Family centered care

1. FAMILY CENTERED CARE
MUHAMMAD SAIFULLAH
MSN*,MPH,BSN

2. Outline
• Define family and discuss its functions.
• Describe the types, structure/ organization of
family.
• Describe the different roles adopted by family
members.
• Discuss the concept of boundaries, family power
and decision-making.
• Identify the stressors prevalent within and
outside family.
• Explain how coping mechanism can help to
maintain family functions.
• Differentiate between values and beliefs.
• Identify Pakistani family value and beliefs.

3. What is family?
• An intimate and relatively permanent domestic
group connected by blood, marriage or adoption
that live together and share social and economic
responsibilities is called a family.
• It is the smallest and most basic social unit and
also the most important primary group found in
any society. It is the most immediate group a
child is exposed to. In fact, it is the most
enduring group, which has a tremendous
influence on an individual life from birth until
death.

4. Characteristics or Features of Family
• It is a universal group: It is found in one form or
other, in all types of societies whether primitive or
modern.
• Marriage as the basis: A family is based on
marriage, which results in a mating relationship
between two adults of the opposite sex.
• Source of nomenclature: Every house provides
an individual with a name, and hence, it is a source
of nomenclature.
• Trace of ancestry: It is the group through which
descent or ancestry can be traced.
• The primary agent of socialization: It is the
most basic group as it is the primary agent of
specialization of an individual.
• Various forms: It is generally limited in size such
as nuclear, even large, joint, and extended families.

5. • The nucleus of all institutions: It is the most
important group in society; it is the nucleus of
all institutions, organizations, and groups.
• Emotional attachment: It is based on
emotions and sentiments. Mating, procreation,
love, and affection are the basis of family ties.
• Unit of cooperation: It is a unit of emotional
and economic cooperation.
• Division of labor: Each member of the house
has duties and responsibilities.
• Social roles: Each family is made up of
different social roles, like those of husband, wife,
mother, father, children, brothers, or sisters.

6. Types of Family (On the basis of Structure and Size)
• Nuclear Family–it is a small group consisting
of a husband, a wife, and children, natural or
adopted. It is more or less an autonomous unit
that is not under the control of adults or elders
of the house.
• Joint Family– It is consists of three or more
generation, living together under the same roof,
sharing the same kitchen and economic
expenses. It is a house consisting of three or
more nuclear families living together.

7. On the Basis of Marriage:
• Monogamous Family: It consists of one husband
and wife including children based on monogamous
marriages.
• Polygamous Family: It is also of two types as,
• Polygynous– It is consisting of one husband, and
more than one wife, and all the children born to all
the wives or adopted by each of them. This type of
family is based on polygynous marriage (Polygyny).
• Polyandrous– It consisting of one wife and more
than one husband, and the children, either born or
adopted with each one of them. This type of family is
based on polyandrous marriage (polyandry).

8. • On the basis of Residential Patterns:
• Patrilocal family– in which the married
couple lives with or near the husband’s house.
• Matrilocal family– in which the married
couple lives with or near the wife’s house.
• Teo-local family– in which the married couple
lives apart from the parents of both spouses.

9. Roles/Functions of the Family
• Procreation or child bearing
• Manifest love to its members
• Provision of food, shelter and clothing for its
members
• Transmits culture and norms from its members to
the society
• Socialization of its members
• Companionship: family members share experiences.
• Personal security and acceptance: people feel more
protected within their families than outside.

10. Roles of each family member and the family as a whole
Each family member has a specific function to perform.
These roles include:
Roles of the father:
1. Provides basic needs such as money for food,
clothing, shelter, education, medical treatment etc.
2. Maintains discipline in the home
3. Shows love and maintain peace
4. A role model in the family
5. The head of the home
6. Protects family members
7. Teaches his children the culture of the society.
8. Breadwinner of the family.
9. Performs his civic right and responsibilities such as
paying of tax, obeying the law of the society.

11. Roles of the Mother:
• Prepares food for the member
• cares for the home
• Bears and nurture children
• Shows love to her husband and children
• helps in buying and maintaining family clothing
• Teaches the children home making skill and
other functional skills
• She is the home maker in the family
• She acts as a model for her daughters
• She takes care of the simple in of the family.
• She performs her civic right and responsibilities.

12. Roles of the Children:
• Respect and obey their parents and other adults
in the society.
• Help in carrying out domestic chores and
errands in the home e.g. cleaning the house,
washing plates, caring for younger ones, fetching
water.
• Learn the culture of the society.
• Give unity and stability to the home
• Bears the family’s name
• Perform their civic rights and responsibilities.

13. Family Tree
• A family tree is a graph or diagram that shows the
kinship pattern of a family. It shows how the family
members relate to each other.
Father
Boy Boy
Girl
Girl
Mother
Spouse
Spouse
Girl
Girl
Boy Boy
Arthritis
HTN
DM
Key:
Male
Female
disease

14. Family values
• Value means the worth of an item
• Values are beliefs, feelings and idea about what is important. They
are based on ideas about what is right, good and desirable. Values
cannot be seen, they are only reflected in our actions. They can be
positive or negative. Examples of positive values are: freedom,
courtesy, good health, orderliness, friendship, leisure, love,
patience, respect, tolerance, compassion, fairness, trust, honesty,
etc. Examples of negative values are: dishonesty, envy, falsehood,
selfishness, corruption, and so on.
• Value System- This is a set of values that a person or group of
people have.
• Family values– These are the beliefs, feeling, and ideas about
what the family esteem as important to the family. A family values
could be uprightness, respect, diligence, education, high moral
stance, trustworthiness etc
• Importance of family values system
• It helps to control behaviour of family members
▫ It helps the family to make decisions
▫ Provides confidence and strength
▫ Provides motivation for action.

