1. / 251 Saudi Diploma in Family Medicine Center of Post Graduate Studies in Family Medicine The Family Life Cycle Dr. Zekeriya Aktürk zekeriya.akturk@gmail.com www.aile.net

2. / 252 Objectives At the end of this session, the participants should be able to; –discuss the definition of “family” –compare marital patterns of KSA with other countries –discuss crtitical tasks during different family stages –identify and describe the various life stages –explore the changes that occur in families throughout the life cycle –explore the responsibilities associated with roles

3. / 253 Definitions a group of individuals living under one roof and usually under one head a group of persons of common ancestry the basic unit in society traditionally consisting of two parents rearing their children اُسْرَة عائلة http://www.merriam-webster.com/dictionary/family

4. / 254 1.Families contribute to the production and/or maintenance of symptoms –To reach a more complete diagnosis and understanding, physician needs to explore the symptoms in terms of the family system –Examples: Depression Obesity and weight loss Heart disease 2.Different stages of the family may have different implications on health Families affect health and illness

5. / 255 Individual Life Cycle

6. / 256 Stages of the Family Life Cycle

7. / 257 Family Life Cycle Duval 1977 1 2 3 4 5 6 7 8 2 yrs 2,5 yrs 3,5 yrs 7 yrs 8 yrs 15 ± yrs 10-15 ± yrs 1.Married couples (without children) 2.Childbearing families (oldest child, birth to 30 months) 3.Families with preschool children (oldest child 30 months to 6 years) 4.Families with school children (oldest child 6 to 13 years) 5.Families with teenagers (oldest child 13 to 20 years) 6.Families launching young adults (first child gone to last child leaving home) 7.Middle-aged parents (empty nest to retirement) 8.Aging family members (retirement to death of both spouses (retirement to death of both spouses)

8. / 258 USA

9. / 259 KSA:Female 24 years; Male 28 years. TFR: 5,74

10. / 2510 Cumulative nuptiality KSA

11. / 2511 Percent having previously cohabited with current spouse by age and sex AGE MALES FEMALES 18-2948%44% 30-3945%51% 40-4934%27% 50-5910% 8% 60-6910% 6% 70+17% 5% TOTAL30%28%

12. / 2512 Consanguinity Saudi Arabia Family Health Survey, 1996

13. / 2513 Polygyny - Bahrain

14. / 2514 Polygyny - KSA

15. / 2515 Divorce - Bahrain

16. / 2516 Divorce - KSA

17. / 2517 Albania 10.9 Armenia 6 Austria 43.4 Azerbaijan 10.3 Belgium 44 Bosnia and H. 5 Bulgaria 21.1 Canada 37 Croatia 15.5 Czech Rep 43.3 Denmark 44.5 Estonia 46.7 Finland 51.2 France 38.3 Georgia 6.6 Germany 39.4 Greece 15.7 Hungary 37.5 Iceland 39.5 Italy 10 Japan 1.9 Latvia 34.4 Lithuania 38.9 Luxembourg 47.4 Macedonia 5 Moldova 28.1 Netherlands 38.3 Norway 40.4 Poland 17.3 Portugal 26.2 Romania 19.1 Russia 43.3 Slovakia 26.9 Slovenia 20.7 Spain 15.2 Sweden 54.9 Switzerland 25.5 Turkey 6 Ukraine 40 United K. 42.6 United States 54.8 Yugoslavia 12 World Divorce Rates; %

18. / 2518 Children’s Reactions to Separation & Divorce Rakel RE. Textbook of Family Practice

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20. / 2520

21. / 2521 Tasks during family stages Often developmental tasks of family members are in conflict, and many of the tensions of family life are caused by these conflicts. –Adolescent: need to achieve independence –Parents: guiding his/her development –Both partners having careers may lead to conflict as well…

22. / 2522 Stage-critical family developmental tasks during the family life cycle StageFamily developmental tasks 1 Married coupleEstablishing a mutually satisfying marriage Adjusting to pregnancy and the promise of parenthood Fitting into the kin network 2 ChildbearingHaving, adjusting to, and encouraging development of infants Establishing a satisfying home for both parents and infants 3 Preschool ageAdapting to the needs of preschool children Coping with energy depletion and lack of privacy as parents

23. / 2523 StageFamily developmental tasks 4 School ageFitting into the families of school-age families Encouraging children’s educational achievement 5 TeenageBalancing freedom with responsibility as teenagers mature 6 Launching centerReleasing young adults into work, military service, marriage etc.. 7 Middle-aged parentsMaintaining ties with older and younger generations 8 Aging family membersCoping with bereavement and living alone Closing the family home Adjusting to retirement Duval 1977

24. / 2524 May be same stage that person’s own parent had difficulty parenting them through Parent didn’t have good model from their parents so hard to negotiate that stage with their child. Examples: – if parent left home before h.s. graduation It may be difficult to help their teen through the “launching” stage. –If lost a parent at age 3, then will experience feelings of loss related to this when child is 3. –Female sexual abuse survivors molested at age 6 > issues will surface when daughter is 6 Predicting tough stages

25. / 2525 Brief counseling encounters Conceptualizing why patient is experiencing emotional upheaval at certain times in their development Normalizing such emotional upset can be very healing—Dr. patient relationship tool How might this be important in your practice?