Family breakdown as a result of death

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1 Family breakdown as a result of death Why do families breakdown after death? There are a number of reasons why families can suffer breakdowns following a bereavement. A key factor is communication, which often ceases after a loss as grief is an individual experience. Difficulty in adapting Some families and individual family members find it incredibly difficult to adapt to the loss of a loved one. For example, think about a child who has lived with a sibling who has finally died from a life threatening or life limiting disease. Where does the surviving sibling now place themselves in a family that no longer has to deal with medical events and medical conditions on a daily basis? They may feel some anger and rebellion at how much time was given to the ill sibling, and to how the survivor feels now about having more of their parent s or carer s attention. There may be an increased burden on surviving sibling to grieve when relief is the prominent emotional response. Mode of death The manner in which somebody died can play a big part in whether families are strong enough to cope with their experiences. The impact of a supported expected death, where families are surrounded by medics and carers may be very different to the impact of a traumatic or sudden death. This can be broken down again into acceptable sudden death. Sudden deaths can occur from unanticipated medical conditions (i.e. a massive heart attack; brain haemorrhage etc.), or the more traumatic experience of accidental death or suicide. Is it possible that family members are more likely to blame each other for accidents or suicide than when they are when someone close dies from a medical condition or event? For children and young people caught up in feuding families it is difficult for them to process their grief over death, as well as emotionally attend to the breakdown of relationships around them. It is very common to hear children and young people talk about how they do not see their grandparents or aunties or cousins since daddy died, because, granny thinks it s all mum s fault. Sense of self If an individual does not have a strong sense of self, in relation to the importance placed on the person who has died, then the emotional shockwave of the death is likely to hit harder. Bowen (1994) suggests that, even in the case of suicide, a family member who is dealing with loss may go through a prolonged grieving process, but will not be unduly emotionally scarred if the person who died did not perform any significant function within the family. Likewise if the person who died was considered important and deemed to have a particular and direct role within the family, it is more likely that surviving individuals will grieve more deeply.

2 Pre-loss experiences For some children and young people, their pre-loss experiences are for them just as powerful as the experience of loss itself. As a result of pre-loss experiences, it may be difficult for an individual family member to begin to form an understanding of the death and then to form good memories about the person. This is because they are so enmeshed in relational difficulties within the family network. These difficulties usually existed before the death and then become more complicated and entwined as a result. Children or young people being told, forget him, he was no good anyway, may find it very difficult to grieve openly and may separate themselves from the family unit because it is too hard to reconcile their views with the views of other family members. Narrative of death In some cases, fatal accidents and deaths have been discovered by family and friends through social media or through news bulletins before the emergency services have had the opportunity to make contact. How people deal with the initial stages of grief can be influenced by how they were told about the death, and they may need to make sense of any anger or hurt about the initial delivery. If certain family members were informed before others this might lead to relationship difficulties and temporary, or even permanent, strained relations. It is not uncommon to hear, They were separated. Why did she hear before me? He was living with me now! Social support Another consideration around how individuals and family units cope through the grieving process is the level of social support they receive. Social support can mean professional support, but in the main refers to support provided by people s own personal social networks. After the initial few days and weeks following the death, continuing social support from friends and family can play a large part in a healthy grieving process. Children and young people supported by their peers and by their schools have more chance of surviving loss and family breakdown if they have a safe place to retreat to each day. For some children having a positive school experience is the only relief that they get from the picture of family grief or post-death family feuding. Family breakdown after death might take on several different guises. The most common fractures that we see are parental separation or divorce, or the breakdown of communication and or contact between parents and older children. Adapted from Child Bereavement UK (2012)

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4 Family Assessment Framework a) Child s Developmental Needs: Health Overall health includes growth and development as well as physical and mental wellbeing. The impact of genetic factors and of any impairment should be considered. receiving appropriate health care when ill an adequate and nutritious diet, exercise immunisations where appropriate and developmental checks dental and optical care for older children, appropriate advice and information on issues that have an impact on health, including sex education and substance misuse. Education This covers all areas of a child s cognitive development which begins from birth. Is likely to Involve an adult interested in educational activities, progress and achievements, who takes account of the child s starting point and any special educational needs. opportunities: for play and interaction with other children to have access to books to acquire a range of skills and interests to experience success and achievement. Emotional and Behavioural Development This involves the appropriateness of response demonstrated in feelings and actions by a child, initially to parents and caregivers and, as the child grows older, to others beyond the family. nature and quality of early attachments characteristics of temperament adaptation to change response to stress degree of appropriate self control.

