of a larger suprasystem and in turn is composed of many subsystems What are some subsystems in the families you know? Are all systems the same? o Marriage, siblings, cousins Family as a system concept 2 The family as a whole is greater than the sum of it's parts Do you agree with this statement? Can you think of a situation when it wouldn't be true? o More complete picture, combine strengths Family as a system concept 3 A change in one family member affects all family members Can you think of examples from your own life, from a movie or story? Family as a system concept 4 The family is able to create a balance between change and stability What are forces and contexts that affect stability? o Social o Economic o Historical o Political o Physical o What was the impact of that event on your family?
Functional families Direct communication Clear literally and emotionally Valid assumptions Evidence based Validated Trust "I" communication o I feel, I believe Dysfunctional Unspoken families rules Threatened by differences Reality distorted o Invalid assumptions or generalizations o No validation Negativity o Disqualifies opinion or worth of a person Speaking for others What are the truths about dysfunction? Do these change over time? o Violence against family members o Disciplining children o Addicted families Family as a system concept #5 Family members' behaviours are best understood from a view of circular rather than linear causality Johnny is 8 years old. He has an older and a younger brother. His Dad is away on business. He has not done his chores and Mom yells at him to "Get at it". What could unfold? What are our lenses? Individual lived experiences? The meanings? Shared? Differing? Significance of issues? Where are we situated? Spiritual perspective or Hope? How do our experiences affect others? Complexity Theory
Nothing is independent of its relationship to something or someone People and human experience are connected People act and react in relation to something or someone else Relational Family Practice The "lenses" that you view your client and their family o Sociocontextual o Interconnected relationships o Complex interrelationships o "View and approach the work through a relational lens, always assuming and looking for how people, situations, contexts, environments and processes are integrally(WebCT) How do we uncover meanings, contexts and relationships of others? A senior's perspective on health? A teenager's perspective on health? A woman living with HIV and TB in Zimbabwe What surprises you? What is very much like your perspective on health? An interview or therapeutic conversation Purpose, initiation, working phase, termination Key ingredients: o Manners o Therapeutic conversation o Genogram & ecomap o Therapeutic questions o Commending family and individual strengths (Wright & Leahey) Calgary Family Assessment Model (Web CT) Make sure to get the family assessment tree slide Structural Branch (Web CT) InternalDevelopmental (Web CT) Stage age related/ Genogram o Age of members `dictates' family tasks Tasks related to stages o How is it being a new wife? o Are you....
Function Instrumental activities of daily living What is your typical day like? o If there is a change in membership, there will be a consequent change in the functioning of the family Expressive o Communication (emotional, verbal, non-verbal, circular) Who is likely to start conversations about feelings? How does your family share information? Observation of non-verbal communication? What effect does what Mom says have on Dad? o Problem solving Who is most likely to say there's a problem? Who is likely to "take the bull by the horns"? o Beliefs What do you think a family should do under these circumstances? o Alliances and coalitions Who is most likely to support Johnny when he doesn't get his chores done? When there's conflict, who sides with whom? o Roles o Influence and power How are major decisions made such as moves? Roles: consistent behaviour in particular situation Expected, learned Family stability depends on adherence to roles o What changes in your family when Susan is sick? o When Dad is away? o Who usually provides discipline in your family? o Who in the family usually knows what member(s) is/are upset? Examples of roles: (WebCT) Your role in your family (WebCT) Boundaries: who participates & how much What roles are open to whom Change over time Facilitate or constrain family functioning o Would there be anyone in your family opposed to talking about this issue? o What would happen if you didn't do it the usual way? Sexual Orientation (Example of a topic that may have some boundary issues)
Can you tell me about the significant relationships of your children? Who has most/least difficulty at family gatherings when the gay or lesbian member is present? Who is most likely to be able to talk about the issue of sexual orientation? Power: ability to affect another's behaviour Instrumental o Who is best at getting Grandma to take her pills? Psychological o How is conflict managed in your family?