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Meetings with family enhance palliative care
Guidelines outline steps for successful meetings
Although family meetings are recognized as an effective way to communicate diagnoses, treatment plans, and goals of care with palliative care patients and family members, research shows that there is little information available to palliative care providers about the best way to conduct these meetings.1
Literature review assisted
A literature review, development of initial guidelines, and revision of guidelines following feedback from an expert panel and focus groups resulted in a set of clinical guidelines that guide palliative care professionals through the process of initiating and conducting the meetings.
In addition to the clinical guidelines, the authors also produced a list of guiding principles for family meetings:
Family meetings can provide safe environment to clarify goals, consider site-of-care options, and share information.
Palliative care providers have a responsibility to offer family meetings based on need.
Service providers should view family meetings as mutually beneficial.
Family meetings are not an opportunity for providers to debate a patient's medical status.
Family meetings should not be saved for "crisis" situations, but they should be used proactively before issues become major dilemmas.
Family meetings should be offered routinely upon admission.
Facilitators should not be chosen based on hierarchical reasons, but they should be chosen based on who is best suited based on knowledge of the family, skills, and issues to be discussed.
When there is significant conflict within the family about prognosis, site of care, or transition from curative to palliative care, providers should involve a health psychologist or family therapist.
Other tools included in the study are recommendations for accurate documentation of the meeting, questionnaires for family members, and follow-up suggestions. To see a copy of the guidelines and other tools, go to www.biomedcentral.com. Select "Journals A-Z" on the left navigational bar, then choose "BMC Palliative Care." Scroll down to "Family meetings in palliative care: multidisciplinary clinical practice guidelines."
1. Hudson P, Quinn K, O'Hanlon B, et al. Family meetings in palliative care: Multidisciplinary clinical practice guidelines." BMC Palliative Care 2008; 7:12.