The Family Life Cycle

MEK VILLAFUERTE-SOLANA, MD
SAN BEDA COLLEGE OF
MEDICINE
FCH 1
SEPT 8, 2009

Objectives for this Session

Learn the effect of families and their
complex relationships to health
Discuss the family life cycle and why
we need to study it
Determine the two levels of orders of
magnitude of change
Learn the stages of the family life
cycle, the key principles and
conflicts in each stages

Research on Families and Health

The family is the primary social
context in which health care issues
are addressed
Most health beliefs and behaviors
are developed and maintained within
the family
Family members provide most of the
health care for patients

Research on Families and Health

Family support affects the outcome of
most chronic medical illnesses
Ex. 3x mortality rate for MI patients
with few or no family support
Emotional support is the most
important and influential type of family
support

Familys Influence on Health

Genetic Influence
Family crucial in child development
Infectious disease spreads in the
family
Family factors affect morbidity and
mortality in adults
Family is important in recovery from
illness

Families go through different stages

for which specific developmental
tasks must be accomplished.
Families who are not able to
accomplish these tasks may develop
difficulties with subsequent
family development.

FAMILY LIFE CYCLE

Provides chronologically oriented
sequence of events in family life
View of the stressful changes in the
family
Events in the FLC can be related to
clinical events and to health
maintenance in the family

FAMILY LIFE CYCLE

The individual life cycle takes place
within the family life cycle, which is
the primary context of human
development
Family stress is greatest at transition
points from one stage to another of
the family developmental process

The FAMILY as a SYSTEM moving

through time:
Boundaries will shift
Psychological distance among
members may change
Roles within and between
subsytems may be redefined
Norris

& Tindale 1994

Cicirelli, 1995

The Family is a System Moving

Through Time
Families incorporate new

members only by birth, adoption,

or marriage, and members can
leave only by death
Main value in families is in the
relationship, which are
irreplaceable

Flow of Anxiety in a Family

SYSTEM LEVELS

Vertical Stressors

1.

Social, cultural,
political, economic

Family patterns, myths, legacies

2.

Community, work,
friends

3.

Extended family

4.

Nuclear family

5.

Individual

Horizontal Stressors
1. DEVELOPMENTAL- Life cycle transitions
2. UNPREDICTABLE- Untimely death, chronic illness, accident

2 Levels of Orders of Magnitude Change

First Order Change
- Involve adaptation
- Do not involve change in the main structure
of the family
- Do not involve a change in an individuals
identity and family
- A NEED TO DO something new
-Tasks that must be accomplished by the
family and its members working within a stage
in the FLC

2 Levels of Orders of Magnitude Change

Second Order Change
- Involve transformation of an
individuals status or meaning
- a NEED TO BE something new
- Change in the role and identity of
family members
- Change in the very basic attributes of
the family system
- Occur between stages in the FLC

Stages of the Family Life Cycle

Unattached Young Adult
Newly Married Couple
Family with Young Children
Family with Adolescents
Launching Family
Family in Later Years

Leaving Home: The Unattached

Young Adult
Start of the family life cycle
Primary task: coming to terms

with their family of origin

Issues on separation from
parents/ family of origin
Formulation of personal goals
Need for self-differentiation
Alcoholism, smoking, STDs,
unwanted pregnancies

Unattached Young Adult

Differentiation of self in

relation to family of origin

Development of intimate peer
relationships
Establishment of self in
respect to work and financial
independence

Newly Married
Couple
The joining of families
Key principle: Commitment to the

new subsystem
Formation of the marital system
Realignment of relationships with
extended families and friends to
include the spouse
Establishing home base
Money matters
Demands on new role

Newly Married Couple

Establishing a satisfying

sexual relationship
Interaction with friends
and associates in the
community
Facing the possibility of
children and planning
for their coming

Newly Married Couple

Marital

adjustment
Family planning
and fertility
management

Family planning
Pregnancy and

pre-natal care
Labor and delivery
Post partum care

The quality of a
marriage has a
particularly
strong influence
on over all
health.

