As a child and family therapist and as a parent, I often see the efforts that families make to try to maintain a sense of family connection in an era of technology, increased demands and very busy schedules. Most families express a desire for more quality time together and an increased sense of connection amongst family members. The medical families that I encounter describe similar goals but often note the added frustration of trying to achieve this within unpredictable medical schedules and the medical parent’s frequent time away from the family. Fortunately, a high level of family connectedness can be achieved in a medical home, even during times of lower predictability and availability.

Many families find it helpful when the expectations, routines, rules and schedules in a home exist regardless of the family members present at a given time. When adults know how the home functions, even when they are away, it can minimize divisiveness and tension between the adults in the home. When children know that the entire family operates as a unified system, it strengthens their sense of family and their sense of security and predictability with each parent.

Many families also find it useful to develop special rituals. While routines are the components of the day that unfold a specific way, regardless of who is in the house at a given time, rituals are special interactions or activities that occur in some kind of predictable fashion with the intent of nurturing a relationship. These can be activities that only occur when the entire family is present to participate, like game night, a weekend trip or a yearly family vacation. Parents can reserve special rituals for interactions with each of their children, like a particular song at bedtime or a bike ride to a favorite location. Children can also develop rituals to incorporate the idea of their medical parent into moments when that parent is unavailable, such as drawing pictures to give him/her, bringing home a souvenir from an activity or planning a surprise or treat for his/her return.

Established methods of communication can also help nurture feelings of connection within a family. Some families like using family meetings. These can serve to keep a medical parent updated about any changes that have occurred as well as ensure that all family members have a place to feel heard, acknowledged and appreciated. In a less formal way, communication games or rituals can be a fun way of checking in with family members over dinner or before bed. For example, everyone can share three positive things and three difficult things from their day or list three things they are grateful for in their day.

In order to foster a sense of family and connection, a family needs to spend time together. This can certainly prove challenging when considering the time constraints of medicine, but families can develop creative ways to see one another when time is limited.

Ideally, families spend some amount of time together each day. However, this may not always be possible in a medical family. Instead, it may make more sense to simply choose a time of day (dinner, evening, bedtime) when all family members regularly try to be present and engage together. The family can then expect that whoever is in the house at that particular time will come together as previously agreed. It may also make sense to focus on creating higher quality family engagements that occur less frequently. Then the family can put more effort into ensuring that all family members are present and fully involved.

In order to further deepen individual relationships within the family, each parent can also spend one on one time with each child. This can happen more or less frequently depending on the family’s needs, but children often like having individual time with their parents. There are fewer distractions and a greater opportunity to focus on that one particular bond within the family.

Adult time can also prove helpful. This does not always need to be time-consuming; small, genuine interactions can go a long way. When parents feel connected, though, they are more likely to support one another, show empathy and engage in kindnesses. This is a strong way to set the tone for family connectedness.

All family members have a role in developing a sense of family connection. Parents need to acknowledge the impact that the medical demands have on the children and on one another. Genuinely listening to and understanding a child’s point of view without trying to dismiss or minimize it can greatly help a child to feel heard and connected. Do not hesitate to ask children for their opinions and enlist their help. What do they think could help? What could ease some of the discomfort during times of absence? What would they like to do with the medical parent when time permits? Involving the children can increase their sense of investment and value within the family.

It takes work, creativity and flexibility, but it is entirely possible to have a strongly connected medical family. Any small step you take matters as long as it comes from a place of genuine caring for the state of your family.

Jordyn Paradis Hagar is a social worker. This article originally appeared in Physician Family.

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