SAN BEDA COLLEGE OF MEDICINE Batch 2011
Topic: Family’s Influence on Health
Family Life Cycle
Lecturer: Dr. Mek Solana
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
 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
 3 types of family support: Instrumental,
Informational and Emotional
1. Instrumental Support - actual provision of
services or care giving by family members
2. Informational Support - involves giving health
related information and advice
3. Emotional Support - provides empathy, love
and care
 Marriage is the most influential family
relationship on health
Married> widowed> divorced/single
 Negative, critical or hostile family
relationships have a stronger influence on
health than positive relationships
 Family psychoeducation is an effective
intervention for health problems
Family Influence
 Genetic Influence
 Family is crucial in child development
 Infectious disease spreads in the family
 Family factors affect morbidity and mortality
in adults
 Family support is important in recovery from
illness
FCM 1
Nov. 26, 2007
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
 Provide view in terms of intergenerational
connectedness in the family
 Clinicians can view family problems and
strengths
 Views symptoms and dysfuntions in relation
to normal functioning over time
 The individual life cycle takes place within
the family life cycle, which is the primary
context of human development. As such, it
is crucial in understanding the emotional
problems that people develop as they move
together through life
 Family stress is greatest at transition
points from one stage to another of the
family developmental process
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
2 Levels of Orders of Magnitude Change
First Order Change
o Involve adaptation
o Do not involve change in the main
structure of the family
o Do not involve a change in an
individual’s identity and family
o a “NEED TO DO” something new
o -Tasks that must be accomplished
by the family and its members
working within a stage in the FLC
Second Order Change
o Involve transformation of an
individual’s status or meaning
o a “NEED TO BE” something new
o Change in the role and identity of
family members
o Change in the very basic attributes
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
 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
 Establishing a satisfying sexual relationship
 Interaction with friends and associates in
the community
 Facing the possibility of children and
planning for their coming
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
 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
Family with Adolescents
 Key principle: increasing flexibility of
boundaries to includ children independence
 Identity crisis
 Re-focus on midlife, marital and career
issues
 Beginning shift towards concern for the
older generation
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

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