Caregivers face a lot of stress every day. One of the most daunting of all challenges is being caught in between opposing views of the patient and their loved ones. Have you been in an awkward situation where you stood witness to a family's heated argument? Was there a time when you just froze because they asked for your opinion regarding a sensitive topic? How did you handle such a situation?
When conflicts arise between the patient and the family, it's normal to feel uncomfortable and confused at the same time, especially if everyone has a good point.
Let's take the case of Martha as an example.
Martha, a hospice patient, decides to stop eating and now refuses all meals offered to her. Her daughter, Debbie, learns about it and then tells the caregiver to ignore her mother's plea and to help her eat.
Although you know that your priority is respecting what your patient wants, the daughter's request also makes sense. Now you are torn between following the patient’s wishes and her daughter’s instructions. Will you allow the patient to starve or continue serving them food against their will? It is often an ethical dilemma, where there’s hardly any right or wrong decision.
Should you encounter a similar scenario, look into the following considerations:
1. The patient has the right to their own care.
Patients have the right to decide for themselves without any influence from the physician and all other staff. This right is called autonomy. Although this kind of independence sounds simple enough, it isn’t so in real life.
Before autonomy can benefit the patient, they must have the right knowledge to make informed decisions. The problem is that the patient’s health condition can affect the way they think, or they may be emotionally traumatized so that they end up making the wrong decisions.
Looking into Martha's case as an example, her worsening condition and perhaps her pain and depression made her wish to give up on her health altogether. Her daughter, however, could not bear to see her parent starve herself. This situation presents a real conflict. Will you help feed her or withhold food?
Should you be confronted with such a dilemma where the patient's overall health is at stake, you can breathe deeply and relax with the following tip. Reach out to other members of the healthcare team because that burden is not yours alone to overcome. The whole team must be involved, including the patient and their family.
All you need to do is relay your patient's concerns to the team, and the physician and nurses will initiate a process to hear the patient out. Sometimes, after considering all sides, the physician writes an order to stop treatment, according to the patient's wishes.
For minor conflicts, however, it's best to consider what the patient wants.
2. Respect both the patient and the family.
Regardless of how seemingly absurd a request is for either side, show respect at all times. As a caregiver, you need to let patients and their loved ones feel valued and heard even in times of family strife.
3. Offer a listening ear.
Because a patient’s healthcare journey can be tough to handle, disagreements can occur within the family. Although conflicts arise, everyone usually just wants what’s best for the patient. In difficult times like this, listening and being there for the patient as their caregiver can already ease the emotional turmoil that the struggle has caused.
4. Ask your supervisor for help.
When conflicts arise between the patient and their family, help them reach a compromise. Avoid worsening the tension. Be careful not to meddle with family affairs.
If you are unsure of what to do, you may always ask your supervisor for help. Not only will they help you take the best course of action, but they can also vouch for you should the disgruntled patient or family decide to file a complaint against you for not doing what they want.
As a caregiver, you will learn many aspects of patient care, including how to handle conflicts between the patient and their family. Your role is to keep the patient safe during such trying times and to relay your concerns to the healthcare team as needed.
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