Family Stages
In the following topics, you will learn about developmental stages and tasks for individuals to achieve. The family also develops through various stages and tasks. Table 9-1 summarizes the important features of these stages, which revolve around the processes of childbirth and childrearing, and are most reflective of nuclear families. Other types of families may skip or overlap certain stages or may never experience them.
BOX 9-1. Cultural, Ethnic, and Religious Considerations That May Influence Family Choices*
???? Choice of marriage partner (who chooses the spouse)
???? Dating customs
???? How many spouses a person may have
???? Living arrangements
???? Status of men and women
???? Family decision-makers
???? Roles of various family members
???? Attitudes toward children
???? Type of discipline
???? Family disciplinarian
???? Attitudes toward older adults in the family
???? Choice of vocation or occupation
???? How to deal with emotions: anger: grief, sadness, and so forth
???? Attitudes toward education
*Note: These could be topics on an NCLEX.
TABLE 9-1. Stages of the Family Life Cycle and Associated Developmental Tasks
| STAGE | SPECIFIC TASKS |
| Transitional | ???? Separating from one?s family of origin ???? Developing intimate relationships ???? Establishing independence in work and finances |
| Expanding Family | |
| ? Establishment | ???? Building a mutually satisfying relationship ???? Incorporating spouse/partner into relationships with extended family ???? Setting up a household and delineating household responsibilities for each partner ???? Planning for own family |
| ? Childbearing | ???? Integrating an infant into the family ???? Maintaining a satisfying couple relationship ???? Expanding relationships with extended family by adding the parenting and grandparenting roles |
| ? Childrearing | ???? Meeting basic physical needs of all family members ???? Socializing children (peers, school, community) ???? Integrating new child members while meeting needs of other children ???? Maintaining a satisfying couple relationship |
| Contracting Family | |
| ? Child launching | ???? Releasing young adults to work, college, military service, and marriage with appropriate assistance ???? Adjusting the couple relationship as children leave the family home ???? Expanding the family circle with the marriage or relationships of children |
| ? Postparenting | ???? Assisting aging parents ???? Maintaining a healthy lifestyle ???? Continuing relationships with children and parents ???? Adjusting to retirement ???? Strengthening the couple relationship |
| ? Aging | ???? Finding a satisfactory living arrangement ???? Maintaining a satisfying couple relationship ???? Coping with the loss of a life partner ???? Keeping intergenerational family connections open ???? Accepting one?s own mortality |
Transitional Stage
The transitional stage refers to the period when single young adults, usually in their 20s or early 30s, are financially independent from their family of origin and live outside the family home. This stage has evolved as a norm in recent years as young adults delay marriage, often choosing to live alone or with others of a similar age first. During the transitional stage, individuals usually develop intimate relationships, perhaps leading to cohabitation or marriage. Men and women experience this stage differently, depending on their goals, which may be family and children, career success, or both.
Expanding Family Stage
In the expanding family stage, families are created, new members are added, and roles and relationships increase. This stage begins when an individual selects a partner with whom he or she makes a commitment, and ends when the first child leaves the home to begin his or her own transitional stage.
Establishment
Single adults move into the establishment phase when they choose a partner and set up a household. Establishing a household may or may not involve marriage. Building a mutually satisfying relationship, maintaining relations with an extended family, and deciding whether or not to have children are developmental tasks associated with establishment. This phase often contains its own transitions, as individuals shift from living independently to learning to share and maintain an interdependent relationship.
Childbearing
A family enters the childbearing phase with the birth or adoption of its first child. Traditionally, a relationship is seldom as fulfilling as that of parent to child. No matter how an individual or couple may initially feel about a pregnancy, the arrival of a first child is usually an occasion of wonder and joy. Individuals, finished with waiting, are ready for their new role as parents. The transition to parenthood, however, is often difficult. Although new parents are now faced with childcare responsibilities, they also need to maintain a mutually satisfying relationship as a couple during this period.
