The object of family care is to provide for patients who no longer need the specialized services of a hospital but still require some treatment, supervision or care. When relatives or friends are unwilling or unable to take care of the patient, family care is given in private homes selected, supervised and subsidized by the hospital or other treatment agency. The service is available to many kinds of patients: elderly people with chronic, irreversible mental disorders, long-term patients who must learn to adjust to life outside an institution, younger patients who need help in making the transition to independent life but who cannot get it from their own family. In some areas the service is also available to the mentally retarded and victims of convulsive disorders. The primary benefit for all these patients is the opportunity to live in a warm, friendly home with close ties to the community. In addition, they receive special care adapted to their individual needs—for example, regular medication, psychotherapy at the hospital or clinic, a chance to follow hobbies or other recreational interests, and the opportunity to do part-time work outside the home. Foster-family care has an interesting history. It can be traced back to medieval times when, according to legend, an Irish princess fled to Belgium to escape the incestuous advances of her mad father. There he overtook her and put her to death near a shrine at Gheel. The girl was later re-incarnated as St. Dymphna, who dedicated herself to the care of the insane. By the fifteenth century so many pilgrims came to the shrine seeking a cure that families religious duty. The number continued in town began to care for them as a to increase, and by the middle of the nineteenth century family care itself was recognized as an important factor in rehabilitating the mentally ill. As a result the Belgian government built a small hospital to serve as a reception center for patients sent by mental institutions for family-care placement. In time the entire area became a colony for mental patients, with as many as 3500 living with families at one time—and, interestingly, mental illness in general became known as “St. Dymphna’s disease.”The family-care concept spread from Belgium to many other European countries. In America the first program was established by the State of Massachusetts in 1885, but the technique did not begin to arouse wide-spread interest until the 1930s and 1940s. At the present time twenty-four states and a majority of Veterans Administration hospitals have active family-care programs, serving about 12,000 patients in all.In developing a program, a search must first be made for suitable homes. Prospective families, or “caretakers,” are thoroughly interviewed by social workers. If they are accepted, they then receive group instruction in the care of patients and their own working relationship with the hospital. The patients themselves must be carefully prepared and oriented, and the homes must be assigned, where possible, not only with their needs but their preferences in mind. Where advisable, arrangeme are made for hospital services such as occupational therapy to be given in the home. In many cases it is also necessary to obtain the co-operation of social agencies in providing vocational rehabilitation, employment opportunities or special family services. A well-run family care program offers many benefits. It helps to release hospital beds for the acutely ill. It enables the community to assume responsibility for patients, and spreads the idea that people who have recovered from mental illness can take part in everyday activities. It gives the families an opportunity to be of valuable service and to receive some financial return. But most important of all, it gives the patients themselves a chance to live as normal a life as possible.FAMILY SIZE. The size of the family has important psychological implications. It helps to determine the relationships or “interactional systems” in which the members are embedded, and it has a pronounced effect on the total character and climate of the home. The number of “interactions” multiplies rapidly as families grow larger. According to a formula developed by Bossard and Boll (1960), in a family of three members, there are five such relationships; a second child raises that number to eleven, a third to 26, and a fourth to 57. Moreover, the nature of these relationships is contingent on many individual factors: the age and sex of each member; their interests, needs and demands; their attitudes and personal characteristics; and the special role they play in the family. In some cases not only grandparents but domestics and roomers play a significant part in the family group, but in general it has been found that the “nuclear family” (parents and children only) is more crucial—especially for the development of the children—than the enlarged or “elongated” family.The effects of the one-child familyon the character and growth of the child are discussed under a separate topic, ONLY CHILDREN. The present article will contrast small families (two- three children) with large families (six or more children) from the psychological point of view. Studies show that the small American family has generally been planned with regard to the number and spacing of children, and the parents devote a great deal of attention to the study of child care and to the children’s education. They are likely to be “wrapped up” in their offspring, eager to do their best for them, and anxious to have the children do their best in school and other activities. The mother is in charge of everyday discipline, but calls upon the father in emergencies. Both, however, make the children the center of attention, and the children, in turn, may come to expect special treatment not only from their parents but from other people as well. They are far more likely to be overprotected, indulged, and dependent than children in a larger family. The small family is often better off financially than the large family, and the children are therefore likely to have educational, recreational, and health advantages. Studies show that in physical and social adjustment they are usually somewhat superior to children from a very large family. Nevertheless, broken homes are more frequent in small families, and crises have a particularly devastating effect because there are so few members to share them. When death or illness occurs in a large family the child has the benefit of greater group support.The large family has a number of other advantages over the small family. The parents are far less likely to over- protect, overindulge, or pressure their children, and the children develop qualities of independence, responsibility, and maturity at an earlier age. They learn to work with others and do their share. The first-born girl is usually assigned the role of mother’s helper, and the first-bom boy becomes the father’s right-hand man, and can usually take over if something happens to the father. The other children contribute according to their abilities, except perhaps for the youngest, who tends to be spoiled. But theres another side to the coin. The older children are often required to do too much household work, and may therefore feel resentful toward the parents and toward the younger children who are put in their charge. They also tend to be underachievers at school, partly because they have too little time to study and partly because of their rebellious feelings. Generally speaking, it has been found that children from large families are less prone to emotional disturbance and problem behavior .than children from small families. But maladjustments do occur, especially in the first-bom and the last-bom, and more frequently among the girls than the boys. The extent of these difficulties, however, depends greatly on two factors: the relationships within the family and its financial status (Bossard and Boll,1960) . If the parents are harsh and autocratic, and also live under constant economic strain, the children tend to be poorly adjusted. But if a spirit of kindness and co-operation prevails, and financial problems are not severe, many of the adverse effects can be avoided.Finally, there are indications that medium-sized families, with three or even four children, do not haVe the disadvantages found in very small and very large families. These families tend to be superior to either extreme in terms of stability and harmony as well as wholesome child development. SeeBIRTH ORDER.An after-care service which provides mental patients with temporary or permanent placement in a foster family

Cite this page: N., Sam M.S., "FAMILY CARE," in, November 28, 2018, (accessed August 9, 2022).


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