Sara Nanetti, Faculty of Educational Sciences of the Catholic University of the Sacred Heart - Centre for Studies and Research on the Family
Observing the family through the lens of the social context allows us to grasp its identity and public role. From the historical point of view, family has contributed to the demographic prosperity, but also to the economic, cultural and social prosperity of the country. By paraphrasing the famous expression of Pope Francis: the generative potentialities of family are not limited to its inside, but they are extended to the solidarity ability to go outside from themselves, thus becoming a place of integration of the person with society, and a meeting point between the public and the private space (AMORIS LÆTITIA, 181). Such generativity can be well synthesised with the expression “social capital” that, starting from the parental bonds of care and reciprocity, extends to society.
Nevertheless, families do not always find themselves in the condition of being able to exercise an active and generative role, both for internal and for external causes. In the first case, we observe how the bonds between its members can flake apart, by corroding the generativity of the nucleus, and its impact on the social reality of reference. In the second case, the cultural, political and economic context can reduce or annihilate the public relevance of family. In these cases, we are facing a particular form of poverty that affects the identity and the relations of the family. When the families stop that virtuous circle of exchange of care with the surrounding environment composed by persons and institutions, when the trust of its components towards the human and social context is lost, in other words, when the generativity of the family is interrupted, thus drastically reducing its relational resources, we find a frequently hidden and hardly measurable poverty.
In the Italian context, the profile of such poverty shows a prevalent family structure: they are families that have limited levels of social capital (mutual trust, cooperation, solidarity and reciprocity), low levels of employment and status, scarce inclination to reading and to religious or political participation. The identity and relational poverty of families is fed and feeds a more spread economic and cultural poverty, thus starting a vicious circle. Such condition has a significant effect on the perception of the family well-being and satisfaction, thus producing a discomfort that, starting from the family, involves the entire social context of reference.
In order to identify more clearly the regenerative potentialities of the social capital of the family sphere, it can be useful to describe a case of good practice constituted by the action of the families, to face a particular form of relational poverty.
The project called Progetto Andrea started in 1995 with the aim of humanising the services connected to paediatric hospitalisation. Such experience aims at giving effective answers to the relational needs of children and of their families. In the case of prolong hospital stays, the relational needs become particularly acute due to the rarefaction of the bonds, isolation, fear of the disease, distance from friend and peers.
The Project is based on a solidarity pact between the parents of the hospitalised children, the health care workers, the local bodies, a family association (Associazione Italiana Genitori, A.Ge.), other voluntary work association and the world of school. At the Paediatric Division of the Hospital, weekly meetings have been activated between the different subjects involves (health care workers, hospitalised children, their parents and the voluntary workers) in order to identify the problematic aspects of the care process. Through the elaboration of a problem-solving strategy, it emerged the need for a closer collaboration between the main actors involved: families and health institute. The areas subject to a potential improvement are: the psychological trauma of the children, the welcoming to the facilities, the amenities and the food service. The localisation of the intervention areas allowed to reorganise the care service with a relational perspective, placing at the centre of every service the relationship between family (patient) and the health institute (health professionals). To this end, the welcoming process, the spaces and the environment were transformed, by giving particular attention to the psychological aspects.
The passage from admission to welcoming involved the health professionals, the families and the voluntaries in listening sessions, groups to raise awareness on the importance of interpersonal relationships and thematic meetings. Structural decorations were introduced, informative protocols were launched, as well as paths and meetings with the volunteers, to humanise the admission of the child and of his/her family to the ward.
The adaptation of the spaces and of the environment transformed both the amenities and the food services. Through the introduction of colours in the rooms and common spaces, the use of armchairs for the parents, the restock of coloured lab coats and sheets, the creation of a games room for the children, the use of a small kitchen and a dining room with a bathroom for the parents, the hospital acquires a more family-like role.
The synergy between the voluntary work organisations, the family associations, families and health professionals, therefore, allowed to humanise the care process, through a redefinition of the situation. A passage from a bureaucratic-technical non-place to a psychological and relational place where one can live was carried out.
Director General of the local health centre (ASL) of Latina
Our intention is to humanise children hospitalisation, the ward has been conceived as a house-school, a non-hospital like place where the parents are always present. We even have a small kitchen managed by the patient’s families. All of this is done in order to avoid traumatising the child, by recreating, as much as possible, a family environment. A great contribution came from the Voluntary Associations, which are very active in our company.
Throughout the years, university clinics, hospitals, research and care institutes joined the project, thus constituting the Network of Andrea's Hospitals. Progetto Andrea allows to see the social generativity of the family at work through the reorganisation of a new system of assistance and services organised through the direct participation of the subjects involved. The intervention of the families in the reorganisation process conferred a new cultural and organisational meaning to the pre-existing structure, by extending the typical modality of creating relations inside families to the hospital setting.
Even in a condition of extreme fragility, caused by a disease, the family, placed at the centre of a culture of bonds, has expressed its typical generative identity.
This ability to act and export the typical form of the family relation of the families-resource and it can become an antidote to fight the relational poverty of the families that are in difficulties, put to test by excessively complex and disruptive events, as the current pandemic is clearly highlighting.