5 Identity This concerns the child s growing sense of self as a separate and valued person. Race, religion, age, gender, sexuality and disability may all contribute to this. the child's view of self and abilities self image and self esteem having a positive sense of individuality feelings of belonging and acceptance by family, peer group and wider society, including other cultural groups. Family and Social Relationships This looks at development of empathy and the capacity to place self in someone else s shoes. a stable and affectionate relationship with parents or caregivers good relationships with siblings increasing importance of age appropriate friendships with peers other significant persons in the child s life and response of family to these relationships. Social Presentation This concerns the child s growing understanding of the way in which appearance, behaviour, and any impairment are perceived by the outside world and the impression being created. appropriateness of dress for age, gender, culture and religion cleanliness and personal hygiene availability of advice from parents or caregivers about presentation in different settings. Self Care Skills This concerns the acquisition by a child of practical, emotional and communication competencies required for increasing independence. Special attention should be given to the impact of a child's impairment and other vulnerabilities, and on social circumstances affecting these in the development of self care skills. early practical skills of dressing and feeding opportunities to gain confidence and practical skills to undertake activities away from the family and independent living skills as older children encouragement to acquire social problem solving approaches.

6 b) Parenting Capacity: Basic Care This concerns providing for the child s physical needs, and appropriate medical and dental care. provision of food, drink, warmth, shelter, clean and appropriate clothing and adequate personal hygiene. Ensuring Safety This is about ensuring the child is adequately protected from harm or danger. protection from significant harm or danger, and from contact with unsafe adults/other children and from self-harm Recognition of hazards and danger both in the home and elsewhere. Emotional Warmth This focuses on ensuring the child s emotional needs are met and giving the child a sense of being specially valued and a positive sense of own racial and cultural identity. ensuring the child s requirements for secure, stable and affectionate relationships with significant adults are met appropriate sensitivity and responsiveness to the child s needs Appropriate physical contact, comfort and cuddling sufficient to demonstrate warm regard, praise and encouragement Stimulation This concerns promoting child s learning and intellectual development through encouragement and cognitive stimulation, and promoting social opportunities. facilitating the child s cognitive development and potential through interaction communication talking and responding to the child s language and questions encouraging and joining the child s play promoting educational opportunities enabling the child to experience success and ensuring school attendance or equivalent opportunity facilitating child to meet challenges of life

7 Guidance and Boundaries This looks at enabling the child to regulate their own emotions and behaviour. The key parental tasks are demonstrating and modelling appropriate behaviour and control of emotions and interactions with others, and guidance which involves setting boundaries, so that the child is able to develop an internal model of moral values and conscience, and social behaviour appropriate for the society within which they will grow up. The aim is to enable the child to grow into an autonomous adult, holding their own values, and able to demonstrate appropriate behaviour with others rather than having to be dependent on rules outside themselves. social problem solving anger management consideration for others effective discipline and shaping of behaviour not over protecting children from exploratory and learning experiences Stability This revolves around providing a sufficiently stable family environment to enable a child to develop and maintain a secure attachment to the primary caregiver(s) in order to ensure optimal development. ensuring secure attachments are not disrupted providing consistency of emotional warmth over time and responding in a similar manner to the same behaviour parental responses change and develop according to child s developmental progress ensuring children keep in contact with important family members and significant others

8 (c) Family and Environment Factors: Family History and Functioning Family history includes both genetic and psycho-social factors. Family functioning is influenced by: who is living in the household and how they are related to the child significant changes in family/household composition history of childhood experiences of parents chronology of significant life events and their meaning to family members nature of family functioning, including sibling relationships and its impact on the child parental strengths and difficulties, including those of an absent parent the relationship between separated parents. Wider Family Who are considered to be members of the wider family by the child and the parents? What is their role and importance to the child and parents and in precisely what way? related and non-related persons and absent wider family Housing Does the accommodation have basic amenities and facilities appropriate to the age and development of the child and other resident members? Is the housing accessible and suitable to the needs of disabled family members? the interior and exterior of the accommodation and immediate surroundings Basic amenities including water, heating, sanitation, cooking facilities, sleeping arrangements and cleanliness, hygiene and safety and their impact on the child s upbringing Employment Who is working in the household, their pattern of work and any changes? What impact does this have on the child? How is work or absence of work viewed by family members? How does it affect their relationship with the child? children s experience of work and its impact on them Income Concerning the income which is available over a sustained period of time. Is the family in receipt of all its benefit entitlements? Is there sufficient income to meet the family s needs? The way in which resources available to the family are used. Are there financial difficulties which affect the child?

9 Family s Social Integration Concerning the wider context of the local neighbourhood and community and its impact on the child and parents. the degree of the family s integration or isolation their peer groups, friendship and social networks and the importance attached to them Community Resources This describes all facilities and services in a neighbourhood, including universal services of primary health care, day care and schools, places of worship, transport, shops and leisure activities. availability, accessibility and standard of resources and impact on the family, including disabled members. Adapted from Department of Health, (2000)