Family things: Attending the household disbandment of older adults

When adults move to smaller quarters in later life, family members become involved in the management and disposal of possessions-some cherished, some mundane. Interviews were conducted with 14 family members who had participated in a household disbandment by elders. This qualitative analysis describes the various tasks that were undertaken by family members; how family members asserted themselves in the process; how they were an outlet for possessions; the way that some possessions are shared; and implications for family's story about itself. Household disbandment is a field for all sorts of family practices that can be summarized along three continua that characterize (1) the receiving of goods, (2) the location of agency between elder and family members, and (3) family's self-understanding.     

Support Network Connectedness in the Lives of Community-Dwelling Rural Elders and Their Families

Rural elders face challenges when accessing assistance from family, neighbors, and paid helpers. This support is essential to allow them to remain community dwelling as they develop physical challenges that limit their ability to care for themselves. This qualitative study followed a group of 16 rural elders with physical limitations for 1 year. In-depth interviews were conducted with them and eight members of their support networks, including five family members, to explore how rural older adults create and maintain support networks that allow them to remain community dwelling despite physical challenges that limit their self-care. The research question is, “How do members of the support network connect with each other to maximize the effectiveness of the network?” Family members coordinated assistance to maximize the abilities and availability of various network members. In addition, family members worked together with other family members, neighbors, and paid helpers to assist the elder. These strategies enhanced the ability of the network to assist the rural elder and also lessened the burden of care by dispersing it among network members.     

Impact of problem gambling on financial,emotional and social well-being of Singaporean families

Problem gambling has a profound impact on family members. While this has been previously documented, this paper reports on the first study to consider the extent of this impact in Asian societies where the family continues to be a very important basis for social organization. This study, based on in-depth interviews with 50 Singaporeans with a family member who is a problem or pathological gambler, examines how their financial, emotional and social well-being is impinged upon by gambling. The enormous losses of savings, property and lifestyle, the emotional tensions based on constant harassment from moneylenders, the threats of suicide by the gambler and the distancing of social networks place family members of problem gamblers in a vulnerable state. The qualitative data in this paper fleshes out the lived experience of family members and reveals the extent to which the family is mobilized in Asian societies to cope with problem gambling. While the impact of problem gambling on families is similar across societies, routine mobilization of the extended family and the greater role of public shame and embarrassment in dictating Asian families' responses underscore the need for specialized services in these societies to assist family members to better cope with the financial, emotional and social strains caused by problem gambling.     

Family Social Networks and Recovery From Severe Mental Illness of Clubhouse Members

This study examined the contribution of family social network variables to recovery among Clubhouse members. A random sample of 118 members from one Clubhouse was recruited for this cross-sectional study. Among all respondents, greater overall family support and better relationship quality with the most supportive network member were correlated with greater levels of recovery. Clubhouse members perceived higher quantity and quality of support and more criticalness from their most supportive network members, principally family members, compared to the rest of their family members. Longitudinal studies are needed to further investigate the relationship between family support and recovery.     

The Blended Family Life Cycle

Blended families face unique challenges that differ greatly from those encountered by nuclear families. Societal stereotypes that view blended families as abnormal, taking nuclear family functioning as the prototype for all family units, create a lack of role clarity for each of the members involved. Although many strategies exist with which to help families, many are based on nuclear family systems and thus are inapplicable to blended families. The creation of a blended family life cycle specific to blended family systems could help members of a blended family create a successful family unit as they work with a counselor.     

Obesity and Living Together

As shown by parent-child, sibling and twin correlations and by comparison of the children of different parental fatness combinations, fatness definitely follows family line. Indeed, fatness level can be predicted from grandparental fatness levels and from the number of obese family members living together. However, a purely genetic explanation for the level of fatness and actual obesity is untenable given fatness similarities of spouses, parents and their adopted children, adoptive siblings and of parents and their adult children who no longer live within the home. Comparing fatness levels of genetically unrelated "family" members and measuring synchronies in fatness change among family members who live together (i.e., parents and children and siblings and spouses) it is clear that fatness and obesity are both acquired in the family context. While parental and grandparental models of eating and exercising may well explain levels of energy intake and expenditure that account for differences in fatness differences in children, there is also some evidence that fatness and fatness gain of younger family members may affect the body fat mass of members of the elder generation. The largely-learned family line nature of fatness and obesity becomes important in the early diagnosis of obesity, the prevention of obesity and in programs of fatness reduction and dietary reeducation if they are to be of lasting effect.     

