A systematic approach to patient education requires including family members. Patient teaching should be conducted with the family present, whether in the hospital, in an ambulatory care setting, or at home. If family members will be the primary caregivers, educational materials should be written to meet their unique needs. Most health-related educational materials for non-professionals are written for patients. They describe what patients can do to cope with problems, but not what the family member can do to help the patient. The family caregiver needs to know everything that the patient does but, in addition, needs guidance in how to work with the patient. Family caregivers usually have a need to plan ahead for problems that may occur. They also need to learn the importance of paying attention to their own needs in order to be able to provide the best possible care to the person with the illness and maintain a reasonable quality of life for themselves.
Family members who are assuming caregiving responsibilities are often uninformed about what to do. Increasing caregiver competence requires training family caregivers with the skills they need to provide comprehensive care at home. It is helpful to plan with the patient and the family when you will be providing teaching and what to expect. Here is a sample of how you might prepare a patient for a teaching session: Mrs. Green, I have set aside 15 minutes this morning at about 10 a.m. I will be asking you and you husband to share some specific information about your home and family situation that will better help us plan your care and your discharge home. This message informs the patient about what the meeting will be about and lets her know that she will be asked specific questions about her home and family situation. In some situations, a questionnaire can be given ahead of time to collect initial data, which will be discussed during the interview. When you do meet with the patient and family, do whatever you can to minimize interruptions and distractions. Keep in mind that 15 minutes of well-planned, well-used time accomplishes more toward reaching your goals than an hour with interruptions and lack of direction.
The COPE model, a system that focuses on helping family members become effective problem solvers, is one means of approaching family teaching, especially when care needs may seem overwhelming to family members. “C” stands for creativity. Creative strategies include helping the family to overcome obstacles to carrying out medical management and to learn how to generate alternatives. To be creative in a problem solving sense, the problem solver learns how to step back from a problem and view it from a new perspective in order to develop creative solutions. For example, instead of consuming time and energy with food preparation, an elderly parent could have food delivered by Meals on Wheels, or a friendly neighbor might be approached to help drive the patient to medical appointments. “O” stands for optimism. Optimism involves looking at the emotional aspects of the patient’s caregiving needs, including helping the family caregiver learn the interpersonal skills that communicate a can-do, optimistic attitude. “P” is for planning-learning how to obtain expert information about what do in specific situations. Planning for future problems is an important part of family education. Developing contingency plans for possible events reduces uncertainty by specifying what will be done under what circumstances. “E” stands for expert information. This part of the model focuses on providing more background information to family members. Although it is important to start your teaching with “what” to do, as the family gains more confidence, teaching them the reasons why they are doing specific care tasks will help them gain a greater sense of efficacy and control. Expert information helps empower caregivers by enabling them to develop effective plans for solving caregiving problems. Table 10 outlines information family caregivers need.
Information Families Need
Source: Houts, P.S., et al. (1996). “The prepared family care-giver: a problem-solving approach to family caregiver education.” Patient Education and Counseling, 27(1), 63-73.
Using case studies of what other families in similar circumstances have done is an excellent teaching strategy. Family caregivers are often very interested in how other caregivers solved their problems and therefore respond positively to learning through care examples.