Family involvement in the nursing home: Family‐oriented practices and staff–family relationships

Ineffective Family Participation in Professional Care: A Concept Analysis of a Proposed Nursing Diagnosis

“…These include the notions that the family is the center of the healthcare system, that family members should be the primary decision makers, caregivers, and advocates for their ill relatives, and that the family is the collaborative and nonhierarchical partner of healthcare providers. Nurses are in a unique position to assist families who have members with acute or chronic problems in all healthsettings, and it is time for nurses to consider how to help families parlicipate in the care of their family members (Bruce & Ritchie, 1997;Cohen, 1999;Friedemann et al, 1997;Jeppson & Thomas, 1999;Maas et al, 2001;Specht et al, 2000).…”

“…involvement in mutual goal setting for care involvement in planning care collaboration in determining treatment Lack of observable or verifiable behaviors indicating family involvement in care. Twelve minor defining characteristics were developed by the authors: a lack of (a) involvement in mutual goal setting for care, (b) involvement in planning care, (c) collaboration in determining treatment, (d) involvement in making decisions with client, (el interpretation of client's needs, (0 advocating for a client's needs when the client is not able to do so, (g) providing hands-on care, (h) providing emotional support, (i) providing social activities for client, (j) evaluation of effectiveness of care, (k) idenhfylng factors that affect care, and (1) providing information to healthcare teams (Friedemann et al, 1997;Li et al, 2000;Schumacher, 1996;Schumacher & Stewart, 2000). The defining characteristics of ineffective family participation in professional care are summarized in Table 1.…”

“…Family members may meet -istance from staff members when attempting decision making, protective care, or other aspects of a new role (Maas et al, 2001;Patterson & Hovey, 2000;Specht et al, 2000). They may be ignored by healthcare professionals and treated without sensitivity or respect for their concerns (Friedemann et al, 1997). Additionally, institutions and hospitals are often characterized by day-to-day rules, regulations, and formal or informal sttuctures that make family participation difficult.…”

“…Despite a decade of family-related research, there is no guide for nurses to assess the issues of family participation in varied settings (Clarke, 2000;Cohen, 1999;Friedemann, Montgomery, Maiberger, & Smith, 1997;Li, Steward, & Imle, 2000;Maas et al, 2001). Though there are several diagnoses (NANDA, 2001) related to the family, compromised family coping, disabled family coping, ineffective family therapeutic regimen management, caregiver role strain, risk for caregiver role strain, interrupted family process, dysfunctional family processes, and noncompliance do not reflect a family's need to be involved in the care of relatives, nor do they cover all the challenging roles of families.…”

Factors associated with constructive staff?family relationships in the care of older adults in the institutional setting

“…Family carers however, have always held an ambiguous position in the healthcare system. 19 They have been variously typecast as hidden patients [Hills, 1998 #81], servants, 20,21 visitors, [20][21][22] workers, 19,22 health team members, 20,21,23 partners in care, 24,25 advocates and protectors, 9,26 resources, 19,27,28 a problem, 22,29 intruders, 30 disrupters 31 and superceded carers. 19 Although health ideology encourages the formation of 'partnerships' with family caregivers, it is apparent from the limited literature examining staff-family relationships, that the experience for the family continues to be fraught with problems and that family involvement in care is far from being either smooth or widespread.…”