Toward a More Optimal Selfobject Milieu: Family Psychotherapy from the Perspective of Self Psychology

This paper applies the theory of self psychology to the understanding and treatment of families. The healthy family is viewed as a reliable source of selfobject experience for its members, while problems in or between family members are seen as due to a lack of adequate selfobject experience for one or more members. Causes of selfobject failures or misattunements in the family are examined, with an emphasis on the influence of previous relational experiences on current needs, capacities, and experiences of others. Curative factors in this form of family therapy are then outlined, and a treatment approach designed to help family members become better able to provide empathically attuned responses to each other is described, with a case example used to illustrate key points.     

Family Discussion Groups for Patients with Chronic Pain: A Pilot Study

This pilot study investigated the benefits of discussion groups for patients with chronic pain and their family members. Nineteen patients with chronic pain and 41 relatives participated in four consecutive groups. Most patients and family members found their participation clearly helpful for themselves and for the family. The group helped them to improve communication, support and mutual relationships, and to better cope with the pain. Reported beneficial factors were experiencing communality, having a place to discuss things with each other, gaining insights, and learning from fellow‐sufferers and their own family. Post treatment, patients also felt less distressed by the pain, less depressed, less insufficient and showed an increase in life‐control and social activities. Moreover, some aspects of the family climate improved, but only in the perception of the family members. The present study points to the value of a multifamily format in chronic pain therapy and suggests the appropriateness of further controlled investigation.     

Resident and family perspectives on assisted living

This research describes and compares the relative importance residents and family members place on attributes of the environment, the programs, and the policies of assisted living; describes their satisfaction with these features; and identifies factors associated with congruence between residents' and family members' ratings of importance and satisfaction. Both residents and their family members had high importance and satisfaction ratings. Family members gave the assisted living setting lower satisfaction ratings on all features than did residents. Congruence ranged from 34% to 71% for importance items and from 29% to 63% for satisfaction. Female residents, affectionate family relationships, and residing in an AL owned by a chain were positively associated with congruence on importance items, while resident and family education, resident income, and family involvement were negatively associated with congruence on importance items. For congruence on satisfaction items, having an affectionate relationship was positively associated and higher ADL dependency, more family involvement at the facility, and family members who viewed the facility as a safe place were negatively associated with congruence. This study makes a major stride forward because cognitively intact residents' perspectives are compared and contrasted with their own family members' perspectives, thus showing that residents and family members are two distinct groups, each with a unique set of preferences.     

Resident and Family Perspectives on Assisted Living

Abstract

This research describes and compares the relative importance residents and family members place on attributes of the environment, the programs, and the policies of assisted living; describes their satisfaction with these features; and identifies factors associated with congruence between residents' and family members' ratings of importance and satisfaction. Both residents and their family members had high importance and satisfaction ratings. Family members gave the assisted living setting lower satisfaction ratings on all features than did residents. Congruence ranged from 34% to 71% for importance items and from 29% to 63% for satisfaction. Female residents, affectionate family relationships, and residing in an AL owned by a chain were positively associated with congruence on importance items, while resident and family education, resident income, and family involvement were negatively associated with congruence on importance items. For congruence on satisfaction items, having an affectionate relationship was positively associated and higher ADL dependency, more family involvement at the facility, and family members who viewed the facility as a safe place were negatively associated with congruence. This study makes a major stride forward because cognitively intact residents' perspectives are compared and contrasted with their own family members' perspectives, thus showing that residents and family members are two distinct groups, each with a unique set of preferences.     

Children Living With Uninsured Family Members: Differences by Family Structure

Despite increased access to insurance through the Patient Protection and Affordable Care Act of 2010, uninsurance rates are expected to remain relatively high. Having uninsured family members may expose children to financial hardships. Eligibility rules governing both private and public health insurance are based on outdated expectations about family structure. Using 2009–2011 data from the National Health Interview Survey (N = 65,038), the authors investigated family structure differences in family‐level insurance coverage of households with children. Children living with married biological parents were the least likely to have uninsured family members and most likely to have all family members covered by private insurance. Controlling for demographic characteristics and income, children in single‐mother families had the same risk of having an uninsured family member as children in married‐parent families. Children with cohabiting biological parents had higher rates of family uninsurance than children with married biological parents, even accounting for other characteristics.     

Counseling for the Family: The Neglected Aspect of Addiction Treatment in Canada

ABSTRACT

There has been a historic neglect of both research and practice in the area of counselling for the family members of alcohol or other drug abusers by the addiction field in Canada. As a result, treatment for individual family members affected by alcoholism and other drug addiction remains a neglected component of the majority of Canadian addiction programs. When family involvement is incorporated, the tendency has been to concentrate on orientation and education rather than on the provision of counseling for the family members. This dearth of programming exists despite the knowledge that an active alcohol or drug abuser's behaviour disrupts the entire family system, including the functioning and development of children. Each family member is uniquely affected with negative outcomes ranging from economic hardship to violence being perpetrated against them to an increased risk among children of becoming alcohol or drug abusers themselves. Thus, treating only the active alcohol or other drug abuser is limiting and an overly narrow orientation for the enhancement of both family and community health.     