An enormously important issue that dual-earner families must confront during this time is adequate childcare arrangements. Regardless of whether both parents work out of financial necessity or by choice, they need to develop and adjust to a plan that leaves young children in the care of another. Sometimes parents can arrange different work schedules for childcare purposes. Although children may benefit from always being with one parent or the other, the relationship between the adults often suffers because of inadequate time for each other.
Childrearing
Families in the childrearing phase include those with preschoolers, school-age children, and adolescents. Once children arrive, family life forever changes. The members of the family must continually adjust to one another.
Socialization of children is a major task of child-rearing. Along with peer relationships and school activities, parents should encourage participation in community activities. Family transportation may seem never-ending, as children are taken to and from their activities. Childrearing families often are pressured for time. Children?s schedules must be considered as part of the family timetable. The parents? mealtimes and sleep patterns must change when children arrive. As children grow older, the scheduling of family members becomes more hectic. Arrangements first must be made for babysitters, then often for carpools and attendance at school functions. The adults? responsibilities and community contacts usually increase during this active time. However, adults must find time to encourage the growth tasks of all members of the family and combine them into a family design or plan (Fig. 9-3).
At this point in the family cycle, communication is a developmental task for all members. Communication between partners, including sexual relations, may be sharply displaced as the family grows. Private conversation is difficult because children are omnipresent. Adults need to plan times when they can be alone together without children, to maintain a mutually gratifying relationship. They also need to encourage communication for the entire family and keep the channels open for children to share their daily experiences, thoughts, ambitions, and ideas.??
FIGURE 9-3 ? The family in the childrearing stage focuses much attention on socializing children and on spending time communicating and sharing activity
Contracting Family Stage
During the contracting family stage, the family becomes smaller. Children who have grown into adults leave to begin lives and families of their own. Parents must adjust to new roles as individuals. A couple may begin to rediscover one another or to reevaluate their relationship and individual paths.
Child Launching
In the child launching phase, the family has reached its maximum size. Child launching begins when the first child leaves home to live independently and ends when the last child leaves home. This phase represents the outcome of preparing children for adult life. As each child leaves home, the parental task is to reorganize the family from a home full of children, to a home again occupied only by adults. The length of this period varies. In past generations, adults were involved in childrearing until old age. With a longer lifespan and smaller families, parents may now launch children 20 years before they retire. In some families, children live at home until their 30s, or return to the family home after college?usually for financial reasons? lengthening the child-launching phase of the family. An important developmental task at this time is to accept and to appreciate, even if one does not always approve of, the differences in ideals, habits, and philosophies of the new generation.
Postparenting
Postparenting begins when the youngest child leaves the home and continues until the retirement or death of a partner. Once associated with middle years (approximately ages 40-60), this phase may occur later, as couples delay starting their families and adult children continue to live in the parental home. Many people find their middle years a comfortable and serene period. Fewer demands allow more time to enjoy life. Financial burdens related to children are fewer, and time for shared activities increases. Readjustment to a period in which children figure somewhat less prominently is necessary. Couples who share common goals and interests are likely to enjoy this period. An important task is maintaining relationships with aging parents and grown children. During this phase, individuals may take on a new role?grandparent. The middle-aged couple finds that the rewards of time allow both of them to come to terms with themselves and to gain satisfaction in opportunities still available. Planning for financial security in later years is essential. The expense of raising children has been lifted, and family income is usually at its peak.
Key Concept Adjustment to retirement may be difficult if careful financial planning is not done or if hobbies and activities were not developed in earlier years.
Aging
As partners get older, they face several challenges. Many older adults decide to relocate. Deciding where to live is difficult for many older people. Often they have lived in the same home for 20 or 30 years or more. The place holds many memories, and it is hard to let go. Sometimes, the need for one partner to go to a nursing home makes the decision more difficult.
