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 unfortunately are often instigated only when problems arise. These meetings can be invaluable, and should be considered on:
- 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, and
- The patient’s condition changes and goals of care need re-assessing.
The Palliative Approach Toolkit
suggests a Palliative Care case conference (family meeting) when a resident or patient meets the following criteria:
- By a positive response to the question: 'Would you be surprised if the resident died within the next six months?'
- If there has been a significant functional or medical decline
- If problems are perceived concerning goals of care around futile treatment (perhaps after acute event), and
- If the resident is transferred or admitted to the RACF specifically for comfort care / palliative care.
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.