Family members' strategies when their elderly relatives consider relocation to a residential home - Adapting, representing and avoiding

The aim of this article is to reveal how family members act, react and reason when their elderly relative considers relocation to a residential home. Since family members are usually involved in the logistics of their elderly relative's relocation, yet simultaneously expected not to influence the decision, the focus is on how family members experience participation in the relocation process in a Swedish context. 17 family members are included in 27 open, semi-structured interviews and follow-up contacts. Prominent features in the findings are firstly the family members' ambition to tone down their personal opinions, even though in their minds their personal preferences are clear, and secondly, the family members' ambivalence about continuity and change in their everyday lives. Family members are found to apply the adapting, the representing, or the avoiding strategy, indirectly also influencing their interaction with the care manager. Siblings applied the adapting strategy, spouses the representing strategy, while family members in the younger generation at times switched between the strategies.     

An exploratory investigation of family functioning for child inpatients: Implications for practice

This paper presents the results of an empirical investigation of family functioning for a sample of child and adolescent psychiatric inpatients. The McMaster Family Assessment Device, completed by patients and other family members at the time of the child's admission, provides an assessment of family competence in six areas; problem solving, communication, roles, affective communication, affective involvement, and behavior control. Results indicate that families of child and adolescent inpatients experience significant problems across all dimensions of family functioning. Further, patients report that family problems are more severe than do other family members. Implications of the study findings for social work practice are discussed.     

An education intervention for families of people with schizophrenia in China: development and evaluation

In China, nurses and physicians are the main care providers for people with schizophrenia. This care is provided primarily in institutions because community services are in their infancy, and families carry the burden of care. In the absence of published nursing research in the area, this article reports the rigorous development and evaluation of a culturally sensitive patient/family intervention, which was implemented in a large psychiatric hospital in Beijing, China. A random sample of 15 nurses responded to an open-ended questionnaire to explore what they believed people with schizophrenia and their family members should learn. A convenience sample of 51 family members who lived with a person with schizophrenia were also interviewed to explore what they understood and needed to know about schizophrenia. Common learning needs were integrated with the literature and presented as the Comprehensive Patient/Family Education Guide, which was implemented with an experimental group of 42 family members, while a control group of 45 received the usual hospital treatment. The effect of the intervention was evaluated by interviewing a random sample of 19 of the family members. The results revealed some useful information for the future planning and implementation of such programs, and although focused on a Chinese sample, do offer insights for nurses around the world.     

Managing Conflicting Roles: A Qualitative Study with Female Faculty Members

The interface and transactions between the roles individuals need to play in their family and employment environments are a source of both positive and negative stressors for women, their employers, and family members. Drawing on interviews with female faculty members working in three types of higher education institutions in Michigan, the paper first suggests that female faculty members’ current employment-household management is influenced by past decisions. In addition, the complexity of their family and employment careers positively and negatively influences their lives.     

Missingness Amount and Mechanisms in Family Economic Stress Research: Mapping (Non)answers to Economic-Related Variables of Fathers,Mothers, and Emerging Adult Children

The percentage of missing data among economic-related items is likely to be particularly high. This study aimed at examining the amount, mechanisms, and variables associated with missingness of different family members participating in a family economic stress study. Portuguese emerging adults (N?=?418) and their parents (N?=?748) were required to answer objective and subjective economic items and complete measures assessing individual and family psychological functioning. Results showed that, for all participants, non-response was more likely to occur among objective economic items than among subjective ones. Children presented higher percentages of item/construct-level missingness than parents, which could reflect a reduced financial awareness on the part of these family members. Although the identification of mechanisms explaining missing data proved to be complex, family members’ missingness was associated with sociodemographic and psychological indicators, suggesting that non-answers do not occur purely by chance. Implications of these findings for further family economic stress research are discussed.

     

Focus Group Study to Examine Content of Family Meetings in Short-Term Substance Use Disorder Treatment

This study explores the content family members find helpful in family meetings that occur while patients are in short-term treatment for substance use disorders. Four focus groups were conducted: 3 with 23 family members and 1 with 10 patients who were asked to identify those topics that are helpful or unhelpful for families with and without prior treatment experiences. Families identified education about substance use disorders and an overview of treatment options as useful for family members new to treatment, and an emphasis on response to relapse and family supports as important for those with prior treatment experiences.