Illness and Family Stress Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Identify the roles of factors related to illness in creating family stress  Compare and contrast positive and negative communication patterns that can influence marital relationships when a spouse is ill.  State the ways gender moderates care giving for aging parents, and explain how care giving is similar or different for sons vs.. daughters, and elderly women vs.. elderly men Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Illness is stressor composed of several characteristics that interact in complex ways.  Factors related to illness influence family stress  Type of illness  Amount of time since diagnosis or illness phase  Life course timing of illness onset  Illness intensity  Illness severity and threat  Illness uncertainty  Projected duration of illness Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Often small sample size focused on particular illness  Often recruited through medical establishment  Large scale studies can track changes in health and family relationships across multiple years with generalizable samples Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Broad range of theories  Majority of theories include aspects of family stress theory or a family resiliency framework  Moderated by both positive and negative enduring characteristics (IE: depression, optimism, eating habits)  Link between health stressors and individual/family outcomes mediated by adaptive process of family  Coping behaviors  Perceptions of prognosis and knowledge of illness  Family communication and support Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

Chance Health Stressors Adaptive Processes Individual and family outcomes Enduring Characteristics of individual/family/community Enduring Characteristics: resiliency, eating habits, depression, etc. Adaptive processes : coping, perceptions, communication etc.

 Approx 8% of kids age 5-17 have some functional limitation resulting from chronic illness  Heath Stressors  Asthma, cancer, cerebral palsy, cystic fibrosis, diabetes, down syndrome extensively studied  Children experience emotional, behavioral, and school-related problems  Parents experience financial, psychological, & employment problems, isolation, grief, medical decision making, added stress of communicating illness to child Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Factors that can protect families from stressors of illness include age, race, gender, SES, family structure.  Chronic illness of child more common among poor, boys, and African Americans – especially in single parent homes  Low SES can limit access to health care system and exacerbate the illness. Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 How family adapts to childhood illness can influence outcomes  Reorganization and reassessment of family resources  Active coping strategies  “Balanced Coping”  Illness demands kept in perspective with other family needs  Collaboration with medical professionals  Maintaining positive outlook in life  Providing emotional protection to ill child Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Perceptions may vary across time and among family members  Availability of family resources linked to positive outcomes for childhood illnesses  Financial resources  Effective communication  Flexibility  Social support  Outcomes examined often include individual psychological stress, health changes, family functioning Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Health Stressors  Impact couples relationship, and amount of stress varies by type of illness  Timing of illness can influence amount of stress experienced by couple  If expected, adjustment may be easier  If illness onset is before or after diagnosis  Health decline related to decrease in marital quality, but onset of disability related to increased marital quality  Disability often comes later giving couples time to adapt Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Age of onset  Decline in health more strongly related to decline in marital happiness for young and midlife adults, but less for older adults.  Whether both spouses suffer illness, and the gender of the ill also influence outcomes  Marital quality at greater risk for healthy spouse  Well female spouses often more distressed than well male spouses  Financial strain Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Illness mechanisms (or life changes due to illness)  Financial changes, division of household labor, marital problems, psychological distress  Stress-prompted resources  Patient/spouse knowledge of disease and how to manage it  Hearing-aids, medical professional supports  Faith or spirituality can be used as coping resource Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Couple communication  Can facilitate positive outcomes  Accurate perception of partner’s pain results in less anger, less irritation, more helpful support, better functioning  Caregiving practices demonstrated by couple  Balance caregiver behavior with autonomy of ill spouse  Continuum of supportive behavior Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Health stressors  Chronic illness  Functional impairment  cognitive impairment  behavioral problems  Intensity of caregiver strain  Sudden vs. expected caregiving role  Full time vs. part time caregiver Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Factors that moderate link between stress resulting from caring for parent and the adaptive process include:  Gender  Women more likely expected to be caregivers  Women provide more car giving hours, assist with more personal care, perform more care giving tasks  Women experience higher depression and more health problems because of discrepancy in care giving stressors and available supports Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Factors that moderate link between stress resulting from caring for parent and the adaptive process include (cont.):  Being married  Having siblings  Can be positive if siblings participate, negative if they don’t.  Ethnicity  SES, cultural constraints on seeking outside help, informal support networks Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Mediate link between caring for aging parent and stress experienced  Perceptions  Perception of being adequate caregiver  Resources  Social support or caregiver strain  Coping activities  Communication Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Adult children report strains and gains of being caregivers  Psychological distress  Caregiver burden  Physical health  Personal and spiritual growth  Mastery of caregiving  Closeness to care recipient Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 With a partner  Choose gray box:  Page 99 to 100 – when a child is ill  Page 104 – when spouse is ill  Page108 – when parent is ill  ABC-X model  Other factors to include/consider  Possible helps  Enduring Characteristics  Adaptive Processes Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications

 Illness may draw families closer together.  Families can experience strains and gains simultaneously  Resources, perceptions, and outcomes can influence the stress or strain felt within the family unit. Prepared by Carrie LeFevre Sillito,Ph.D. © Sage Publications