Family Life Cycle
Families change in a predicable manner over time, moving from one stage to the next, with identifiable transitions between one stage and the next. Turnbull and Turnbull categorize these stages as follows:
are familiar with these stages from their own life experiences, as well as the
sociological content learned during their basic nursing education. When working
with families who have a child with disabilities, there are additional implications
for each stage within the family life cycle.
and Early Childhood:
During the birth and early childhood years, parents of children with special
needs are faced with the same tremendous emotional adjustments and learning
curve that all new parents face. In addition, they will be involved in the momentous
task of discovering and coming to terms with their childs special needs.
If the child is diagnosed with developmental delays, or is at risk for these
delays, the parents will be plunged into the complex world of the early intervention
system. Nurses working with the family can provide information and support as
the family struggles to adjust to these major issues.
When parents bring up any developmental or educational issues, the nurse should refer them to experts in those systems right away.
Nurses who have established
a trusting relationship with the parents can serve as a valuable sounding board
for thoughts and perceptions, while providing realistic information to ground
the process. During the early school years, parents also face the dilemma of
how appropriate (and to what degree) inclusion is for their child. Is the child
best-served by being fully included in school classes and activities or will
he do better in an adapted educational environment? Again, nurses familiar with
the childs abilities and the school system can provide a reality check
for parents and facilitate their decision-making.
The teen years are difficult enough for families of typically developing
adolescents. When the teen has a disability, the normal process of establishing
an identity and separating from parents can be even more complex. The teen years
are generally a time to expand self-determination skills, which include the
motivation, knowledge, skills, and responsive content to live life according
to the individuals values, preferences, strengths, and needs.
Nurses who work with families
of adolescents with disabilities can provide information, resources, and support
to help parents overcome the four obstacles that Powers (1993) identifies as
impediments to self-determination in individuals with disabilities:
programs and supports, supported living environments, and supported employment
are key areas of focus. The nurse who is knowledgeable about these programs
and options is in an excellent position to coach and support the individual
and his family.