Ch 10 Caring for Families N116

What is Family? People related by biology, law, or social network People with personally constructed ties and ideologies

Concepts of Family Durability Resiliency Diversity

Family Forms Nuclear Extended Single parent Blended Alternative multi adult; skip-generation; communal; lone adults; same-sex parents

Family Structure Promotes or impedes ability to respond to stressors Determines who is able to perform a task Pattern of relationships, power, role Rigid vs. flexible vs. “open”

Family Function “what the family does” Reproduces, socializes, meets economic needs, relates to larger society Processes used by family to achieve its goals: goal setting, communication, conflict resolution, use of resources

“graying” of America For the first time, the average American has more living parents than children Children likely to have living grandparents or great grandparents “sandwich generation” Elders in 60-70’s are caregivers for one another More grandparents are primary caregivers for grandchildren

Threats to Families Changing economic status Homelessness Family violence Illness

Families and Health Family is the primary source of health beliefs and practices Primary social context in which health promotion and disease prevention take place Health status of each member influences how the family functions and its ability to achieve goals Harmful practices are acceptable in some families

Family Nursing Based on theory that all people are part of some kind of family Families need to make adjustments when a member is ill Family nursing helps all individuals and the family as a whole maintain maximum health during and beyond the illness Important is which care setting?

Family Nursing Family as context Primary focus is on individual member Assess how much family provides needs Physical, material, psychosocial needs

Family Nursing Family as Patient Family process are focus of nursing care Concentrate on patterns and processes Be aware of Nursing’s limits and collaborate with other disciplines

Family Nursing Family as System Caring for each individual AND family as a unit Use all community, social, environmental resources “who cares for the caregiver?’

Family Centered Care “Family Focused nursing” Establish relationship with patient and family Include family in acceptable goals Collaborate with, teach family Support communication among all members Help family find resources

Challenges for Family Nursing Assess care needed at discharge, and potential shortcomings in the home settings Arrange out-patient care to compensate for what family and home setting can’t provide: home health visits outpatient P.T. Remember cultural context of care

Caregiver role strain Daughter or DIL; works for pay ;may not recognize need for help or ask for help; may not pursue own health care; conflicting responsibilities

Nursing Diagnoses Ineffective Family therapeutic regimen management Sleep deprivation Fatigue Risk for lonliness Caregiver role strain Risk for impaired parenting Ineffective relationship Parental role conflict