FAMILY MEETINGS
(see Family Therapy, Talking with Families)

Definition –  A family meeting is a discussion with involved family members and the caring team to exchange information and improve communications. The patient can be included.

«  There is often no better way of caring for a patient than demonstrating that the professionals are also concerned about the family.

What is the aim? – The first aim of a family meeting is to meet some of the needs of each member of the family - needs for information, explanation and the opportunity to safely express and share feelings.

The second important aim is to emphasize that care is family-centered, and that members of a family cope best in a crisis when they support each other.

Discussion – A family meeting is a valuable, and in the long term often a time-saving, method of improving communications among professionals and within the family. It is an essential component of care, and is probably the most neglected aspect of patient care in hospitals (and occasionally in home care settings, too).

Ideally, it should be part of the normal intake procedure to offer to meet the patient with any family members or close friends he would like to have with him. A specific invitation is important. (“We would like to meet with you and your family.”) All families benefit from this approach, but it is especially important for families with young children.

«  Families brought together talk together. They are the experts in the details of their own problems. A single family meeting convened at a time of crisis is often enough to enable a family to solve problems and find new energy for the future.

Most patients welcome the opportunity to be drawn back into their family circle. Often illness has stripped the person of established family roles and responsibilities. Relationships are often strained through fear or embarrassment at discussing sensitive topics like cancer or dying. (“We didn’t want to upset him.”) Professionals sometimes unwittingly worsen communication by the incompetent breaking of bad news. (“The doctor told us not to tell him.”)

Illness and death can isolate family members as they withdraw into their own particular worries or grief. Meeting a patient alone, and meeting family members without the patient’s presence, tends to further split relationships and emphasizes the isolation of the patient. A brief family meeting can strengthen relationships and encourage feelings of shared security. Just sitting down together to talk (free of TV and interruptions!) may be an unusual and strengthening experience. As painful subjects are shared, tension is released.

Patients commonly worry about their families, but many worries and fears go unspoken. A family meeting usually brings relief to patient and family members as these issues are discussed together. For caring relatives, the family meeting emphasizes their strengths. (“You have coped so well up to now.”) It can boost their confidence to see that they are in partnership with a team of professionals.

Even if the offer of a family meeting is initially refused, the invitation itself is a significant message. It should be gently repeated because resistance and denial are often overcome in time, and the results are almost always beneficial. The visits of family members or close friends who live far away provide useful opportunities for a renewed invitation.

The idea of meeting a whole family (including a very ill person who may be near death) is a frightening prospect for many doctors and nurses. It usually requires experience and learning-by-apprenticeship to feel comfortable with this approach. Psycho-social professionals who have training and experience in working with families should involve doctors and nurses whenever possible to demonstrate the many benefits of meeting a family together.

It is important to document the event of the meeting in the clinical notes to maintain communication among professionals. Record who attended, and summarize significant conversations or problems. Note any decisions or conclusions.

The author and publisher have taken precautions to ensure that the information in this book is error-free. However, readers must be guided by their own personal and professional standards of good practice in evaluating and applying recommendations made herein. The contents of this book represent the views and experience of the author, and not necessarily those of the publisher.