Family Issues

1 Routinely ask about family issues to understand their impact on the patient’s illness and the impact of the illness on the family.

SOO: this is important for the social & developmental context and illness experience.

• Use open-ended questions to inquire periodically about family issues
• Focus attention as needed on important family issues which may not be directly related to the patient’s medical condition, but may significantly affect their illness or Tx
• Analyze potential conflicts between pt and family members / physician, general family functionality, and the impact of the sick role on the family structure and function
• It can be helpful to have both the pt and family be willing participants in the pt’s Tx plan
  • pregnancy as motivation to stop smoking
  • death of a family member and grieving leading to noncompliance with medications.

2 Explore family issues:

• periodically
• at important life-cycle points (e.g., when children move out, after the birth of a baby)
• when faced with problems not resolving in spite of appropriate therapeutic interventions (e.g.medication compliance, fibromyalgia, hypertension).

Family Life Cycle:

• Living independently from family
• Committing to a relationship
• Living together
• Raising children / adolescents
• Children leaving home, empty nest
• Retirement

Provide emotional support & education to pt and their family; empower them to take charge of the pt’s management.

Reference:

Crouch Michael A, Leonard R. The Family in Medical Practice. New York: Springer-Verlag; 1987.