Chronic and acute illnesses in a family bring about an entirely new set of
responsibilities and roles for each member. Everyone experiences the illness in a unique way, whether you are a friend, a relative, a sibling, or a parent. All parties included have their own reactions, feelings, and alterations to make in response to this major change. In addition, a multitude of people from a variety of social structures are generally involved as they surround the ill person and their family for support. This includes teachers, counselors, mentors, doctors, recreational or physical therapists, social workers, and day-care personnel. In the end, illness brings about change for everyone, and again everyone participates and copes in their own way. One of the most affected populations in these circumstances is siblings. When a child in a family falls ill, his or her brothers and sisters are part of the immediate family structure that is thrown in to disequilibrium. As a result, they endure changes and encounter emotions that they were not expecting and often do not know how to deal with. For one, siblings can be extremely confused by the role shifts that are taking place, and may start to question their identity within the family unit. They also may feel sadness over the loss of what they considered to be “normal” family life. Fear can also take over as siblings worry about the health and prognosis of their brother or sister. Additionally, siblings can even become jealous, angry, or feel neglected if they sense that the ill child is receiving all of the love and attention in the home. One of the most difficult aspects of helping siblings deal with these situations is that depending on their stage of development and their personality, their coping mechanism will greatly differ. For instance, one sibling may start to act out in school while another decides to become the perfect child in search of attention. As a result, the most common advice for parents is to foster continued open communication among all family members, excluding no one, especially not the one who is ill. In general, if siblings are given a healthy outlet for their emotions they are less likely to manifest themselves in problematic ways. Also, it is important to remember that even if siblings are presenting no signs of distress, it is undeniable that the illness is affecting them and therefore important to discuss their feelings anyway.
Another hugely affected group is parents! While it may seem obvious, as we saw in the video clip about the Wagners, there are a multitude of stressors that present themselves when a child falls ill. Two of the biggest issues that arise for parents is taking on their new roles as caregivers, and refiguring their finances in order to pay for their child’s care. Time management becomes extremely difficult as parents struggle to care for their child and spend quality time with one another. Parents can easily become overwhelmed, and consequently begin to experience social isolation, lessening their sense of support and life outside of their family struggles. Along with many of these stressors, unfortunately separation and divorce among parents of ill children is not uncommon.
However, a large piece of how parents deal and cope with a sick child or sick children has to do with gender roles. To look at things from a sociological perspective, it is crucial to consider the different ways in which men and women are involved in the care of a sick family member or even their own health, and how this too can affect family dynamics. Through a feminist perspective lens, the gender norms that have existed for centuries delegating domestic and nurturing roles to women have led to a trend in our culture now in which women are much more responsible for the care of a sick family member than men. In some cultures, this is more of an extreme trend in which men are still supposed to remain removed from care giving and housework. Looking at things from a comparative point of view, studies conducted in South Asia have shown that men who took on care giving roles, especially those who left work in order to do so, were extremely stigmatized and disrespected throughout society. In this way, there are still many societies were men are expected to remove themselves entirely from care giving roles, which is more extreme yet still evident in our culture. Gender roles translate in to care giving also in types of responsibilities men and women generally take on. While women tend to see caring from the sick as an obligation, but do so in an emotionally connected and supportive way, men are typically emotionally removed from the situation and thus help in more managerial areas such as finances, lawn mowing, or physical labor. Men also receive considerable help, while women tend to seek less assistance from others and act more independently. At the same time, women maintain more relationships that provide emotional support rather than physical aid. In the same way, men and women cope with illness in very different way. For instance, women tend to rely on their husbands more for support when they are sick, while men attempt to deal with illness independently. In one study of husbands of breast cancer patients, the husband’s ability to cope was the number one indicator of how well the wife was coping, while the husband’s ability to cope was based more heavily on his own emotional state. In this way, when dealing with illness women are more expressive and depend more on others while men try to remain more emotionally removed and autonomous. Lastly, gender also influences the way in which parent’s perceive and thus care for a sick child. It has been found that parents see sick sons as less capable and in need of more attention and care because society sees sickness as a sign of weakness for men. As a result, they actually put more energy in to caring for boys than for girls. Due to the same societal belief, boys are more likely to hide their chronic illnesses and thus make their care more difficult to administer for their parents, while girls are more honest with their needs. In the end, the fact that women are still subject to this gender norm in society means that they take on the heaviest care giving role in families, only adding to the amount of extra work they already perform in the family unit. The “second shift” that still exists in society proves that women are still majorly responsible for housework, and when they then take on the role of caregiver in family, they are essentially now working three jobs if they (as the majority of women do) work outside of the home as well. Unfortunately, this can then end up limiting their access to employment or out-of-home activities.
