- SELF STUDY MODULES
- 1. Intro to TBI
- 2. Communication
- 3. Skills for independence
- 4. Cognitive changes
- 5. Behaviour changes
- 6. Sexuality
- 7. Case management (BIR)
- 8. No longer available
- 9. Mobility & motor control
- 10. Mental health & TBI:
an introduction - 11. Mental health problems
and TBI: diagnosis
& management - 12. Working with Families
after Traumatic Injury:
An Introduction - 13. Goal setting
- 12.0 Aims
- 12.0A Take the PRE-Test
- 12.1 Why is working with families important
- 12.2 What is the adjustment experience for families
- a) The journey
- b) The challenges
- 12.3 Principles and skills
- a) Partnering
- b) Whole of family
- c) Family reactions
- d) Respect
- e) Empowering
- 12.4 When to get help
- 12.5 Take home messages
- 12.6 Resources
- 12.7 Take the POST-Test
12.3a Principles and skills: Partnering with families
- i) Principle:
Partnering with families Q - ii) Including
families - iii) Cheryl: Video
Feeling overwhelmed - iv) Setting
boundaries
Principle: Partnering with Families
Partnering with families recognises the vital role they play in providing support to the person with traumatic injury.
With the agreement of the person with the injury family members can provide crucial information regarding assessment, goal setting, therapy, evaluation and discharge planning.
Family members knowledge of their relative’s situation and expertise in knowing how to provide specific support is invaluable to the multidisciplinary team. Yet, the expertise of family members is often not recognised, and many decisions are made without family member input.
By partnering and consulting with family members, staff encourage active participation and assist family members to be better prepared to manage the challenges they may face in the future.
It is important to recognise that the family will be facing and dealing with the long term consequences of the injury.
To work together as a team with family members, communication channels must be clear and open. Both staff members and family members need to be able to exchange important information with one another. Families need to be both included and informed.
Brainstorm
Having family meetings (usually 4-5 people)
Family members come to sessions
Set family up to continue therapy
Provide education
Involvement in goal setting
Spend time outside of the hospital with them where possible to see them perform their other roles
- For eg. on ward outings
- Getting to know them for who they are
- Not talking about therapy all the time
Including family in goal planning
- Encourage questions
- Provide information
Include them in the process of planning for transfer prior to arriving in rehabilitation
- Knowing who their staff members will be
- Helping them to prepare for change so it is not as daunting
Including families and sharing information
Some ways to include and share information with the family are:
- Check family involvement with the person who has the injury
- Ask family members about how involved they want to be
- View the family as part of the team and involve them in discussions, planning and goal setting. If they are unable to attend give them notes from meetings so they are kept up to date about the process
- Acknowledge the level of involvement may change over time due to other responsibilities or commitments they may have
- Although the person with the injury may be an adult, it is helpful to include the family in the decision making process so they understand what is being suggested and why
- You can encourage families to be present sometimes at therapy so they can learn some of the skills required to care for the injured person.
This can include:
o watching and learning about bowel care, hoisting, and skin care.
o When teaching family members, make sure you use language that can be understood
and if required, repeat instructions or write things down - Encourage other team members to discuss care and treatment with the family and make sure the team are all providing consistent messages to the family
- If family are unable to be present during working hours, keep them informed by telephone or e-mail so they can continue to feel they are part of the process
- Most importantly remember that family members are a great resource to better understand the person with the injury. They can give insight about a person’s coping, strengths, likes and dislikes which make it possible to work more effectively with them
It is important to remember that the person with the injury may not want to involve family members or for you to provide them with information. If this is the case, and the person has the capacity to make their own decisions, you must respect their privacy and confidentiality. You may need to ask for permission from the person to give family members feedback or information.
Partnering with a family (1 min 34 secs)
Cheryl is the wife of Peter who had a Spinal Cord Injury.
Here is an example of what someone might be experiencing when you are trying to partner with them.
Peter was in hospital immediately after his injury and Cheryl was dealing with what had happened.
The video may take a few moments to load.
Here are some strategies for staff to help families access information:
- Repeat information
- Provide diagrams and write information down
- Encourage questions
- ask for information to be written down
- Provide explanations in Plain English with no jargon
- Encourage family members to write down questions ahead of time
- Check if family members have understood
- Provide family members with times you are available
- Offer minutes of family meetings
- Allow meetings to be recorded if appropriate
Here are some strategies for families who feel overwhelmed by offers of help:
- Use a family member or friend as a key contact point
- Write a group email
- Set up a blog on the computer
- Use “Facebook”
- Send an SMS on your mobile phone
- Use your answering machine
- Prepare your story
- It is OK to say No to requests!
- It is OK to not answer every call
Here are some general strategies for families to assist them to be organised:
- Keep a diary and write down key dates for hospital admission, surgery, scans, appointments and so on
- Make sure you write in your diary every day
- Ask staff if you can get copies of reports (discharge reports, assessment reports, reports from scans)
- Create a folder for all the letters you receive from the hospital, from lawyers, other people involved
- Ask for information to be written down
- Write down a daily or weekly ‘To Do’ list
- Create a book with all the key phone numbers
- Enter all the key names and phone numbers into your mobile phone address book or contact list
- Keep all receipts
Setting boundaries
Partnering with families be very helpful, but there may be times the relationship becomes so close that the family or staff overstep the boundaries.
How to know when a family member is asking too much...
- Staff are being asked:
- for personal details such as address, phone number or date of birth
- to perform duties outside of their role, or usual work hours
- to take sides
- for any personal information which they would rather not share
Strategies staff can take....
- Be clear about their role at the first meeting.
- Do not share personal circumstances with family members
- If asked, explain that they are unable to share personal details with clients
- Respond to personal questions broadly, for eg. “I live in the Eastern Suburbs”, rather than “I live in Bondi”.
- Contact the manager if there is any clarity required regarding roles, and inform the family member of the manager’s response
- Make clear ‘I’ statements. Suggest support avenues where appropriate and available
- Do not share information about their own relationship status, or that of other staff and clients
