The role of family & friends

We’ve pulled out a discussion of the role of family/friends as a distinct unit in this e-learning because it is such an important part of best interests decision-making and because research shows that this is an element of best interests decision-making that is often problematic. If you have already done our course on “Communicating with Families” a lot of the issues discussed here will already be familiar to you and you will find some overlapping materials.

Different countries or states have different legistation about the role of the family in decision-making. The law in England and Wales is that families are very important – but they are not automatically the decision maker. The patient’s clinical team take that responsibility.  (You’ll see some observations from other learners in the comments section at the end about how this differs in some countries).

Judges working with the law in England and Wales have emphasised that a best interests decision requires learning as much as possible about the person’s values, wishes, feelings and beliefs and the decision the person would have made if they were able to do so. It is usually the person’s family and friends who are best placed to provide that information.

Look at the two statements below from judgments by Mr Justice Hayden from the Court of Protection.

In listening to families, it is important that they are clear about what they are being asked and understand their role. We identified six common problems in relation to consulting families/friends.

• Take a moment now to write down what you think might ‘go wrong’ such that family and friends are not always consulted appropriately.
• Try to come up with at least 6 possible ways in which family and friends might (at least in retrospect) feel that consultation did not happen in the way it should.
• Then have a look at what our research identified and see whether your thoughts overlap with or add to this list.

Clarity about the role of the family is vital for families, and for professionals, during any consultation about the patient’s best interests.  For example, healthcare professionals need to be clear in their focus on what the person themselves would have chosen (and unpick this from what a relative might want for themselves, or for the patient, and indeed, other factors such as family, cultural and community pressures to take a certain course of action).

Here is a 15-minute presentation for families which you can use to help them understand their role. View this resource to check your own understanding and to help you learn or refresh you knowledge about how to explain to families about their role and why they are being consulted.

Links to the materials mentioned in the presention can also be found in the Further Resources unit at the end of this course.

Think about a family you are working with at the moment – do you think they understand their role in decision-making? Make sure they have the link to this presentation if you think it will be useful to them.

Finally, listen to one interviewee describe how important it had been to consult close neighbours, and her aunt’s hairdresser too.

T

Links to the materials mentioned in the presention can also be found in the Further Resources unit at the end of this course.

Think about a family you are working with at the moment – do you think they understand their role in decision-making? Make sure they have the link to this presentation if you think it will be useful to them.