[02.16] Caring for the Family through the Life Cycle V2.1.pdf

Predictable and chronological sequence of events

What does the Family Life Cycle (FLC) provide in a family's life?

Clinical events and health maintenance

The events in the FLC can be related to what two aspects in the family?

Family dynamics through clearly defined stages of development

What does the FLC describe?

Adapt to changes in each shift of stages

What are families supposed to do to maintain equilibrium?

To maintain equilibrium

Why are families supposed to adapt to changes in each shift of stages?

Adaptation

What is a key element in the approach to studying families as they move through different stages over time?

Problems later

What may happen if a family member is unable to accomplish specific developmental tasks at different FLC stages?

Individual encounters challenges, learns and masters new skills, these experiences mold identity

According to the FLC approach, what happens as an individual encounters challenges?

Forming appropriate hypotheses about patient problems

How does the FLC help in clinical practice?

Individual life cycle

What happens within the FLC?

Boundaries, psychological distance, relationships, roles

What four aspects within a family system may shift or be affected as it moves through time?

Parent and adolescent child boundaries shifting to an adult with financial independence

What is an example of boundaries shifting within a family system?

Stressors within and outside the family

What can affect relationships within a family system?

Roles within and between subsystems

What can be redefined due to shifting boundaries, psychological distance, and stressors?

Nine-Stage, Five-Stage, Six-Stage

What are the three models used to study the family life cycle?

Three models

How many models are used to study the family life cycle?

Six-Stage Cycle

Which FLC model is most widely used and will be studied for Family Medicine?

Consolidates the 5- and 9-stage models

What is a characteristic of the Six-Stage Cycle model that makes it widely used?

Lauer & Lauer, 2004

Who developed the Six-Stage Cycle model?

Establishment

In Duvall's Nine-Stage Cycle, what is the stage for newly married, childless couples?

New parents

In Duvall's Nine-Stage Cycle, what is the stage for families with an infant to 3 years old?

With pre-school children

In Duvall's Nine-Stage Cycle, what is the stage where the oldest child is 3 to 6 years old?

With school-age children

In Duvall's Nine-Stage Cycle, what is the stage where the oldest child is 6 to 12 years old?

With teenage children or adolescents

In Duvall's Nine-Stage Cycle, what is the stage where children's ages range from 13 to 19 years old?

Late adolescents

In Duvall's Nine-Stage Cycle, what is the stage from 20 years old until the first child leaves home?

Launching family

In Duvall's Nine-Stage Cycle, what is the stage when all children have left home?

Middle-aged parents

In Duvall's Nine-Stage Cycle, what stage is characterized by an "Empty Nest" until retirement?

Aging family

In Duvall's Nine-Stage Cycle, what stage spans from retirement to death?

Independence

What is the first stage in the Five-Stage Cycle?

Coupling or marriage

What is the second stage in the Five-Stage Cycle?

Parenting: babies through adolescents

What is the third stage in the Five-Stage Cycle?

Launching adult with children

What is the fourth stage in the Five-Stage Cycle?

Retirement or senior years

What is the fifth stage in the Five-Stage Cycle?

The young unattached adult, The newly married couple, The family with young children, The family at midlife: adolescents and aging parents, Launching Family/The stage of launching children and moving on, The family in later life/years

What are the six stages of the Family Life Cycle according to the Lauer & Lauer model?

Changes, processes, and transitions

What must a family undergo to proceed to the next stage?

First Order Changes

Which type of order change involves increments of mastery and adaptation, and are "need to do" changes?

"Need to do" changes

What are First Order Changes also known as?

No change in the main structure of the family or individual's identity and self-image

What aspects of the family or individual do not change during First Order Changes?

Tasks that must be accomplished within a stage

First Order Changes are characterized as what kind of tasks?

Finding a stable job for the unattached young adult

What is an example of a First Order Change for an unattached young adult?

Establishing a home or living space for the newly married couple

What is an example of a First Order Change for a newly married couple?

Second Order Changes

Which type of order change involves transformation of an individual's status and meaning, and are "need to be" changes?

"Need to be" changes

What are Second Order Changes also known as?

Change in the basic attributes of the family system, role and identity of family members

What aspects of the family or individual change during Second Order Changes?

Between stages of the FLC, in the transition period from one stage to another

When do Second Order Changes typically occur?

Differentiation of oneself in relation to the family of origin for the unattached young adult

What is an example of a Second Order Change for an unattached young adult?

Realignment of relationships within extended families and friends to include the spouse for the newly married couple

What is an example of a Second Order Change for a newly married couple?

Accepting emotional and financial responsibility for one's self

What is the emotional process of transition for an unattached young adult?

Differentiation of self in relation to family of origin

What is a key Second Order Change that needs to happen for an unattached young adult concerning their family of origin?

Development of intimate peer relationships

What is a key Second Order Change that needs to happen for an unattached young adult regarding social connections?

Establishment of the self in relation to work and financial independence

What is a key Second Order Change that needs to happen for an unattached young adult concerning career and finances?

Proper nutrition, physical fitness, safe sexual practices

What health issues should be addressed for an unattached young adult?

To be independent from the family of origin

What are all the changes in the unattached young adult stage preparing the young adult for?

Commitment to the new system

What is the emotional process of transition for a newly married couple?

