The patient and family adjustment to chronic disease in the home

The increase in chronic disease with shortened hospitalizations has led to an increase in home care, with added adjustment problems for patients and their families. The majority of families cope satisfactorily, although most have periods of instability or difficulties which require appropriate support. In considering the impact of chronic illness, cognizance must be taken of the patient, the illness, the caregiving system, the medical care system, the interrelationship between them and the effect of the environment on all of them. The adjustment to chronic illness depends on the complementary meshing of the life and time cycles of the above factors during the alternating periods of crises and chronic maintenance. It is apparent that, in a pluralistic multicultural society, a broad range of diverse family forms and functioning is compatible with adjustment to a member with chronic disease. Finally, a scheme for the medical team's assessment and care is presented.