Caring for Families:Caring for Families:The ECPB WayThe ECPB Way

Consensus from Working PartyConsensus from Working PartyG’dansk October 2008G’dansk October 2008

Collated by Hugh Martin, AustraliaCollated by Hugh Martin, Australia

The “Second Patient”The “Second Patient”

o ParentsParentsTogether Together SeparatedSeparated

o GrandparentsGrandparentso Distant relatives – extended familyDistant relatives – extended familyo Important othersImportant others

The “Second Patient”The “Second Patient”

o ParentsParentsTogether Together SeparatedSeparated

o GrandparentsGrandparentso Distant relatives – extended familyDistant relatives – extended familyo Important othersImportant others

All are involved in the patient’s recoveryAll are involved in the patient’s recovery

Strategic Principles Strategic Principles

1.1. Quality of CareQuality of Care2.2. CommunicationCommunication3.3. Individualised CareIndividualised Care4.4. EmpathiseEmpathise5.5. Emphasize the positive.Emphasize the positive.

Strategic Principles Strategic Principles

1.1. Quality of CareQuality of CareThe origin or status of the family The origin or status of the family should not alter the quality of care.should not alter the quality of care.

Strategic Principles Strategic Principles

1.1. Quality of CareQuality of Care2.2. CommunicationCommunication

Whole teamWhole teamMake timeMake timeSurgical leader must validateSurgical leader must validate

Strategic Principles Strategic Principles

1.1. Quality of CareQuality of Care2.2. CommunicationCommunication3.3. Individualised CareIndividualised Care

Care tailored to needsCare tailored to needsPlanned at team meetingsPlanned at team meetings

Strategic Principles Strategic Principles

1.1. Quality of CareQuality of Care2.2. CommunicationCommunication3.3. Individualised CareIndividualised Care4.4. EmpathiseEmpathise

With family and patientWith family and patient

Strategic Principles Strategic Principles

1.1. Quality of CareQuality of Care2.2. CommunicationCommunication3.3. Individualised CareIndividualised Care4.4. EmpathiseEmpathise5.5. Emphasise the positive.Emphasise the positive.Without distorting the truthWithout distorting the truth

Care of Family: FactorsCare of Family: Factors

• Factors common to patient & familyFactors common to patient & family• Factors confined to familyFactors confined to family• Factors confined to patientFactors confined to patient

Factors Common to Patient & FamilyFactors Common to Patient & FamilyEstablished FactorsEstablished Factors

• CulturalCultural• LanguageLanguage• Pre-morbid coping skillsPre-morbid coping skills• Pre-morbid psycho-social pathologyPre-morbid psycho-social pathology

Factors Common to Patient & FamilyFactors Common to Patient & FamilyResponse to IncidentResponse to Incident

• GuiltGuilt• BlameBlame• DenialDenial

Factors Common to Patient & FamilyFactors Common to Patient & FamilyHospital & Treatment RelatedHospital & Treatment Related

• Unfamiliar environmentUnfamiliar environment• Fear of loss of functionFear of loss of function• Fear of unknownFear of unknown• IsolationIsolation• Loss of autonomyLoss of autonomy• Unrealistic expectationsUnrealistic expectations• Highly visible nature of burnsHighly visible nature of burns

Factors Common to Patient & Family Factors Common to Patient & Family

In the acute phase;In the acute phase;most decisions are taken by the team.most decisions are taken by the team.

In the later stages:In the later stages:there is more opportunity for the patient and there is more opportunity for the patient and

the family to participate.the family to participate.

Factors Influencing Family Factors Influencing Family • Education – ability to understandEducation – ability to understand• Financial status – effects of loss of earningsFinancial status – effects of loss of earnings• Family structure – where decision making liesFamily structure – where decision making lies• Society norms – how is the family expected Society norms – how is the family expected

to respond?to respond?• ExhaustionExhaustion– Prolonged treatment – acute phase & Prolonged treatment – acute phase &

rehabilitationrehabilitation– Commitment to care after dischargeCommitment to care after discharge

Factors Confined to the PatientFactors Confined to the Patient

• Age Age • Developmental stageDevelopmental stage• PainPain

SummarySummary

• Importance of the whole family being involved in care is re-affirmed: a 2 way interaction.

• Every member of the team is involved• Good leadership is essential• Multiple factors affect the way the team

interacts with the family.• If things go wrong, re-examine the factors to

ensure all have been considered.

• Importance of the whole family being involved in care is re-affirmed: a 2 way interaction.

• Every member of the team is involved• Good leadership is essential• Multiple factors affect the way the team

interacts with the family.• If things go wrong, re-examine the factors to

ensure all have been considered.