Family focused care trial#
Family focused care series#

A structured review of family meetings at the end of life synthesized findings from 24 studies and noted that family satisfaction increased when the clinician allowed time for family speaking, provided assurance to alleviate patient suffering and not abandon the patient, while also supporting family decisions ( 10). However, no effects were found on emotional issues including anxiety and depression.

Family focused care trial#

Psycho-educational interventions to prepare caregiversĪ Swedish collaboration across ten services showed in a randomized controlled trial that a program of three family group educational sessions by physician, nurse and social worker/chaplain significantly increased family caregivers preparedness for and competence in caregiving ( 3). These issues echo those addressed in psychoeducational and supportive interventions, where in a meta-analysis, Northouse and colleagues confirmed benefits in reducing the burden of caregivers, enhancing their ability to cope, and improving both caregivers’ self-efficacy and quality of life ( 9).

Family focused care series#

In a series of studies of family caregivers for patients with colorectal and lung cancer, Mosher and colleagues identified four consistent challenges experienced by caregivers: (I) emotionally coming to terms with disease progression towards end-of-life (II) managing caregiving (III) dealing with uncertainty and (IV) responding to symptom-related suffering ( 1, 7, 8). Perspectives on family caregiving challenges The classic times that families struggle include when (I) families with young children have a parent with advanced cancer, including the single parent (II) couple conflict affects the whole family (III) a depressed parent has limited coping (IV) a disabled child will become bereaved and (V) a dysfunctional family with poor communication, unbridled conflict or reduced cohesion has limited coping and support mechanisms for the family.

However, one quarter of families have extra needs that demand specialist psychosocial care ( 6). A routine psychoeducational model should meet their needs. When is the family in need? While all families have educational needs to prepare for and provide caregiving, many are resilient and need not tax clinical services heavily. Most importantly, they are those folk that the patient will want to invite to meet together when the clinician asks for a family meeting. As we seek to learn from these developments, key questions include, “Who is the family?” “When to intervene with families?” and “Which model to apply in what circumstances?”įirstly, who is the family? One helpful definition is the notion of ‘psychological family’ as a cluster of like-minded people who hold a shared history and will support each other in the future ( 5). Yet there is clear consensus that the unit of care is the patient and family.įortunately, recent studies have emerged that continue to throw light on the unmet need ( 1, 2), effects of psychoeducation ( 3), and interventions to support difficult families from palliative care into bereavement ( 4). While the rhetoric has been strong, models of effective family-centered care have proved challenging, leaving this as one of the key domains warranting the sustained focus of our discipline in the twenty-first century. Palliative care has long aspired to the competent delivery of family-centered care alongside outstanding person-centered care.

Head, Department of Psychiatry, P Block, Level 3, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia. David Kissane, MD, MPM, FRANZCP, FAChPM, FAPM.