Monday, 22 January 2018

DO FAMILIES BELONG IN HEALTH CARE?

If you have ever been in the same room with your loved one and a health care professional, you'll know that it's disorienting. I say that because it's like going to the principal's office, or having a business meeting when what you really want to do is have tea and a fire in the grate to cosy up for a long chat about what hurts. You want to have your health care needs met in the context of comfort and family, not a sterile lab.

So today, I want to address health care providers - all of them - to suggest some ways that we can be cared for and still have family around us.



HOME CARE

The first rule for home care workers should be to ask themselves, "How can I help this family do the things they would like to do in their normal way?" Professional health care aides should be prepared to take on a role of a 'shadow person' in the household, alert to what might need to be done, but watchful for cues to fit in to either a boisterous home or a bookish one. I'll never forget the time a caregiver friend told me that a personal support worker had complained to her nursing agency that my friend and her family 'laughed too loud'. When I heard that, I wondered whether it was ever possible to be entirely yourself in your own home if you needed professional care support.

HOSPITAL

How can a family still be a family when one of its own is acutely ill? The fact is, everyone fares better (including the patient) when families are allowed to care for each other. Family centred care is a concept that bandied about by hospital staff all the time. On the ward, caregivers can experience family centred care like 'family do-it-yourself care'. In a system that is over-taxed and under-staffed, hospitals may prefer to leave feeding the patient and even changing his sheets to a loved one who is holding vigil. But what can hospital staff do to welcome families and support them in a joint healing venture? By offering them a cup of tea, making clear that family washrooms are nearby, not on another floor. By acknowledging the family care role by making hospital parking free. By assuring family caregivers that special attention will be paid to their loved during caregiver breaks for meals and respite. By providing chairs at the bedside and a comfortable cot for overnights if a patient is very ill or particularly vulnerable.

LONG-TERM CARE

Paid staff at long term care institutions may cling to strict routines in order to avoid chaotic disruptions of medication or physical care schedules. Families visiting residents may threaten those routines. Telling families how they can help staff by caring for a patient in a health care institution may be akin to admitting failure or incompetence, so families end up being discouraged from helping a loved one to eat, get dressed or move about. Family members may want to visit and they may want to continue giving care to a loved one in order to preserve intimacy and the integrity of long-standing relationships. So, what can managers and front line staff of long-term care facilities do to welcome families? They can have a chat about what role the family would like to take with their loved one. They can offer to be most supportive but least restrictive to enable family gatherings. That means if the family wants to bring special food for a party, routines are adjusted for that. If family members would like to visit at a mealtime, they are welcomed to join the residents.

I think families do belong in health care. But I don't know that all health care providers agree that we do. What I can guarantee is that most patients want us there because we provide the comforts of home when we're together. And I also know that we cannot do our family care work unsupported, either at home, in hospital or in long-term care settings.


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