In sum, when looking at how family members respond to illness, the most important thing to remember is that everyone reacts differently depending on several factors, including their stage of development and their role within the family unit. Siblings are a great example, as they are all going to have different feelings based on their age, their change in role, their relationship with the ill sibling, their relationship with their parents, or their personality. Most importantly, parents can facilitate their coping process by opening the lines of communication, allowing them to express their feelings and regain a sense of equilibrium within the family. Additionally, it is crucial to take a sociological perspective and think about how societal forces and norms affect the way illness influences each family member’s life in a different way. A significant example of this is how societal expectations of men and women and their applied gender roles change the ways in which they experience and deal with illness. And ultimately, in the case of gender, it means that having a family member fall ill affects the lives of women in the family much more significantly than those of men. These trends should also encourage more research on how other societal factors regarding issues such as race and ethnicity affect care giving as well.
Here is one example from a journal article that gives narratives of working mothers of children with chronic illnesses. While the mother here is divorced, which only adds more strain between the man and woman, it still gives an example of a woman who is overwhelmed by the amount of care she has to give and feels as though she lacks support or help from the man in her life.
“As fathers tend not to have the same investment in caring responsibilities for the child, their confidence and expertise in relation to the chronic illness tends not to be developed over time, and certainly not commensurately with the mother's (Gibson, 1995, p.1205). The mothers remained, for the most part, as the 'sweepers' in the family, needing to be ever-attentive to the wellbeing of their family (Bianchi, 2000). Dolly confirms the imbalance in caring responsibilities reflected in many of the stories:
Dolly: What he doesn't understand is, yes, he takes Margaret three weekends out of four. But who organises all Maggie's medication, organises all her doctor's appointments? Who takes her to all her blood tests? Who irons all her clothes? Who washes all her clothes? Who changes all her bed? Who organises all the nappies? This all just 'happens'. Who buys all her clothes? Who finds time to go and buy her clothes and get her shoes fitted? And this all happens around Steven, and he doesn't get it. Who does all the grocery shopping? You know, the food's just there. The clothes are there. She g0es with a perfect little bag, like an overnight bag, with all the medication, all the stuff. And I'm really filthy with him, because it all comes back dirty. And I said to him, you know, "You can wash.' ... 'I don't expect two or three sets of pyjamas to come back filthy'. Because Maggie's a bit of a grub. You know, 'It wouldn't hurt you to do a wash" and all that sort of thing. So, hopefully he will do that (Dolly, #1, p.36).”
Some things to think about…
1) Have you ever had a sibling fall ill in one way or another so that it had a significant impact on your life? Maybe it was an acute problem and not chronic, such as surgery. Either way, do you remember ever experiencing some of the feelings listed above? What were they and how did you cope with them?
2) What are your opinions about the way gender roles in society dictate care-giving roles? Do you think these roles are true based on your own experiences?
3) What are some things you might suggest to help change these gender trends in society?
“Working mothers of children with chronic illness: narratives of working and caring”
“Chronic Illness – Famliy Caregiving”
“Social Networks, Social Support And Coping With Serious Illness: The Family Connection”