The Impact of Chronic Illness on the Family

1 Many different coping strategies can help familymembers deal with the stresses of chronicillness. But when coping strategies aren tenough, help should be Impact of Chronic Illnesson the FamilyBy Erika Lawrence, PhD21 June-July 2012 IG Living!Afamily develops a kind of homeostasis a normaldynamic and routine that is disrupted when amember of that Family develops a Chronic , Chronic Illness changes Family members roles,responsibilities and boundaries. It disrupts their self-images and self-esteem. It results in uncertain and unpre-dictable futures. And it triggers distressing emotions anxiety, depression, resentments, feelings of helplessness,as well as Illness -related factors such as permanentchanges in physical appearance or bodily functioning . How a Family responds to Chronic Illness varies based onthe age and developmental stage of the ill individual, thestrength and coping mechanisms of the Family , and thefamily life-cycle stage.

2 There are many different ways thata Chronic Illness can affect a Family . The person who ischronically ill may feel guilty about the demands his or herillness makes on the Family . He or she may resent the changein roles and responsibilities caused by the limitationsimposed by the Illness , and he or she must deal with thethreat to his or her autonomy and the need to depend onhealthy Family members. The spouse or partner of a person with a Chronic illnesscan be faced with dual challenges: 1) as the primaryprovider of support to the ill partner and 2) as a familymember who needs support in coping with the Illness -related stresses he or she is experiencing. The burdens ofbeing the primary caregiver may take their toll. The spousemay feel trapped while trying to balance dependence andautonomy of the patient with his or her own needs. He orshe may feel tired or emotionally drained by the long durationof the Illness or the extent of the caregiver workload.

3 Thespouse may struggle with feeling powerless when his orher partner is in pain, or by the pressure to be emotionallystrong. There may be concerns about the consequences ofthe Illness for the spouse, his or her partner and, if relevant,the children. And, he or she may have to restructure familyroles and responsibilities as the disease progresses orpresents new challenges. Having a child with a Chronic Illness affects the parentsin unique ways as well. Some studies suggest that havinga child with a Chronic Illness has a negative Impact on therelationship, including lack of time with the spouse,communication problems, higher divorce rates, increasedrelationship conflict, increased role strain, and decreasedrelationship satisfaction. Yet, other studies indicate thatthere are no effects, and still others have found positiveeffects including increased closeness, greater cohesionand increased support.

4 Indeed, rates of divorce are loweramong couples who have a child with a Chronic , the Impact that having a child with a chronicillness has on the adult relationship depends on the severity,course and prognosis of the Illness , as well as on the qualityof the relationship before the child became ill. Given all of these adjustment demands, one might expectthat the presence of a Chronic Illness would inevitably resultin significant emotional difficulties and breakdown in familyfunctioning. But, despite the presence of conditions andsituations that are clearly traumatic and disruptive, asubstantial proportion of families make satisfactory if notmagnificent adjustments. Effective Ways for Couples to CopeMost people talk about coping as problem-focused(taking care of what needs to get done) or emotion-focused (trying to reduce emotional distress). However,there is a third type of coping that is critical for couples orfamilies faced with a Chronic Illness : relationship-focusedcoping.

5 Relationship-focused coping means focusing onmaintaining the quality of the relationship as part of thecoping process. When faced with a stressful situation,each partner may attend to the other s emotional needs inorder to maintain the integrity of the relationship. Partnersendeavor to manage their own distress without creatingupset or problems for the other partner. Relationship-focused coping involves a balance between self and other,with the goal of maintaining the integrity of the relationshipabove either spouse s needs. Effective strategies includenegotiating or compromising, considering the otherperson s perspective and being empathic. Specific strategiesinclude:View the Illness as a couple or Family problem: If bothpartners take a relationship perspective, they see the illnessas a problem for the relationship, rather than just a problemThe person who ischronically ill may feelguilty about the demandshis or her Illness makeson the 2012 IG Living!

6 For one individual. They talk about the relationship as away to cope and maintain the relationship. Couples whobecome aware of and discuss the relationship implicationsof a partner s Illness can anticipate how their relationshipmay change and prepare for the difficulties they may who are resilient when faced with a Chronic illnessbelieve that they are in it together and serve as each other sconfidante, advisor and sounding board. Therefore, theirattention should focus on the relationship as its own example, if the caregiver is thinking about how diffi-cult it must be for his or her partner to be ill, then thefocus is on the partner within the relationship but not onthe relationship itself. With relationship awareness, thecaregiver focuses on the relationship by telling his or herpartner that the difficulties posed by the Illness are their difficulties, thereby taking a relationship perspective indealing with the Illness .

7 Use similar or complementary coping strategies: Thegoal of couple coping is to maximize the fit between part-ners coping styles in order to most effectively cope as acouple. Strategies that work in direct opposition or cancelout each other lead to poorer Family dynamics. Couples coping strategies can be effective if they are similar orcomplementary, though. If partners use similar copingstrategies, it might be easier to contend with efforts are coordinated and mutually reinforcing that is, one partner s efforts do not impede the other sefforts. Complementary coping styles can be effectivewhen they work together to reach a desired goal, , byfilling a coping gap. In fact, complementary strategiesmay be more effective than similar strategies because thecouple, as a unit, has a broader coping repertoire. What if each partner has very different coping strategies?

8 Partners need to be aware of and talk about their own andtheir partner s coping styles. The goal is to understand andrespect each other s ways of coping. Also, given that eachhas different coping styles, it is especially important tocompromise, communicate about feelings to each other,give each other time alone, and reassure each other oftheir love and relationship-focused coping strategy is protectivebuffering, which involves hiding concerns, denying worriesand yielding to the partner to avoid disagreements. Although protective buffering is ostensibly used to avoiddisagreements and protect the relationship, it cannegatively affect the person using it because the partner may feel constrained in expressing negative emotions orworries. However, protective buffering doesn t appear toharm the partner being protected. In general, it is necessaryto balance taking care of oneself and the partner forboth the individuals and for the relationship.

9 Effective Ways for the Whole Family to CopeCommunicate with each other: Family members shouldcommunicate constructively about the Illness and should use active and empathic listening skills andconsider other Family members perspectives. Whensharing something sensitive, they should be mindful ofwhat is being communicated, how it is being said, andwhen it is communicated in relation to the others level ofreception. They need to talk openly about the chronicillness, but not allow talk of the Illness to dominate thefamily members daily lives. Support each other: Effective support in a familyinvolves more than just being supportive. First, differentpeople want different types of support: Some people wantpractical help, others want to be listened to, and stillothers want to know that the other Family members thinkthey are strong enough or capable enough to handlethings.

10 More support is not necessarily better. What kindof support the Family member wants needs to be understood and then provided. Second, Family membersneed to learn to ask for the kind of help or support that iswanted. Each member of the Family wants some kind ofsupport. Others tend to provide the kind of support theywould want, but they may not know what the otherswant. It shouldn t be assumed that Family members canread each other s minds. Increase and lean on social support outside of thefamily. It is well-known that having a social supportnetwork outside of the Family benefits all members of thefamily, both physically and psychologically. Sometimes,just knowing they are available if needed even if theyare not turned to can be helpful. Integrate tasks of Illness into the Family s daily will help the Family develop a coordinated, cooperativeCouples coping strategiescan be effective if they aresimilar or 2012 IG Living!