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Psychiatric Nursing Ch 14 -Family Assessment and Interventions

Terms in this set (11)

What provokes family dysfunction?
• interactions, decisions, or behaviors that interfere with the positive development of the family and its individual members
• a family can be mentally healthy and have a member with a mental illness
• a family can be dysfunctional and have no member with a diagnosable mental illness
Services families provide to mentally unhealthy members
• provide support: people with mental illness may have difficulty maintaining non familial support networks --> rely on family
• provide information: families have complete, continuous info about care patient has received
• monitor services: families observe the progress of their relative and report concerns to healthcare providers
• advocate for services: family groups advocate for money for residential care services
Effects of mental illness on family functioning
• families are attached a negative stigma --> increased burden and stress
• they can become socially isolated and financially stressed as they care for their loved one
• parents and mental health workers may come into conflict (especially when it comes to allowing dependence vs pushing for the patient's independence)
Genogram
a multigenerational schematic depiction of biologic, legal, and emotional relationships from generation to generation
• used as framework for exploring relationships and patterns of health and illness
Components of a genogram
• age, dates of marriage and death, geographic location of each member
• symbols are used and defined in a legend
• ex: squares = men; circles = women; etc.
*** include mental disorders and other significant health problems
Family life cycle stage 1: Leaving home -emerging young adults
Emotional transition:
• accepting emotional and financial responsibility for self

Required family changes:
• differentiation of self in relation to family of origin
• development of intimate peer relationships
• establishment of self in respect to work and financial independence
• establishment of self in community and larger society
• spirituality?
Family life cycle stage 2: Joining of families through marriage or union
Emotional transition:
• commitment to new system

Required family changes:
• formation of partner systems
• realignment of relationships with extended family, friends, and larger community to include new partners
Family life cycle stage 3: Families with adolescents
Emotional transition:
• increasing flexibility of family boundaries to permit children's independence and grandparents' frailties

Required family changes:
• shift of parent-child relationships to permit adolescent to move into and out of system
• refocus on midlife couple and career issues
• begin shift toward caring for older generation
• realignment with community and larger social system to include shifting family of emerging adolescent and parents in new formation pattern of relating
Family life cycle stage 4: Launching children and moving on at midlife
Emotional transition:
• Accepting a multitude of exits from and entries into the system

Required family changes:
• renegotiation of couple system as a dyad
• development of adult-to-adult relationships between parents and grown children
• realignment of relationships to include in-laws and grandchildren
• realignment of relationships with community and larger social system to include new structure and constellation of family relationships
• exploration of new interests or career given the freedom from child care responsibilities
• dealing with care needs, disabilities, and death of parents (grandparents)
Family life cycle stage 5: Families in late middle age
Emotional transitions:
• Accepting the shifting generational roles

Required Family Changes:
• Maintenance of won or couple functioning and interests in face of physiologic decline: exploration of new familial and social role options
• Making room in the system for the wisdom and experience of elders
• Realignment of system in relation to community and larger social system to acknowledge changed pattern of family relationships of this stage
• supporting more central role of middle generation
• supporting the older generation without overfunctioning for them
Family life cycle stage 6: Families nearing the end of life
Emotional transition:
• Accepting the realities of limitations and death and the completion of one cycle of life

Required family changes
• dealing with loss of spouse, siblings, and other peers
• making preparations for death and legacy
• managing reversed roles in catering between middle and older generations
• realignment of relationships with larger community and social system to acknowledge changing life-cycle relationships
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