Formation of marital system

What is a key Second Order Change that needs to happen for a newly married couple concerning their relationship?

Realignment of relationships with extended families and friends to include spouse

What is a key Second Order Change that needs to happen for a newly married couple regarding their social and familial connections?

Pregnancy and childbirth, other changes in becoming parents

What health issues should be addressed for a newly married couple?

Accepting new members into the system

What is the emotional process of transition for a family with young children?

Adjusting the marital system to make space for children

What is a key Second Order Change that needs to happen for a family with young children concerning the marital relationship?

Both parents joining in child rearing, financial, and household tasks

What is a key Second Order Change that needs to happen for a family with young children concerning parental roles?

Realignment of relationships with extended family to include parenting and grandparenting roles

What is a key Second Order Change that needs to happen for a family with young children regarding extended family connections?

Children with illnesses, child's healthy development

What health issues should be addressed for a family with young children?

Increasing flexibility into family boundaries

What is the emotional process of transition for a family with adolescents?

Children’s independence, grandparents’ frailties

What two factors contribute to the increasing flexibility of family boundaries in the Family with Adolescents stage?

Family with Adolescents

In which Family Life Cycle stage do families begin to see the effects of aging, such as grandparents' frailties?

Shifting of parent-child relationship to permit adolescent to move in and out of the system

What is a key Second Order Change that needs to happen for a family with adolescents concerning parent-child dynamics?

Focus on midlife marital and career issues

What is a key Second Order Change that needs to happen for parents in a family with adolescents concerning their personal lives?

Peer pressure for adolescents, dealing with negative coping mechanisms like smoking and drug abuse

What health issues should be addressed for a family with adolescents?

Accepting a multitude of exits from and entries into the family system

What is the emotional process of transition for a launching family?

Beginning shift toward joint caring for the older generation

What is a key Second Order Change that needs to happen for a launching family concerning the older generation?

Recognition of marital system as a dyad

What is a key Second Order Change that needs to happen for a launching family concerning the marital relationship?

Children are starting to move out of the system, leaving only the husband and wife

Why is the marital system recognized as a dyad in the Launching Family stage?

Development of adult-to-adult relationships between grown children and their parents

What is a key Second Order Change that needs to happen for a launching family concerning relationships with grown children?

Realignment of relationships to include in-laws and grandchildren

What is a key Second Order Change that needs to happen for a launching family regarding extended family?

Dealing with disabilities and death of grandparents

What is a key Second Order Change that needs to happen for a launching family concerning the oldest generation?

Hypertension, heart disease, arthritis, osteoporosis, menopause, andropause

What are common health concerns for a launching family?

Last stage

What stage of the FLC is the "Family in the Later Years"?

Accepting the shifting of generational roles

What is the emotional process of transition for a family in the later years?

Maintaining own and/or couple functioning and interest in the face of physiological decline

What is a key Second Order Change that needs to happen for a family in later years concerning personal and marital functioning?

Exploration of new familial and social role options (e.g., from parents to grandparents)

What is a key Second Order Change that needs to happen for a family in later years concerning roles?

Support for a more central role of the middle generation

What is a key Second Order Change that needs to happen for a family in later years concerning decision-making roles?

Decision-making role shifts from grandparents to parents

What shift in decision-making roles is supported in the Family in Later Years stage?

Making room in the system for the wisdom and experience of the elderly

What is a key Second Order Change that needs to happen for a family in later years concerning the elderly's contribution?

Supporting the older generation without over-functioning for them

What is implied by making room for the wisdom and experience of the elderly?

Dealing with the loss of spouse, siblings, and other peers and preparation for own death

What is a key Second Order Change that needs to happen for a family in later years concerning loss and mortality?

Life review and integration

What is a key Second Order Change that needs to happen for a family in later years concerning personal reflection?

Chronic conditions (e.g., heart and kidney problems), degenerative conditions (e.g., dementia), debility related to aging

What health issues are common at the Family in the Later Years stage?

Disruptions in daily functioning

What can take place in a family's daily functioning despite the FLC being normative and developmental tasks predictable?

Crisis brought about by an illness, stresses brought about by daily living (finances, environment, living conditions)

What two types of challenges does a family have to cope with?

Delay transitions in the individual and family life cycle

What can disruptions and stresses in family life cause?

Transition points from one stage to another

When is family stress greatest?

Vertical and horizontal

What two flows can the anxiety in the family be considered?

Vertical Flow

Which flow of anxiety includes patterns of relating and functioning transmitted from one generation to another?

Family attitudes, taboos, expectations, labels, other loaded issues

What are examples of aspects included in the Vertical Flow of anxiety?

Given to us, no choice to receive them

How are aspects of life described in the Vertical Flow?

Vertical Flow

Which flow of anxiety refers to aspects of life that are "already given to us" and "we have no choice to receive them"?

Horizontal Flow

Which flow of anxiety includes anxiety produced by stresses on the family as it moves through time?

How a family copes with stresses through time and the family life cycle

What does the horizontal flow of anxiety induce or include?

Predictable developmental stresses, unpredictable events, events we have no control over

What does the Horizontal Flow of anxiety include?

Moving from an unattached young adult to a newly married couple

What is an example of a predictable developmental stress?