Family with Young

Children
Pregnancy for the first child to

emergence of adolescents
Stage when child starts to go to
school
Becoming parents
Key principle: Accepting marital
system to make space for
children

Family with Young

Children
Taking on parenting role
Key principle: Realignment

of relationship with extended

family to include parenting and
grand parenting roles
FLC phase that has the highest rate
of divorce

Family with young children

Child care

Parenting and

child rearing
Discipline

SOLANA-VILLAFUERTE FAMILY
I
Graciano

Remedios

82

David

Tess

58

55

65

II
Manding

Amy

Victoria

III 4

George
Nene

Lydia

C Caregiver

Grace

Reggie

Mien

Jhay
Hearty

Mandy

28

28

22

Michael
Lester

Heart disease
Diabetes
Asthma
HPN
Stroke
P Provider

Elizabeth

31

Julie

Imelda

Junilyn
28

Justin

Mek

39

33

Chai
3

Nanay
Puring
58

Thea
2 mos

Nov. 25, 2007

Bhen
20

Family with Adolescents

Key principle: increasing

flexibility of boundaries to
include children
independence
Identity crisis
Re-focus on midlife, marital
and career issues
Beginning shift towards
concern for the older
generation

Family with Adolescents

Adolescent care

Adolescence

Injury prevention

Identity

STD

Autonomy

Teen age

pregnancy
Drug use and
abuse

sexuality

Midlife
Art of

negotiation

Launching Family
Begins when the first child leaves home
Longest stage, most problematic of all

phases
Key Principle: accepting a multitude of
entries and exits into the family system
Adjustment to new family members
Dealing with illness or death of
parents/grandparents
Career stagnation vs financial liberation
Extramarital affairs vs a restructured
marital relationship

Launching Family
Physiologic

decline
Diseases of
middle age

Letting go
Midlife crisis

Launching Children and

Moving on
Development of adult to adult

relationships between parents and

their grown children
re-alignment of relationships to
include in-laws and grandchildren
Dealing with disabilities and
deaths of parents

SOLANA-VILLAFUERTE FAMILY
I
Graciano

Remedios

David

Tess

58

55

II
Manding

Amy

Victoria

III

George
Nene

Lydia

Reggie

Mien

Jhay
Hearty

Mandy

28

28

22

Lester
Chai
3

Junilyn

Stroke

Grace

Michael

Heart disease
Diabetes
Asthma
HPN

Elizabeth

31

Julie

Imelda

28

Justin

Mek

39

33

Nanay
Puring
58

Thea
2 mos

Nov. 25, 2007

Bhen
20

The Family in Later Life

Begins with departure of last

child and continues through

retirement and death
Old age and disease
Financial/ retirement
adjustments
Death of spouse
Empty nest syndrome
Key process: accepting the
shifting of generational
goals

SOLANA-VILLAFUERTE FAMILY
I
Remedios

Graciano

65

82

David

Tess

58

55

II
Manding

Amy

Victoria

III

George
Nene

Lydia

Reggie

Mien

Jhay
Hearty

Mandy

28

28

22

Lester
Chai
3

Junilyn

Stroke

Grace

Michael

Heart disease
Diabetes
Asthma
HPN

Elizabeth

31

Julie

Imelda

28

Justin

Mek

39

33
Thea
2 mos

Nov. 25, 2007

Bhen
20

The Changing Family Life

Cycle
Due to lower birth rate
Longer life span/ expectancy
Changing role of women
Increasing divorce and remarriage

rate

Role of Women in the FLC

Central to the functioning of the family
Identities determined primarily by their

function as wife and mother

Life cycle phases linked almost
exclusively to child rearing activities
A woman who choose a primary role as
mother and homemaker will have to face
an empty nest phase later on in life

Role of Women in the

FLC
Women most prone to symptom

development at life cycle transitions

The goals of career and family
present severe dilemma
Likely to be depressed at childbirth
Seek help during the child-rearing
years
Responsible for older relatives
Bear emotional responsibility for all
family relationships

References:
Isabelita Samanego, MD. Proceedings of the
Orientation Course in Family Medicine. PAFP,
Inc.
Carter, B. and McGoldrick, M. The Changing
Family Life Cycle, A Framework for Family
Therapy, 2nd ed. 1989. p3-28.