Offering a structured family meeting conducted in a hospital setting for patients with advanced disease receiving palliative care may be helpful in reducing family caregiver distress and enhancing their sense of preparation for the caregiving role.
The cluster randomised, multi-site study was lead by Prof Peter Hudson at St Vincent’s Hospital in Melbourne. It examined results from around 150 control and 150 intervention patients and caregivers.
The purpose of this study was to assess the effect of structured family meetings on patient and family caregiver outcomes and to determine the cost-benefit and resource implications of implementing family meetings into routine practice.
Family caregivers in the intervention group had significantly lower psychological distress scores and higher preparedness scores two weeks after the intervention, but the scores were not significantly different two months after the patient died.
The family meetings in intervention participants were structured according to published guidelines and tailored to the needs of the patient and family.
In summary, the guidelines incorporate:
(1) principles for conducting family meetings;
(2) pre-meeting procedures, such as liaising with the patient/family and prioritising issues;
(3) deciding who needs to attend the family meeting;
(4) a procedure for conducting the meeting; and
(5) strategies for follow up after the meeting; including phoning the primary family caregiver 2 days later to discern if discussion and actions arising from the meeting were helpful.
What is already known about the topic?
A family meeting (also known as a family conference) is a clinical tool for healthcare providers to facilitate communication and care planning with patients and their family caregivers.
Whilst these meetings are considered integral to palliative care they are commonly not provided systematically, nor according to best available evidence.
Implications for practice
Hospital staff should consider conducting a family meeting as soon as feasible after admission of a patient with advanced disease, or referral to the palliative care team where resources allow. This is commensurate with guidelines and standards for family support. It is also in keeping with the concept of ‘early’ palliative care for which there is a growing evidence base.