Fixed retirement income is insufficient for many people because of inflation. Even though costs go up, the pension stays the same. Many older people have saved what they once thought would be enough money to take care of themselves in their retirement years; however, even one short illness can wipe out a modest savings account. Older adults then may be forced to sell their home or seek financial assistance.
As people get older, they may experience a decline in their physical faculties. A good sense of humor is probably the greatest asset in dealing with this deterioration. Older adults must get some sort of exercise, maintain an adequate diet, and get sufficient rest. Single adults may experience difficulty with proper nutritional habits. Individuals who lose a partner may not know how to cook or may not want to bother to cook just for themselves. A regular physical examination is important to detect minor difficulties before they become major problems.
Older adults must accept death as another stage of life. They need to plan their legal affairs and to discuss finances for the future. If they have not yet made a will, they should do so now. Many people will live alone at least part of their lives because of divorce or death of a partner. Five times as many widowed women as widowed men are in the United States. Three reasons contribute to this disparity: women live longer than men; women tend to marry men who are older than they are; and widowed men are much more likely to remarry than widowed women.
STRESS AND FAMILY COPING
Every family encounters stress, which is inevitable but can be faced and handled appropriately. In addition to the normal changes, adaptations, and pressures of the family cycle, financial, physical, and emotional stresses may occur at any time. Often, stressors are interrelated, contribute to, and exacerbate one another.
Family stress is different from other types of stress because of the interdependent relationships that exist in families. When one member is under stress, the entire family is affected. Many families are able to develop socially acceptable means of dealing with stress. These functional families use resources to cope and often become stronger as a result of the stressful experience. Other families cannot cope. The result is that, as stressors build, coping systems disintegrate. The latter type of family is called a dysfunctional family or at-risk family.
NCLEX Alert An NCLEX clinical situation may discuss types, functions, or dysfunctions of a family Knowing the specific defined name of the "family? (e.g., single, nuclear, extended) may not be as important as knowing how to assist the individuals when needed in times of stress. Keep in mind that stress can interfere with survival or for psychosocial or financial needs more for some families or individuals or groups than for other types of family structures. Prioritization of needs is critical.
Socioeconomic Stressors
Socioeconomic circumstances can greatly influence families. Income determines recreational pursuits. One family may be able to afford a vacation, whereas another family finds recreational opportunities in picnics and free community offerings. A family?s income level often influences choices such as housing, education, daycare facilities, material goods, and nutrition.
Because of economic constraints, adults may have to work two jobs or several part-time jobs to provide for the family, which affects the amount of time they can spend with partners or children. Older siblings may be required to take on more household or babysitting responsibilities. Daycare may replace home care for children. In extended families, grandparents, aunts, or uncles may provide childcare. All these circumstances can place significant levels of stress on the entire family unit.
Poverty knows no boundaries. Families living in poverty face a variety of health and social problems, including homelessness, high rates of infant mortality, malnutrition, anemia, lead poisoning, school dropout, crime, and shortened lifespan. Individuals who may be defined as living in poverty include the working poor, the homeless, migrant farm workers, residents of low-employment areas (including rural, mountain, and urban communities), and many older adults Women living alone or with their children represent a significant percentage of people living in poverty. Further difficulties can arise when a parent fails to pay needed child support.
Divorce and Remarriage
A family?s coping ability may be significantly compromised during a divorce. Adults who are facing separation from their partners?and a return to single life?may feel overwhelmed. They may become preoccupied with their own feelings, thereby limiting their ability to handle the situation effectively or to be strong for their children. The breakdown of the family system may require a restructuring of responsibilities, employment, childcare, and housing arrangements. Animosity between adults may expose children to uncontrolled emotions, arguments, anger, and depression.
Children may feel guilt and anxiety over their parents? divorce, believing the situation to be their fault. They may be unable to channel their conflicting emotions effectively. Their school performance may suffer, or they may engage in misbehavior. Even when a divorce is handled amicably, children may experience conflicts about their loyalties and may have difficulties making the transition from one household to another during visitation periods.
