Module I: Today's’ Families & Communities

1. Module I: Today's’ Families & Communities NU 550 OL

2. What is Family? • Individuals • Parents with children • Born, married, adopted • Bound legally • Bound by caring, love • Sacrifice • Biological ties • Latin “familia” • Tradition • Togetherness • Shared experiences • Bondedness • Different relationships • Groups

3. So What is a Family? • Many different phrases to define family with no one correct phrase • Family can begin with or without the concept of caring • No single theme for the family that encompasses all cultures, age groups, and time frames

4. Family • Variety in family structure existed before present time • Patterns had to be understood in relation to national and regional cultural variations (Shorter, 1977) • Family is not an object but a social concept without specific place or tangible substance (Gubrium’s and Holstein,1990)

5. Definition of Family • Family represents an intra or interpersonal relationship where there is a history of concern and caring and the potential for continued commitment to caring • Family can be defined as 2 or more individuals or other beings involved in an interdependent relationship; not necessarily bound by blood relations.

6. Disciplines that Research Family • Religious groups • Social sciences • Economists • Developmental theorists • Psychologists • Lawyers • Anthropologists • Educators • Politicians

7. Why Nursing? • “Family Centered Care” (Cunningham,1978) • “Family Focused Care” (Janosik and Miller, 1979) • Bevis and Watson reconfigured family health nursing education around a “caring model” • Freidman, Wright and Leahy in the 1980’s started to look at families as a system or family aggregates (groups) based on assessing the functioning of a family as interactional system of dyads or triads.

8. Nursing Theorists • “Family Interviewing” (Wright & Leahey, 1984) • “Family Systems Nursing”(Wright & Leahey, 1984) • Martha Rogers (1983) integrated family systems theory • Betty Neuman (1983) integrated family theory: “the family is a system in society … viewed as one singular internal environment or system” • King (1983) focused attention on the family as a social system that influences the growth and development of individuals.

9. ANA Social Policy Statement & Standards of Practice (1980) • “family as co-provider of care” and nurses to become competent in assessing and intervening with families

10. Family as a Concept • VonBertalanffy Systems Theory (1936): • 1) Concept #1: A family system is part of a large suprasystem and is composed of many subsystems (systems defined by boundaries) • 2) Concept #2: The family as a whole is > that the sum of its parts • 3) Concept #3: A change in one family member affects all the family members  

11. Family as a Concept continued… • Calgary Family Assessment Model (CFAM) (Wright & Leahey) • Integrated framework based on systems theory and change theory • 3 components of CFAM: • structural • developmental • functional

12. 2 Myths Concerning Family • Traditional Nuclear Family • “All American Family” • Married with kids, mother doesn’t work • National Family and Work Institute in NY 1993 showed 56% of women with children ages 6 – 11 worked and 43% worked with children under the age of 6 y.o.

13. US Department of Labor: 2008

14. 2nd Myth Extended Families • Several generations living in the same household working toward a common goal • Intergenerational relationships means support is available but also means stress, fulfilling obligations, maintaining family rituals, attending celebrations, and honor relationships

15. Other Combinations of Family • DINKS • Single Parents • Interracial Marriages • Homosexual families • Grandparent Families • Adopted Families • Melded Families • Reproductive technologies

16. Influences on the Family • Baby Boomers (1946 – 1962) • Aging Population • Media • Isolating/Addicting Technology • Pop Psychology • Migrating Families

18. Impact of the Changing Family on Health and the Health Care System • Religious influences • Cultural influences • Genetic • Policy influences • Disparities in health care • Financial and ethical issues • Age of family members • Woman and work • Immediate neighborhood and community

19. Historical Perspectives on American Families • Colonial times: surrounded by family and community • 19th Century: family was a refuge, (men were public), (women were at home) • 20th century: family become the encounter group (let it all hang out and find the meaning of life) • 21st century: atypical families

20. Myths of Life in America • Focus years 1945-1968 • Post WWII years focus on what life was supposed to be like • American families and the nostalgia trap • ( Coontz, S. 1992, Bellah, R. 1992, Finklestein, N., 2000)

22. Myth # 1 “People Were Healthier • Image of the Family Doctor: • Limitations to Medical Care: • Major Health Concerns: • Preventable Disease by Immunization • Statistics on Life Expectancy • What has extended Life Expectancy? • Discuss advances for various health concerns

23. Myth 1 continued… • Safety and Government Interventions • Motor vehicle safety • Lead • Accidents

25. Myth 2: Please Pass the Pot Roast

26. MYTH # III: HOME SWEET HOME, MAN’S HOME IS HIS CASTLE • Image of the perfect family • Historical Events that impacted family life in the 50’s and 60’s • Women and family life • Compare and contrast family life today and yesterday • Parents and kids • Suburbia • Growth of homes • Housing for the poor

27. MYTH # IV: WE NEVER LOCKED OUR DOORS • Historical Perspectives on Violence • Racial Violence & Discrimination

29. MYTH #5: See the USA in Your New Chevrolet

30. MYTH # 6: WE RESPECTED OUR ELDERS • Historical factors that influenced aging : • Life Expectancy: (1776) 35 y.o. • (1900) 47 y.o. • (1950) 68 y.o. • (1991) 76 y.o.

31. . MYTH #7: GOLDEN CHILDHOOD • Historical Events that Impacted Childhood in the 50’s • Schools in 2009

32. MYTH # 8: WE COULD BREATH THE AIR • Events that led to better environmental control

33. Group Reflection/Discussion : Orenstein Article • 1) What terms come to mind when we think of this article? • 2) What relationships are portrayed in this paper? • 3) Explain the similarities and differences between the 2 girls. • 4) Which character do you find more hopeful and why? • 5) What implications does this article have for APRN’s, CNL’s and Nurse Educators?

34. Discussion: American Myths • Read the major concepts regarding the historical myths that Americans faced in the 40’s, 50’s, and 60’s. Answer the following questions: • Do you agree or disagree with the comments • Has this information changed the scope of the way you perceive the current health care industry • How have these historical changes increased or decreased the stress in families today • Think of a memorable patient that you have taken care of recently; analyze the patient’s struggle to maintain a balance between the old ways (sense of stability) and current trends (change). How did this impact on his/her health care.