The Family Life Cycle

MEK VILLAFUERTE-SOLANA, MD
SAN BEDA COLLEGE OF
MEDICINE
FCH 1
SEPT 8, 2009
 Objectives for this Session
Learn the effect of families and their
complex relationships to health
Discuss the family life cycle and why
we need to study it
Determine the two levels of orders of
magnitude of change
Learn the stages of the family life cycle,
the key principles and conflicts in each
stages
 Research on Families and Health

The family is the primary social context

in which health care issues are
addressed
Most health beliefs and behaviors are
developed and maintained within the
family
Family members provide most of the
health care for patients
 Research on Families and Health
Family support affects the outcome of
most chronic medical illnesses
Ex. 3x mortality rate for MI patients
with few or no family support

Emotional support is the most important

and influential type of family support
Family’s Influence on Health

Genetic Influence
Family crucial in child development
Infectious disease spreads in the family
Family factors affect morbidity and
mortality in adults
Family is important in recovery from
illness
Families go through different stages
for which specific developmental
tasks must be accomplished.

Families who are not able to

accomplish these tasks may develop
difficulties with subsequent
family development.
 FAMILY LIFE CYCLE
Provides chronologically oriented
sequence of events in family life
View of the stressful changes in the
family
Events in the FLC can be related to
clinical events and to health
maintenance in the family
 FAMILY LIFE CYCLE
The individual life cycle takes place
within the family life cycle, which is the
primary context of human development
Family stress is greatest at transition
points from one stage to another of the
family developmental process
The FAMILY as a SYSTEM moving
through time:

Boundaries will shift

Psychological distance among
members may change
Roles within and between
subsytems may be redefined

Norris & Tindale 1994

Cicirelli, 1995
 The Family is a System Moving
Through Time

Families incorporate new

members only by birth, adoption,
or marriage, and members can
leave only by death
Main value in families is in the
relationship, which are
irreplaceable
 Flow of Anxiety in a Family
SYSTEM LEVELS Vertical Stressors
1. Social, cultural, political, Family patterns, myths, legacies
economic
2. Community, work, friends
3. Extended family
4. Nuclear family
5. Individual

Horizontal Stressors
1. DEVELOPMENTAL- Life cycle transitions
2. UNPREDICTABLE- Untimely death, chronic illness, accident
 2 Levels of Orders of Magnitude Change
First Order Change
- Involve adaptation
- Do not involve change in the main structure of
the family
- Do not involve a change in an individual’s
identity and family
- A “NEED TO DO” something new
-Tasks that must be accomplished by the family
and its members working within a stage in the
FLC
 2 Levels of Orders of Magnitude Change

Second Order Change

- Involve transformation of an individual’s
status or meaning
- a “NEED TO BE” something new
- Change in the role and identity of family
members
- Change in the very basic attributes of the
family system
- Occur between stages in the FLC
Stages of the Family Life Cycle

Unattached Young Adult

Newly Married Couple
Family with Young Children
Family with Adolescents
Launching Family
Family in Later Years
Leaving Home: The Unattached
Young Adult

Start of the family life cycle

Primary task: coming to terms with
their family of origin
Issues on separation from parents/
family of origin
Formulation of personal goals
Need for self-differentiation
Alcoholism, smoking, STD’s,
unwanted pregnancies
 Unattached Young Adult

Differentiation of self in
relation to family of origin
Development of intimate peer
relationships
Establishment of self in
respect to work and financial
independence
 Newly Married
Couple
The joining of families
Key principle: Commitment to the
new subsystem
Formation of the marital system
Realignment of relationships with
extended families and friends to
include the spouse
Establishing home base
Money matters
Demands on new role
 Newly Married Couple
Establishing a satisfying sexual
relationship
Interaction with friends and
associates in the community
Facing the possibility of children
and planning for their coming
 Newly Married Couple
Marital
adjustment
Family planning
and fertility
management Family planning
Pregnancy and
pre-natal care
Labor and delivery
Post partum care
The quality of a
marriage has a
particularly
strong influence
on over all
health.
 Family with Young
Children
Pregnancy for the first child to
emergence of adolescents
Stage when child starts to go to
school
Becoming parents
Key principle: Accepting marital
system to make space for
children
 Family with Young
Children

Taking on parenting role

Key principle: Realignment
of relationship with extended
family to include parenting and
grand parenting roles
FLC phase that has the highest rate
of divorce
 Family with young children
Child care Parenting and
child rearing
Discipline
 SOLANA-VILLAFUERTE FAMILY

I
Graciano Remedios David Tess
82 65 58 55

II
Manding
Amy George Lydia Imelda Elizabeth Grace
Reggie Jhay Bhen

Victoria 31 22 20
Nene Julie Hearty Mandy
Mien
28 28

III 4 4 6 Lester
Michael

Heart disease Chai

Diabetes P P 3

Asthma Justin Mek

Nanay
39 33 Puring
HPN
58
Stroke Junilyn
Thea
P Provider 28
2 mos

C Caregiver Nov. 25, 2007

Family with Adolescents
Key principle: increasing
flexibility of boundaries to
include children
independence
Identity crisis
Re-focus on midlife,
marital and career issues
Beginning shift towards
concern for the older
generation
 Family with Adolescents

Adolescent care Adolescence

Injury prevention  Identity

 Autonomy
STD
 sexuality
Teen age
Midlife
pregnancy
Drug use and Art of
abuse negotiation
 Launching Family
Begins when the first child leaves home
Longest stage, most problematic of all
phases
Key Principle: accepting a multitude of
entries and exits into the family system
Adjustment to new family members
Dealing with illness or death of
parents/grandparents
Career stagnation vs financial liberation
Extramarital affairs vs a restructured
marital relationship
 Launching Family
Physiologic Letting go
decline Midlife crisis
Diseases of
middle age
 Launching Children and
Moving on
Development of adult to adult
relationships between parents and
their grown children
 re-alignment of relationships to
include in-laws and grandchildren
Dealing with disabilities and
deaths of parents
 SOLANA-VILLAFUERTE FAMILY
I
David Tess
Graciano Remedios
58 55

II
Manding
Amy George Lydia Imelda Elizabeth Grace
Reggie Jhay Bhen

Victoria 31 22 20
Nene Julie Hearty Mandy
Mien
28 28

III 4 4 6 Lester
Michael

Chai
Heart disease 3

Diabetes Justin Mek

Nanay

Asthma 39 33 Puring
58
Junilyn
Thea
HPN 28
2 mos

Stroke Nov. 25, 2007

The Family in Later Life
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 generational
goals
 SOLANA-VILLAFUERTE FAMILY
I
Graciano Remedios David Tess
82 65 58 55

II
Manding
Amy George Lydia Imelda Elizabeth Grace
Reggie Jhay Bhen

Victoria 31 22 20
Nene Julie Hearty Mandy
Mien
28 28

III 4 4 6 Lester
Michael

Chai
Heart disease 3

Diabetes Justin Mek

Asthma 39 33

Junilyn
Thea
HPN 28
2 mos

Stroke Nov. 25, 2007

The Changing Family Life
Cycle

Due to lower birth rate

Longer life span/ expectancy
Changing role of women
Increasing divorce and remarriage
rate
 Role of Women in the FLC

Central to the functioning of the family

Identities determined primarily by their
function as wife and mother
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
 Role of Women in the
FLC
Women most prone to symptom
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
relationships
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.