The arrival of a stepparent in the home presents additional stressors for children. Adapting to new rules of behavior, adjusting to a new person?s habits, and sharing parents with new family members can cause resentment and anger. When families blend children, rivalries and competition for parental attention can lead to repeated conflicts.
Family Violence
The most common and least reported cases of violence in the United States are incidents of family violence. Abuse of children, partners, siblings, and older adults usually manifests itself in physical, emotional, or sexual mistreatment, exploitation, and neglect. Other, less blatant forms of abusive behavior include interfering with another family member?s outside social networks; misusing money and other resources; displaying inappropriate jealousy; monopolizing another person?s time; and blocking a person from receiving needed healthcare. Cultural and economic pressures may contribute to such situations because abused individuals may be afraid to expose the situation to outsiders or may be financially or emotionally dependent on their abuser.
Abusive situations and other dysfunctional patterns of coping usually affect children the most. Children model their behaviors and develop their attitudes by watching the adults they love and trust. Many children who were abused or who witnessed abuse in their families often grow up to be abusive as well, continuing a cycle of family violence. Child abuse is discussed in more detail in Unit XI.
Addictions
The family in which one or more members have an addictive disorder faces continual pressure and stress. Addictions may be in the form of drug or alcohol abuse, gambling disorders, sexual compulsions, or ?workaholism.? In all such cases, the addiction begins to replace the family as a well-spring of support and a source for social interaction. The entire family suffers as it begins to focus on ways to accommodate and incorporate the addictive behavior, while hiding it from those outside the family circle. Partners and children are often neglected, and financial resources often begin to dwindle as addicted individuals continue their behavior.
Acute or Chronic Illness
Illness can strike anyone at any time. Some illnesses are acute, whereas others become chronic. In either case, the family must deal with an enormous amount of pressure when one of its members faces illness. Financial issues may become a great concern, even if the family has good insurance coverage. Employment issues may need to be reconsidered, along with adjustments in schedules and social activities. Worry, anxiety, concern, and fear may be issues for the family witnessing a loved one?s compromised or declining condition.
Key Concept As a nurse, you are likely to work with many families who are dealing with acute and chronic illnesses. It is important to identify key issues or problems.
Effective and Ineffective Coping Strategies
Individuals and families respond to both everyday and more severe stressors in many ways. The response to major stressors can be depicted in two phases: adjustment and adaptation. During each phase, a family will employ different coping strategies. Box 9-2 highlights the two phases of a family?s response to stress.
BOX 9-2. Phases of a Family?s Response to Major Stress
Adjustment Phase
1.??? The family tries to maintain the status quo with minimal disruption to the family unit.
2.??? The family may deny or ignore the stressor
3.??? The family may remove the demands of the stressor.
4.??? The family may accept the demands created by the stressor.
Adaptation Phase
1.??? The family realizes that regaining stability will involve changes in the family structure.
2.??? Friends and community provide assistance with the problem-solving process during the stressful period.
3.??? Roles, rules, boundaries, and patterns of behavior within the family are altered as needed in order to regain stability.
KEY POINTS
???? The family is the basic unit of society, but it is a complex unit.
???? All nursing care should involve clients and their families.
???? Although each family is unique, families share five universal characteristics: Every family is a small social system; it has certain basic functions, a structure, its own cultural values and rules, and it moves through stages in its life cycle.
???? Roles and relationships within a family are many and varied; the primary ones include parent-child and sibling relationships.
???? The functions and tasks of the family help individuals to meet their basic human needs.
???? Although many different family structures exist, all can be efficient, supportive, and satisfying.
???? Cultural, ethnic, and religious factors influence family outcomes.
???? Family development progresses through predictable stages, with important developmental tasks.
???? The family that can cope with stress is functional; families that cannot cope are dysfunctional or at risk.
Source: http://what-when-how.com/nursing/the-family-development-throughout-the-life-cycle-nursing-part-2/
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