Skills/Chapters

Our new family conference video outlines 7 steps that enable you to inform, connect, and make decisions with families when patients have a serious illness are aren’t able to participate. We designed a new format for this video so that you can get an overview of the entire process of a conference. A TED-Ed lesson and a quick 1-page guide will follow soon, so stay tuned!

A serious illness is a family matter. (And by ‘family’ we mean anyone important enough, biologically related or not, to be present at a conversation with a clinician.) Your willingness to meet with a family is hugely important, especially when a patient’s medical condition is worsening, decisions need to be considered, and you want to support constructive coping. Enlisting the family by enabling them to understand will help you, and help your patient. But you may need to get them on the same page.

Often the family conference is assumed to be about resetting goals of care, but here we will focus on the skills needed to communicate with a group. The trigger for holding a family conference might be serious news, prognosis, or goals of care—yet if a family is involved, communication skills for dealing with a group might be more important than the skills needed for talking one-on-one.

To work effectively with a group, you can’t talk to just one person. Perhaps the most common pitfall is for a well-meaning clinician to address just one person in the group. You need to give every person a little face time—and for big decisions, you need to hear from every person, if only a little. Then you have to realize that group behavior is more than just the sum of the individuals. Each family member has their own views, needs, and relationship with the others. You shouldn’t be aiming to change their dynamic. But you can learn to make the best of it.