Chronic Illness and Aging Section 3: Typology of Chronic Illness and Impact on the Family

Chronic illness is a term applied to a broad range of diseases that vary greatly both in their essential characteristics and the ways in which they affect the family system and its adaptive functioning. To understand the most critical ways a chronic disease affects not only the family system as a whole but also the individual family members, one must consider the key characteristics of both the disease and the family system (Rolland, 1994). Rolland developed a typology of chronic diseases that categorizes diseases by a core set of four characteristics―onset, course, outcome, and degree of incapacitation―that are particularly relevant to the adaptive functioning of family systems. The impacts of chronic disease on the family system should be assessed in two essential domains: the family’s instrumental functions as a social unit and the critical components of family functioning. The first domain, the impact of chronic disease, considers how the disease affects the family’s capacity to fulfill its essential purposes: for example, providing material security for its members, providing for their developmental needs, and providing care and support for ill and disabled members. The second domain, the impact of critical components of family functioning, includes family structural and organizational patterns, communication processes, multigenerational patterns and the family life cycle, and family belief systems (Rolland, 1994).