2.1.5: Family and Diversity

Families play an important part in most people’s lives. It is important to keep in mind that what “family” means differs from person to person. There are many different kinds of families. This unit will explore different types of families that healthcare providers may encounter.

What makes up a family?

Nuclear families: Nuclear families include a father, mother, and at least one child. About half of all families are nuclear families (American Academy of Pediatrics, 2015).

Single–parent families: Single-parent families include one parent and one or more children. Approximately 27% of households are made up of single-parent families (American Academy of Pediatrics, 2015).

Same–sex parent families: Same-sex parent families include couples of the same sex (gay, lesbian, or bisexual) with one or more children. Approximately 2 million children in the U.S. have same-sex parents (American Academy of Pediatrics, 2015).

Unmarried couples: In families with unmarried couples, the couples may be the same-sex or opposite-sex and with or without children. About 1.5 million children in the U.S. have parents who have never married (American Academy of Pediatrics, 2015).

Couples without children: Some families include couples who are married or committed to one another, but do not have children. Couples may or may not live together, but consider their unit to be part of what makes up their family.

Extended families: In some families, parents, children, grandparents, aunts, uncles, cousins, other relatives, and even friends may be considered to be part of a patient’s extended family.

Blended families: Blended families consist of divorced or widowed parents who have remarried and have children from previous relationships. They may also have children from the current marriage. About 20% of children in the U.S. live in blended families (American Academy of Pediatrics, 2015).

Grandparents as parents: In some families, one or more grandparent serves as the child/children’s’ parent(s). Approximately 1.3 million children in the U.S. have grandparents who serve as their parent (American Academy of Pediatrics, 2015).

Adoptive/foster families: Some families have adoptive or foster children live. About 120,000 children are adopted each year and 6.3 children out of 1,000 live in foster homes (American Academy of Pediatrics, 2015).

A patient’s family may be different than that of the Home Health Aide/Personal Care Aide. Who they consider family may not be the people who you identify as family. Some people don’t have any living family or their family lives far away. They may rely on neighbors and friends to help them, and consider these people part of their family. Whatever kind of family a patient has, it is important to recognize the important role they have in a patient’s life. Any person within a family may help a patient to make important health-care decisions, provide daily care, drive the person to appointments, contact the health-care team on behalf of the patient, or provide emotional support to the patient. Remember, family is who the patient says is family.

Supporting Family Members

Family members must also adjust to a patient’s illness or disability. They may have trouble accepting the consequences of the illness or disability. Family members have many kinds of reactions to a loved one becoming sick. They may be afraid, sad, angry, or frustrated. There are numerous reasons for this. They may be concerned with finances and how to pay for their family members’ medical expenses and medicines. They may be dealing with the patient not being able to work due to their illness and disability, and are concerned with how to meet the family expenses. They may be confused with the large amount of paperwork that needs to be filled out and trying to understand medical information related to their loved one. Family members may also be physically tired from providing daily care for the patient or from frequently traveling to and from the patient’s home to care for or visit them. They may also be afraid their loved one will never become well, or worse, die. Home Health Aides/Personal Care Aides play an important role in caring for their patient and their family.

Health Aides/Personal Care Aides must be sensitive to the adjustments their patient’s family must make. They should perform their job well and refer any issues that they cannot competently handle to their supervisor. Empathize with family members. This means try to understand how they feel. If a family member comes to them with a problem, listen to their concerns. Sometimes just talking about a problem can make a person feel better about it. Be supportive and encouraging. Try not to use cliché phrases such as, “It will all work out.” Being able to paraphrase (summarize) what the person says and the feelings they are conveying (what they are trying to express) is most helpful.

If a family member or patient says, “I am scared”, or “I am so stressed out”, the Home Health Aide/Personal Care Aide can use reflection to let them know they have heard them and understand how they feel.Phrases such as: “You are feeling scared”, “I can imagine how stressful this must be for you” or “You are feeling anxious about what will happen to (patient name)” lets a person know that you are listening to them. If the problem is out of their ability to handle, they should contact their supervisor for assistance.

Be respectful of family members and allow for privacy during visits. Report to the supervisor any obvious changes or problems with the patient resulting from family visits or involvement. Not every patient has good relationships with their family. For example, if a Home Health Aide/Personal Care Aide notices abusive behavior or language, it is important that they immediately report this to their supervisor. If they notice that their patient becomes depressed or their mood changes, they must document and report these findings to their supervisor immediately. These could be signs of potential abuse.