1 The Family Life Cycle Atatürk University Medical Faculty Semester I Class 1 Family Medicine Lectures Yrd. Doç. Dr. Memet IŞIK

Objectives At the end of this session, the participants should be able to; discuss the definition of “family” compare marital patterns in Turkey with other countries discuss crtitical tasks during different family stages identify and describe the various life stages Discuss effects of divorce on children explore the responsibilities associated with roles 2

Definitions a group of individuals living under one roof and usually under one head a group of persons of common ancestry the basic unit in society traditionally consisting of two parents rearing their children اُسْرَة عائلة 3

Families affect health and illness 1. Families contribute to the production and/or maintenance of symptoms To reach a more complete diagnosis and understanding, physician needs to explore the symptoms in terms of the family system Examples: Depression Obesity and weight loss Heart disease 2. Different stages of the family may have different implications on health 4

Individual Life Cycle 5

6 Stages of the Family Life Cycle

Family Life Cycle 7 Duval yrs 2,5 yrs 3,5 yrs 7 yrs 8 yrs 15 ± yrs ± yrs 1.Married couples (without children) 2.Childbearing families (oldest child, birth to 30 months) 3.Families with preschool children (oldest child 30 months to 6 years) 4.Families with school children (oldest child 6 to 13 years) 5.Families with teenagers (oldest child 13 to 20 years) 6.Families launching young adults (first child gone to last child leaving home) 7.Middle-aged parents (empty nest to retirement) 8.Aging family members (retirement to death of both spouses )

USA 8

9 TR:Female 20,8 years;

Percent having previously cohabited with current spouse by age and sex 10 AGE MALES FEMALES %44% %51% %27% % 8% % 6% 70+17% 5% TOTAL30%28%

11 TNSA (Türkiye Nüfus ve Sağlık Araştırması) 2008

Albania 10.9 Armenia 6 Austria 43.4 Azerbaijan 10.3 Belgium 44 Bosnia and H. 5 Bulgaria 21.1 Canada 37 Croatia 15.5 Czech Rep 43.3 Denmark 44.5 Estonia 46.7 Finland 51.2 France 38.3 Georgia 6.6 Germany 39.4 Greece 15.7 Hungary 37.5 Iceland 39.5 Italy 10 Japan 1.9 Latvia 34.4 Lithuania 38.9 Luxembourg 47.4 Macedonia 5 Moldova 28.1 Netherlands 38.3 Norway 40.4 Poland 17.3 Portugal 26.2 Romania 19.1 Russia 43.3 Slovakia 26.9 Slovenia 20.7 Spain 15.2 Sweden 54.9 Switzerland 25.5 Turkey 6 Ukraine 40 United K United States 54.8 Yugoslavia World Divorce Rates; %

Children’s Reactions to Separation & Divorce 13 Rakel RE. Textbook of Family Practice

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Tasks during family stages Often developmental tasks of family members are in conflict, and many of the tensions of family life are caused by these conflicts. Adolescent: need to achieve independence Parents: guiding his/her development Both partners having careers may lead to conflict as well… 16

Stage-critical family developmental tasks during the family life cycle StageFamily developmental tasks 1 Married coupleEstablishing a mutually satisfying marriage Adjusting to pregnancy and the promise of parenthood Fitting into the kin network 2 ChildbearingHaving, adjusting to, and encouraging development of infants Establishing a satisfying home for both parents and infants 3 Preschool ageAdapting to the needs of preschool children Coping with energy depletion and lack of privacy as parents 17

StageFamily developmental tasks 4 School ageFitting into the families of school-age families Encouraging children’s educational achievement 5 TeenageBalancing freedom with responsibility as teenagers mature 6 Launching centerReleasing young adults into work, military service, marriage etc.. 7 Middle-aged parentsMaintaining ties with older and younger generations 8 Aging family membersCoping with bereavement and living alone Closing the family home Adjusting to retirement 18 Duval 1977

Predicting tough stages May be same stage that person’s own parent had difficulty parenting them through Parent didn’t have good model from their parents so hard to negotiate that stage with their child. Examples: if parent left home before h.s. graduation It may be difficult to help their teen through the “launching” stage. If lost a parent at age 3, then will experience feelings of loss related to this when child is 3. Female sexual abuse survivors molested at age 6 > issues will surface when daughter is 6 19

How might this be important in your practice? Brief counseling encounters Conceptualizing why patient is experiencing emotional upheaval at certain times in their development Normalizing such emotional upset can be very healing—Dr. patient relationship tool 20