Monday, April 26, 2010

Illness, Family, and Society Introduction - Stress and Coping

It is estimated that 20% of all US children have a chronic illness or disability, and 10% have problems that create some type of caregiving need. With numbers this high, it begs the question - what implications does illness have on the family unit and its relationship with society?
Improvements in technology and doctoring have created higher expectations and a heavier reliance on medical care throughout society. As a result, when someone announces that they are ill, others tend to think of their hospital or their doctors as their chief care givers. In reality it is the family unit that acts as the person’s primary caregiver. As we have discussed, the family is a personal experience, but it is also part of a larger social structure. Therefore, when a family member becomes ill, it is not simply a personal experience and struggle for that person to deal with. Instead, it is an experience shared by all those in the family unit. It changes both interactions within the family, as well as those between the family and its outside community. Therefore, it affects various aspects of their social life including their job, relationships with friends, and most importantly – their family! Overall, sickness is a significant source of change for families, and thus we will be examining the various ways in which illness impacts the family as well as its relationship with society. There are a few theoretical perspectives that are especially useful when examining this topic, including family systems theory and life course theory. In addition, feminist theory can be addressed as we look into gender roles in the midst of illness. We will also look at the specific problems created by stigmas attached to particular illnesses, especially mental disease or disability, as well as the issues surrounding potentially terminal and terminal illness. In addition, considering the family’s connection to society we will discover what resources exist to support families as they struggle with this issues! Overall, it is important first to recognize the many changes and stressors that are created by the arrival of illness in the family. Families and family members all react differently to this transition as they develop coping responses, and it is imperative to remember that all members of the family experience their loved one’s illness in different ways. Some of the most difficult stressors include…
• Uncertainty and fear regarding the family member’s condition and prognosis
• Changes in daily routines due to the limitations of the sick member, as well as due to the new demands of treatment
• Emotional strain, including feelings of anger, sadness, guilt, anxiety, or depression
• Understanding the illness, its implications, and treatment
• Role reassignment –according to family systems theory, a medical condition is a force that can throw the family system in to disequilibrium. As a result, responsibilities and roles must be reorganized in an effort to gain this balance back among the family system as well as unto each individual family member. Communication patterns are also in need of similar reorganization.
• Shifting of family expectations of behavior
• Working to give the sick family member as much independence as possible
• Enormous financial strain, often worsened by being uninsured or underinsured
• Learning new and important skills, such as how to use machines or give medications, in order to administer at-home-care
• Scheduling and time management issues
• Making important medical decisions

In the end, all of these added stresses on family life can lead to secondary results such as sibling conflict, poor school performance, social isolation, or marital conflict. Health is an expectation in society, and illness deviates from this “norm”. As a result, families must learn to function in new ways and cope with the personal and societal implications of the illness. The following youtube clip tells the story of the Wagner family, a married couple with two young boys who found out when their younger son Timothy was two that he had Muscular Dystrophy. It gives several examples of how having a son with a chronic illness has altered their lifestyle, including the many stresses that they have had to learn to deal with. It also presents several coping mechanisms, such as Timothy’s mom’s decision to emphasize his capabilities rather than his inabilities in order maintain an attitude of optimism. In the end, they show how learning to deal with chronic illness is a day-by-day task that takes a toll on every family member is unique ways.

After reading this entry and watching this clip, here are some things to think about as we embark on a discussion of these topics…

1. In the past, have you considered illness in the family to be a societal issue as well? Why do you think it is so often considered a personal issue to be dealt with within the family alone?
2. How do you feel about this list of stressors? Do any of them in particular strike you as more or less important/difficult for a family to deal with?
3. What was your reaction to the Wagner’s story? Do you think Timothy’s parents are handling the situation well? Why or why not? What might you do similarly or differently?
4. Is there anything regarding illness and the family that you identify with already? Any experiences that you have had with these stressors in your family? And as we continue the discussion throughout the week, think about ways in which you have dealt with illness personally or in your family (which includes fictive kin and friends as well) and how you can apply your experiences to the information presented.

"AAMFT Consumer Update Chronic Illness"

"Chronic Illness - Family Caregiving"

"Social Networks, Social Support and Coping with Serious Illness: The Family Connection"

"Caring for Siblings of Seriously Ill Children"

"Illness - A Family's Response"


  1. Good advice; hope all of you read the article above. Family perspective is crucial from my 40 years as a child/adolescent psychiatrist.
    School's over soon!
    Lucky you!
    School is stressful
    Vacations are stressful
    You and your kids can try my
    Help Me Cope! quiz
    William R. Taylor, M.D.

  2. I never really given much thought about family illness being a societal issue. Looking at that fact now definitely brings into perspective that society plays a major role in familial illness. Societal institutions work with the family to give the ill member treatment and mdical help, services that help pay for the expensive things, such as medication and surgeries, and services to help the family cope with the stresses and the harships that often accompany a sick family memeber. I feel that it is seen as such a personal and family issue because most families don't want outsiders interveneing in the lives of their sick family member because they often feel that other family members know how to treat the ill family member with the utmost care and respect. I know in my experience, I know that I would never just hand my mother or my father offto an institution to take cre of them because I don't know if the institution will actully do what they say they will do. I don't know if they'll abuse and take advantage of my parents and I would never want to put my parents' lives in jeopardy like that.
    I feel that the list of sressors is a great and thorough one because I believe it "jits" upon eery apects of life that could be targeted after a family member becomes ill. One that particulaly strikes me is the learning of new skills that pertain to the administer of at home care and medication and the use of machines. I find this to be particularly vital because if a persn is simialr to me I'd have to learn of hese skills to be able to take care o my parents ifthey becme ill and I didn't want to place them in an institution.
    I think the Wagner story is asolutely remarkable. The family seems to be handling the situation very well. they are both open to both of their sons with Timothy's illness and they both want to emphasize what Timmy can do and de-emphasize what he cannot do. I think they are doing a great job a giving Timmy what he needs, but to an extent that they're not "babying" him. I would do exactly as they do. I wold probably seem much more of a "worry wart" but I believe the Wagners ae doing a fabulous job in handling Timmy's illness.

  3. II'm glad this was interesting for you! And yes, with all the technology today, home and self care are much more available to people. However, learning to use equipment or administer medications correctly can be extremely difficult and stressful at first. In the case of diabetes for example, all blood monitoring can be done through packs and machines at home, or even at school for kids. The other difficult part is that in most cases, all members of the family unit must learn some form of treatment or response to the ill member. For instance, siblings of kids with diabetes would also need to be educated on how to respond and what to do if a diabetic crash or siezure were to occur. Overall - its great that people can do this themselves, but it doesn't work to decrease stress especially in the beginning stages!