Family Centred Care Module

Key issues in this chapter:

• The concepts of 'the family'
• Sociological perpectives of the family 
• Health and the Family 
• The family and Caring 

LO:

• Understand the nuclear family and family diversity 
• Discuss the sociological perspectives on the family 
• Explore the link between family life, health and illness and caring 
• Recognise the need to challenge common-sense ideas around the family 

Introduction points:

• It draws attention to the fact that sick people are often part of a family and that families can play an important role in patient care. However, families also hold the potential to make people sick 

The concepts of the family'

• Most of us are born into families and spend, whether we choose to do so or not, most of our childhood and teenage years within that family (Bernades, 1997,p1)
• It is important to that the defination of family change and family can mean different things to different people according to thier personal circumstances and life experiences 
• As nurses we provid care to people/families whose values we do not share and who we may see making decisions different to us. We find outselves in relations with families where members harm one another or where it is different to connect becuase some family members are absent (Doane and Varcoe 2006).

Common sense and the family

• Common sense understanding -family disguise the complexities of family life 
• This masking perpetuates(continues) and maintains images of supposedly normal families and the naturalness of roles ascribed to individual family members. 
• This prevents us from understanding the impact on family life of differences such as gender, class, ethnicity, racism , sexuality etc.
• Prevents us from understanding the differences of family life such as gender, class, ethnicity, racism and sexuality 
• Thinking about the family sociologically enables us to challenges these common sense understanding of family. 
• Sociological explanations challenge common sense assumptions and allow us to recognise that society, throughout history and cultures encompasses(surround) a diversity of family forms. 
• It also enables to questions the 'natural rtoles' assumed by individual family members e.g 
• wmomen's innate ability to care'
• Bond argued , 'the family is the context within which health is maintained and where illness occures and is resolved.' recognise the complexities of family life is important for holistic care. 

The universal nuclear family:

• To recognise that families are social not natural, phenomena 
• They change over time and are influenced by social, economic and political development 
• In western societies there is powerful assumption of universal family form- Nuclear family consisting of husband, wife and thier children living together and connected by mutual affection care and support. 
• This type of family exists as a standard of how sexual, emotional and parental responsbility should be structured. 

Functionalist perspectives on the family:

• One the most prominent and influential sociological attempts to expalin the existence of the family was put forward by Talcot Parsons
• Parson's Theory was based on research carried out with American middle calss families 
• He argued that families exist becuase of the functions they perfom and consequently have evovled over time because of the role they play in helping us meet the social and enconmic demands of socieity. 

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• Nuclear family (small king groups) have evovled to fit the needs of the industrial  enconmy 
• Nuclear family were better than large king groups to performing two specialised functions 
• Primary socialiastion of children and the stabilisation of adult personalities e.g emotional secity for adult members allowing them to address thier worries at home.
• Children taught how to act and behaviour in society(socialisation).
• Cheal 2002 - socialisation of children enables them to grow into valuable, productive and law-abiding members of society. 

Critiques of functionalist perspectives:

• Too neat social change does not happen in such a an orderly manner 
• Young and Wilmott suggested found that extended kin network were still strong in East London late as 1970s
• Geographicall mobility was a common occurence in pre-industrial society e.g children were sent away to domestic service or appreticeships this challlenges Parson notion that nuclear family evovled to fit the need of an industrial society.

Families play an important role in caring for sick, frail and disabled people

General characteristics that can be identified amongst carers are as followed:

• high levels of stress, depressed mood and sleep disturbance 
• Reduced earnings and poverty 
• Employment difficulties 
• Poor health and difficulty in accessing health care for themselves 
• Feelings of isolation
• Inadequate housing 
• Marital breakdown (Department of health,2008) 

Caring for others often becomes the responsilibilty of female family members as this role can be percieved as an extension of the normal caring that women perfrom within the family. 

The health status of one family member can adversely affect both the material and emotional well being of all family members eg:

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• Parents often take less well-paid jobs closer to home to be neaeer to thier children 
• Emergency care can mean a loss of earnings owing to time off work 
• one-off costs (new bedding) and regular hosptal visits can be financial drain 
• Asth,a attacks can cause disrupted sleep for all family members leading to tiredness, irritability and lack of concentration 

Caring is often perceievd to be a natural means of demonstrating love and support and something that is carried out unstintingly. However the burden of caring for a family members or being cared for by the family member can exacerbate exiting illness or make other fmaily members sick. 

A carer strategy for England - A version for valuing and supporting carers. Emphaisises the importance of carers having a life of thier own alongside thier caring role, treated with dignity and supported with physical and mental wellbeing. 

Domestic Violence:

• It is estimated that one in four women will experience this at some point in thier lives 
• Domestic violence features in ta least one in every four divorces 
• In speech given to the Women's Aid Federation in England, the minister for women Sally Morgan said that - ' a man who is capable of violence towards his wife/partner is also capable of violence towards his children'.

Tackling domestic violence:

• Giving all women basic information about the unacceptability of domestic violence in all forms 
• Giving all women information that will be relevant not just to them but thier friends, family members and neighbours. 

Key points:

• The ideology underpining the nuclear family is still pervasive, but the reality today is that many is live families that little resembalance of this model
• The ideology of the nuclear family has played an importnat role in informing the organisation and delivery of health care in Britain. Nurses should be sensitive to this and aviod stereotyping families according to this ideology. 
• Families are pivotal to the maintenance of health, but at the same time are facing a growing responsbilitiy to care for sick, frail and disabled people. this can place an increasing pressure on family members of which nurses should be aware. 
• Some family members particularly women, are perceived to be naturally more inclined to caring and nurturing roles with the majority of the health task role being deemed thier responsiblity. 
• Whilst families can be of vital support for many individuals there are also occasions when families can be affect health negatively and it is important to recognise  that not everyone's experience of family life is positive.