Once a patient is admitted to a hospital, the health care team is likely to be involved in the patient’s treatment.
However, there’s always another team working discreetly in the background.
The family.
A daughter recalls a reaction she had with a medication 3 years ago. A spouse knows that the patient’s confusion isn’t normal. A son recalls the onset of symptoms. Someone else is aware of which hospital the patient went to last year and what treatment was useful.
All this might not be recorded in a tidy, formal fashion in the medical record.
A large amount of unofficial healthcare work is carried out by families. They provide history, notice changes, communicate with different healthcare professionals, help with medications, arrange appointments, provide emotional support and often continue caregiving long after the patient leaves the hospital.
Family members can be especially valuable information sources in elderly, confused, unconscious, very young or poor communicators.
However, this contribution can be easily forgotten.
The family can appear to the healthcare worker as a visitor, and to the member of the family as part of the patient’s care.
The involvement of families isn’t always easy, of course. Information may be incomplete, feelings may be strong and family members may have different recollections. Respecting the patient’s autonomy and maintaining confidentiality is also vital.
However, when communication is effective, families can give something no laboratory test can give: knowledge of the person prior to being a patient.
They are familiar with their own ‘normal’.
They are aware when something is unnatural.
Healthcare systems might be better served to make more of an explicit acknowledgment of this service, rather than viewing it as an informal additional service.
Sometimes, the one who knows the patient best doesn’t have the stethoscope.
They are sitting next to the bed.
Have you ever witnessed a family member give a piece of information that changed the understanding of a patient’s condition?
MBH/PS