15. Common Family Stressors
• No matter how strong and healthy a family is, common
stressors are bound to pop up from time to time. Identifying
stressors and methods of navigating them can help families
move through stressful occurrences efficiently.
A Death in the Family
• No one lives forever, and at some point, every family will lose
a loved one. Losing someone close to your family is going to
be hard on all family members. Keep in mind that death will
impact everyone differently. Be sensitive to the fact that all of
your family members process loss in their own way.
• Encourage family members to talk about their feelings
surrounding the loss.
• Practice self-care so that you can then help care for grieving
family members.
• Celebrate the good times and the love that your family has for
your passed love one.

16. Job Loss or Job Change
• Losing a job is scary, especially when there are dependents to care for. Even
families who undergo a wanted job change or a transfer often experience
some level of stress related to a major change like this. When a family goes
through either of these common stressors, it is important to:
• Stay supportive of the family member who lost or changed their job.
• Allow time and space to rant about a loss or transfer, but then focus on what
is in your control and what is practical.
• Create short and long-term goals regarding finances and future occupations.
Moving
• Moving homes can be rewarding and exciting, but also scary. When you
leave a space of physical and emotional safety, uncertainties arise. Change is
harder on some people, and there might be a few family members who fully
embrace the adventure of a new place and other family members who
remain wary and hesitant. Helping family members work through a big
change like a move isn't easy, but it can be done. Three ways that you can
help family members positively cope with change are:
• Keep routine and schedule as normal as possible. This will provide structure
and stability through the change.
• Focus on the positive. Talk about the pros to moving and have family
members who don't embrace the chance write down all benefits to a move.
• Acknowledge the change and discuss feelings surrounding it.

17. Divorce or Separation
• Nearly 15% of all marriages end in divorce, and while this is
lower than years past, it is still common. Divorce can be
especially hard on the children in a family and on a spouse
who didn't want the divorce. Stress such as this may cause
children to withdraw or act out, feel anger and resentment,
experience insecurities or suffer from anxiety and depression.
While parents can not always save a marriage, they can do a
few things to make a split easier on their children and
themselves.
• Listen to children's thoughts and feelings. Allow them to heal
and process on their own time.
• Be civil with the other parent. Keep personal discussions and
feelings between divorced parents away from children's ears.
• Have a solid support system in place your yourself and your
children.
• Seek counseling if depression, anger, and anxiety are
impacting daily functioning.

18. Remarriage
• Divorce is a common family stressor, but it is often followed up by another
common stressor, remarriage. Blending two families together can certainly
be a beautiful thing, but it can also be stressful and emotionally charged.
When blending a family, all sets of adults need to be communicating
effectively and remain sensitive to everyone's feelings, no matter what they
are.
• Communicate openly with kids about their concerns.
• Be realistic with your expectations of step-children.
• Always treat everyone in the family equally.
• Agree on discipline measures.
• Remind children that they come first.
Physical of Mental Illness
• When someone in your family falls ill, it takes a toll on everyone. Illness can
either affect a person's physical or mental health. Supporting family
member's through an illness is stressful, but important. Ways to help an
ailing family member include:
• Be realistic in your expectations of regaining health. Sometimes people want
and wish for their loved ones to recover more speedily.
• Help them attend all important appointments.
• Openly discuss feelings about illness and recovery with your ill family
member.
• Seek professional assistance if needed.

19. Conflict With Extended Family
• Even though you are family and you love one
another doesn't mean that you won't butt heads over
certain topics. Quarreling with in-laws or extended
family members is a common stressor that families
endure. Working through issues with family
members can make you uncomfortable, but it is
important to confront the issues at hand and work
through them effectively.
• Create a united front with your partner.
• Know your boundaries and expectations.
• Meet in a neutral place to discuss issues.
• Be an active listener and use non-aggressive body
posture when working out issues.

20. New Baby
• Having a new baby is a thrill and something to celebrate, but along with a
new family member comes new family dynamics and certain stressors.
Babies bring joy, but they also bring exhaustion. Parents can become
overstretched and overworked, lashing out at loved ones. Adjusting to a
new life takes careful planning and consideration.
• New parents must practice self-care.
• Give existing children extra praise, attention, and special jobs to make them
feel included.
• Acknowledge feelings of family members who are struggling with the new
baby. Help them talk about what they are feeling.
• Know that transitions like this one take some time.
Difficulty With Child Behavior
• Kids start to exhibit concerning behaviors for various reasons, and behavior
difficulties can result in tension and stress in marriages and families.
Parents of challenging children tend to feel exhausted, resentful, and angry
at the child and sometimes at their spouse. When dealing with problematic
behaviors, stay focused and team-centered.
• Locate the root of the problem. Knowing the "why" is very important.
• Be consistent in your approach to problematic behaviors.
• Make sure all family members know the plan. All boundaries, rules,
rewards, and consequences should be laid out clearly.
• Support and love the struggling family member.

21. Caring for Elderly Family Members
• We become so accustomed to parents taking care of
children that when it is time for roles to reverse, the
adjustments can be stressful and difficult. Aging
parents are bound to happen. Caring for them can
be made more simple with a few key steps.
• Decide what aging parents need and make a plan
that includes their input.
• Work on the financials regarding your parents' care.
• Keep on top of medications and create as much
safety as possible in their home and hire help to care
for them if need be.
• Make sure they know that they are loved and
appreciated.

22. Effects of Stress on a Person
• Stressors can affect a person's health greatly.
Common effects of stress include:
• low self-esteem
• depression and anxiety
• lack of willingness to interact with loved ones
• lower levels of energy
• insomnia
• chest pains and cardiovascular disease
• headaches and migraines
• increased rate of viral infections
• racing thoughts
• lack of focus and attention
• gastrointestinal problems

23. References