Foundations family dynamics slides week 2

Family durability

is a system of support and structure within a family that extends beyond the walls of the household.

Family Resiliency

Ability to cope with expected and unexpected stressors The family’s ability to adapt to role and structural changes, family members’ developmental milestones, and crises shows resiliency.

Fmaily diversity

Attention to uniqueness each person face different challenges

the interactions between and among family members that are affected by a family’s makeup (configuration), structure, function, problem solving, and coping capacity.

gives us hint to family strengths and weaknesses

Family dynamics

For example, marriages may end in divorce or death, and remarriage may occur, or children may leave home as adults, but in the end the “family” transcends long periods and inevitable lifestyle changes.

example of family durabilty

For example, a family is resilient when the wage earner loses a job and another member of the family takes on that role. A family survives and thrives because of the challenges encountered from stressors.

overall someone has to step up into that role

family resiliency example

se this knowledge to build on a patient’s and family’s strengths and resources

Family DYNAMICS 

definition of family

Family is what the individual believes family to be

some include friends or even pets as family to keep note of this

The family is defined biologically, legally, or as a social network with personally constructed ties and ideologies. (this is a legal sense)

overall what they believe family is

Concept of Family

Families represent more than a set of individuals.

A family is more than a sum of its individual members.

Families are diverse.

Patients have deeply ingrained values about their families that deserve respect

Family influence on each other Influences on  Family

culture

family giving

access to care

poverty

homelessness

domestic violence

family members influence health promotion activities practices and status and disease prevention

some of the family have lack of resources to focus on health we as nurses should be sensitive to that assist them if possible

unhoused families affect health

Family Health & Family Centered Care

genetic factors

acute and or chronic illness, disease trauma

end of life care

those who are crisis proof are mor effective in a tough situation

crisis prone (not effective in a critical situation)

Family Caregivers
“Sandwich Generation”

• Conflicting responsibilities for aging parents, children, spouse, and job

• Frequently tries to “do it all”

• May not recognize need for help or request help

• May not focus on own needs or health care

what is tough is that they have to be a parent and a caregiver which can lead to burn out

These individuals, who are usually in their middle years, must meet their own needs along with those of their children and their aging family members. This balance of needs often occurs at the expense of their own well-being and resources.

More grandparents are raising their grandchildren

Family Caregiving

• Maintain patients' functional abilities within the context of the family.

• Make sure home environment will accommodate a patient’s strengths and limitations.

• Show how to perform aspects of physical care.

• Stressful for family members as caregivers.

• Establish caregiving schedule.

• Connect caregivers with community resources

Caregiver Role Strain

Should be assessed at every primary care visit & hospitalization

• Make sure to provide adequate resources upon discharge (Social Services)

• Teach family members to identify caregiving role strain.

  • Change in appetite, sleeping, leisure activities

  • Caregiver is fearful when learning.

  • Loss of interest in personal appearance

Individuals who assume the role of family caregiver are at risk for caregiver burden. Family caregivers provide a significant amount of direct and indirect patient care for their family members; as a result, they often fail to address their own personal and health-related concerns (Family Caregiver Alliance, 2016b). They also often receive little help from others, which can lead to anxiety and increased caregiver burden

Potential Interventions

• Help families establish realistic priorities.

• Suggest that family members use family leave plans or obtain some “flex time” from their employer.

• Explore resources (e.g., delivery of meals, respite care).

Elder abuse

Physical, emotional/psychological, sexual, financial, abuse or confinement, passive neglect,  or willful deprivation of an elderly individual 

Elder Abuse is severely UNDERREPORTED

Elder abuse as “an intentional act or failure to act that causes or creates a risk of harm to an older adult”

Category types of abuse

Physical Abuse

Psychological Abuse

Sexual Abuse

Caregiver Neglect

Financial Exploitation

Warning Signs of Abuse

• Bruises, pressure marks, broken bones, abrasions, and burns

• Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression

• Bruises around the breasts or genital area can occur from sexual abuse.

• Sudden changes in financial situations may be the result of exploitation.

• Bedsores, unattended medical needs, poor hygiene, and unusual weight loss 

• Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.

Risk & Protective Factors

• Current diagnosis of mental illness,  physical health problems, or high levels of stress

• Current or past abuse of drugs or alcohol.

• Past experience of disruptive behavior, abuse, or traumatic events

• Inadequate preparation for caregiving 

• Inadequate coping skills

• Social isolation.

• High financial/emotional dependence on vulnerable elder

Risk & Protective Factors part 2

Victims and abusers come from all races, genders, sexual orientations, and countries of origin

It is important  NOT to paint a picture of a typical victim or abuser in one’s head
You might miss someone 

right in front of you!

Nurses are Mandated Reporters

Under California law, health professionals are “mandated reporters” for both child and elder abuse or neglect purposes. 
What does this mean??? 

• Failure to do so is a crime. 

• Even if you have reasonable doubts or concerns, it is best to err on the side of caution and the law and file the report.

Family Forms

look into structure and function

what is ongoing membership of family the patterns of family

it can benefit or not benefit example flexible bad or tor strict

being a bit of both is good