How to Speak with a Patient’s Family: Tips for the Home Health Aide

As a home health aide (HHA), your primary workplace is the patient’s home, where you’ll likely be in constant interaction with their family. Patient care is one thing, but communicating with the family is entirely another, which can be a huge challenge.

By challenging, we mean that, other than building a trusting relationship with the patient, the home health aide also needs to consider the family. Here's where the job of caregiving gets more interesting.

Every family is different, with their own set of rules and unique ways of doing things. As a home health aide, you need to acknowledge this while still providing proper care for your patient. To do so, you'll need to know how to speak up regarding your concerns.

A lot of communication challenges experienced by home health aides relate to patient and family expectations, and their knowledge of the HHA's skillset and job description. Some families feel it is not a home health aide's place to speak up and that the family has the final say on a patient's health concerns.

There are some trust issues, too, like whether or not a caregiver's observations are valuable. They'd rather ask the nurse or physician, leaving the home health aide without a voice. HHAs are just expected to do as they're told. The communication gap between the HHA and the family results in compromised patient care.

Here are some common scenarios where communication with the patient's family can be a cause of anxiety for the home health aide as well as some ways they can work around such situations:

1. Family conflicts

It is not easy to feel trapped between family members who oppose each other regarding patient care. If you find yourself in this situation, what should you do? Should you side with one and risk angering the other?

The answer is no. As long as the patient is an adult capable of deciding for themselves, and the request does not risk their safety, the final say rests with the patient.

If the matter exposes the patient to some risk, respectfully say “no” and explain why you cannot follow their requests. If they are persistent, ask them to contact your supervisor or agency and get formal permission before going along with their wishes.

2. Unreasonable patient demands

There are times that a patient makes unreasonable demands, like insisting on taking a walk in the middle of the night in very cold weather. You decide to ask the family for help explaining to the patient why such demands are not safe to allow.

First, consider talking to the patient's spouse or other immediate family members such as adult children or parents. Ask for a few minutes of their time, or ask for the best time to talk to them about your concerns.

3. Chores beyond your scope

Sure, you do light housekeeping for the patient and family, and the patient’s daughter asks you to water the plants. But, considering her instructions, it seems more like gardening and landscaping to you. How do you handle it?

If ever you're in a similar situation, where the family asks you to do a task beyond the care plan, politely say “no.” You may tell them that you'd like to help, but your contract, as per agency instructions, does not allow you to do tasks beyond your scope of duty.

Be assertive but respectful. Have the confidence to tell them your concerns and observations or ask for their help if needed. Your focus should be on helping the patient, not making your tasks easier.

For example, you want to move your patient and need a family member to assist you. Instead of saying, “I need help transferring your dad to the wheelchair,” try “Your dad needs transferred to the wheelchair. Could you give me a hand to make sure he doesn’t fall?”

See how a patient-focused request makes a world of difference?

Being a home health aide is rewarding because you’re able to appreciate how a family shares common values and traditions. Building a trusting working relationship requires you to always communicate respectfully, while following agency policies and the care plan as you go about your daily duties.