Part 2: Family Health During and After Death of a Family Member

Abstract

An ethnographic study of families who used hospice services was conducted to identify how families defined and practiced family health during a time of family transition. Eight families (N = 29) who recently experienced the death of a family member participated in three interviews. Key findings were: (a) family health is a complex construct with dynamic intergenerational linked patterns, (b) mothers continue to have roles related to family health when children are adults, (c) household context influences family health, and (d) health routines changed during caregiving and loss. Hospice care was a valued family health support during caregiving and following death. Family members deconstructed, reconstructed, and established some new health routines during the terminal phase and bereavement. Future family research should consider transgenerational influences, mothers' roles related to the health of adult children, contextual influences most predictive of family health, and interventions most supportive of families during change and transition.Health care providers often meet families when an individual has identified an illness or medical problem. Although medical encounters may be brief times, the impact of these visits often means that some aspect of family life needs to be altered. Although medical interactions occur thousands of times daily, little is known about the ways Special thanks to the American Nurses Foundation who provided funding for this study, the Hospice of Southern Ohio, Portsmouth, Ohio, who provided access to the study participants, and the hospice families who were willing to tell their stories.

Families That Do Well: Lay Conceptualizations of Well‐Functioning, Healthy, Strong, and Good Families

“…Although a few grandparents over age 60 years with experiences of various life course stages participated, the focus of our larger study on family functioning in families with young children might have narrowed participants' attention to attributes of young families that do well. Importantly, however, our findings are consistent with previous studies on lay conceptualizations, which included laypeople of various ethnocultural origins, ages, and life-course stages (Ayón & Villa, 2013;Denham, 1999aDenham, , 1999bDenham, , 1999cKelley & Sequeira, 1997;Kushner, 2007;Lam et al, 2012;Martin & Yurkovick, 2014;Niska et al, 1999;Zwane et al, 2012). Comparable attributes to those described by our participants were included in these disparate samples' conceptualizations of family health/healthy family, well-functioning family, and strong family, suggesting that ethnocultural origin, age, and life course stage do not have substantial influence on how laypeople make sense of terms that refer to families that do well.…”

“…A few studies have explored laypeople's conceptualizations. Most of these focused on the concepts of family health (Denham, 1999a(Denham, , 1999b(Denham, , 1999cLam et al, 2012;Niska, Snyder, & Lia-Hoagberg, 1999) or healthy family (Kushner, 2007;Martin & Yurkovich, 2014), with smaller numbers focused on the concepts of well-functioning family (Kelley & Sequeira, 1997;Zwane, Venter, Ternane, & Chigeza, 2012) and strong family (Ayón & Villa, 2013). Common across these studies is the use of qualitative methods that involved written or oral descriptions by participants of family health/healthy family, well-functioning family, or strong family.…”

“…Each study included a disparate sample, but together the studies generated data from a diverse range of people that varied by family structure, socioeconomic status, ethnocultural origin, and age. In addition to primarily White Euro-Canadian/American samples (Denham, 1999a(Denham, , 1999b(Denham, , 1999cKelley & Sequeira, 1997;Kushner, 2007), other studies included Mexican Americans (Ayón & Villa, 2013;Niska et al, 1999), Native American Indians (Martin & Yurkovich, 2014), Hong Kong Chinese (Lam et al, 2012), and Black South Africans (Zwane et al, 2012). These samples also included diversity in age, with participants ranging from 7 to more than 90 years.…”

“…However, laypeople also identified differences among terms. Laypeople included health and healthy lifestyle behaviors in their descriptions of family health/healthy family (Denham, 1999a(Denham, , 1999b(Denham, , 1999cKushner, 2007;Lam et al, 2012;Martin & Yurkovich, 2014;Niska et al, 1999) but not in their descriptions of well-functioning family (Kelley & Sequeira, 1997;Zwane et al, 2012) and strong family (Ayón & Villa, 2013).…”

Family Homelessness Viewed Through the Lens of Health and Human Rights

“…Denham [22][23][24] conducted a series of ethnographic research studies with families living in an Appalachian area of southeast Ohio and discovered that Appalachian mothers were the primary health care resource for the family, acting as gatekeepers as well as care providers. Denham [22][23][24] conducted a series of ethnographic research studies with families living in an Appalachian area of southeast Ohio and discovered that Appalachian mothers were the primary health care resource for the family, acting as gatekeepers as well as care providers.…”