Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T18:14:53.505Z Has data issue: false hasContentIssue false

9 - Conducting a Family Conference

Reading the Room Under the Light of Group Dynamics

Published online by Cambridge University Press:  05 April 2024

Robert M. Arnold ,
Anthony L. Back ,
Elise C. Carey ,
James A. Tulsky ,
Gordon J. Wood  and
Holly B. Yang
Robert M. Arnold
Affiliation:
The University of Pittsburgh School of Medicine, Pittsburgh
Anthony L. Back
Affiliation:
University of Washington Medical Center
Elise C. Carey
Affiliation:
Mayo Clinic, Minnesota
James A. Tulsky
Affiliation:
Dana-Farber Cancer Institute, Boston
Gordon J. Wood
Affiliation:
Northwestern Memorial Hospital, Chicago
Holly B. Yang
Affiliation:
Scripps Health, San Diego, California
Get access

Summary

Multiple family members means multiple perspectives, agendas, emotions, and values. And, families are more than a collection of individuals. They have with their own way of functioning as a whole. When meeting with family about their loved one’s care, there are important steps similar to the maps we used with patients themselves. First, pre-meet to decide who’s going to be invited. The team should also agree upon a big picture headline. During the conference, introduce all participants and the purpose of meeting. Assess what the family knows and their different perspectives. Update the family using a headline, and address questions and concerns. Empathize and respond to the various emotions in the room. Prioritize the patient’s values. Align with the patient’s values and support the family. Finally, summarize and provide a concrete follow-up plan. An effective family conference can get everyone on the same page, ensure that the patient and family understand the medical situation, and help the family and care team come together to make treatment decisions that align with the patient’s values.

Keywords

family meetingsurrogatesubstitute judgementproxy decision makingcare conference
Type
Chapter
Information
Navigating Communication with Seriously Ill Patients
Balancing Honesty with Empathy and Hope
 , pp. 136 - 154
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further Reading

Curtis, J. R., and White, D. B., Practical guidance for evidence-based ICU family conferences. Chest, 2008, 134(4): 835–43.CrossRefGoogle ScholarPubMed
Goold, S. D., Williams, B., and Arnold, R. M., Conflicts regarding decisions to limit treatment: A differential diagnosis. JAMA, 2000, 283(7): 909–14.CrossRefGoogle ScholarPubMed
Hammond, S. A., Thin Book of Appreciative Inquiry, 3rd ed. Thin Book Publishing Company, Bend, Oregon, 2013.Google Scholar
Lautrette, A., Darmon, M., Megarbane, B., et al., A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med, 2007, 356(5): 469–78.CrossRefGoogle ScholarPubMed
McDonagh, J. R., Elliott, T. B., Engelberg, R. A., et al., Family satisfaction with family conferences about end-of-life care in the intensive care unit: Increased proportion of family speech is associated with increased satisfaction. Crit Care Med, 2004, 32(7): 1484–8.CrossRefGoogle ScholarPubMed
October, T. W., Schell, J. O., and Arnold, R. M., There is no I in team: Building health care teams for goals of care conversations. J Palliat Med, 2020, 23(8): 1002–03.CrossRefGoogle ScholarPubMed
Schenker, Y., Crowley-Matoka, M., Dohan, D., Tiver, G. A., Arnold, R. M., and White, D. B., I don’t want to be the one saying “we should just let him die”: Intrapersonal tensions experienced by surrogate decision-makers in the ICU. J Gen Intern Med, 2012, 27(12):1657–65.CrossRefGoogle ScholarPubMed
Scheunemann, L. P., Arnold, R. M., and White, D. B., The facilitated values history: Helping surrogates make authentic decisions for incapacitated patients with advanced illness. Am J Respir Crit Care Med, 2012, 186(6): 480–86.CrossRefGoogle ScholarPubMed
Wendler, D. and Rid, A., Systematic review: The effect on surrogates of making treatment decisions for others. Ann Intern Med, 2011, 154: 336–46.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×