Family meetings are one way in which families can be involved, empowered and supported by nurses. They can be a proactive way of managing and planning care but often are instigated only after problems arise. These meetings can be invaluable, and may be indicated when considering:

• Referral to palliative care
• Confirmation of disease progression
• Discontinuation of treatment or when maximal medical management has been reached
• Discharge is planned from an inpatient setting
• The patient’s condition changes, and goals of care need re-assessing

When considering a family meeting (sometimes called case conferences in General Practice and Residential Aged Care) it is important to decide who should be present, such as relevant members of the multidisciplinary team, family, GP, community and or /care organisations. The patient and their family should also be asked who they think should be present.

Sometimes discussions are held after hours where crisis management may be required. As soon as possible bring in the wider team to communicate and plan what is required next.

Resources

• The Department of Health and Ageing has: Multidisciplinary Case Conference Medicare Items for GPs (whereby GPs can claim MBS Primary Care items)
• Centre for Palliative Care Education and Research - Family meetings in palliative care: Multidisciplinary clinical practice guidelines
• Clayton J, Hancock K, Butow P, Tattersall M, Currow D. Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. Med J Aust. 2007 Jun 18;186(12 Suppl):S77, S79, S83-108.
• There were a number of relevant presentations made at the 2009 Palliative Care Australia National Conference. 
  • Caring for Families: The hidden dimension of the nursing workload
  • Running effective family meetings: Can clinical guidelines help?
  • Toward Optimal Facilitation of Family Meetings in Palliative Care
  • Preparing family carers to support a relative who needs palliative care: An overview of several interventions
• End of Life / Palliative Education Resource Centre (EPERC) Fast Facts
  • Moderating an End-of-Life Family Conference
  • Preparing for the Family Meeting
  • The Family Meeting: Starting the conversation
  • Responding to emotion in family meetings
  • The Family Meeting: Causes of conflict
  • The family meeting: End of life goal setting and Future Planning

Related CareSearch page

Nurses Hub
Communication
Advanced Care Planning

Free Full Text Article

Wittenberg-Lyles E, Oliver DP, Demiris G, Petty B, Day M. Caregiver involvement in hospice interdisciplinary team meetings: a case study. J Palliat Care. 2008 Winter;24(4):277-9.

References

• Gueguen JA, Bylund CL, Brown RF, Levin TT, Kissane DW. Conducting family meetings in palliative care: themes, techniques, and preliminary evaluation of a communication skills module. Palliat Support Care. 2009 Jun;7(2):171-9.
• Hudson P, Thomas T, Quinn K, Aranda S. Family meetings in palliative care: are they effective? Palliat Med. 2009 Mar;23(2):150-7. Epub 2008 Nov 21. 
• Radwany S, Albanese T, Clough L, Sims L, Mason H, Jahangiri S. End-of-life decision making and emotional burden: placing family meetings in context. Am J Hosp Palliat Care. 2009 Oct-Nov;26(5):376-83. Epub 2009 Jul 1.