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LEARNING OUTCOMES: In this section, you will learn how to distinguish between wanted active family involvement and signs of unwanted family dominance. You will learn strategies to respectfully address and productively contain any inappropriate carer dominance.
It can be hard to know whether a very active family member is helpfully articulating the patient’s needs and providing welcome corrections or comments, OR they are silencing the patient and reducing their autonomy. 18,62,63
Sometimes, a family member's active involvement (or even what might be perceived by others as "dominance") is actually welcome and appreciated by the patient. This may be a normal part of their relationship. However, there are other times where a patient's voice may be taken away by a dominant or controlling family member.
The challenge for health professionals is figuring out if displays of dominance are unwanted.
OVERALL COMPLETION
Guideline 11: Managing dominant, controlling, or coercive family carers
Quote from an oncology health professional
Guideline 11: Guiding Principles
11.1 Attempt to ascertain if family dominance/control is wanted or unwanted
ACTIVITY: Detecting family dominance in a short film
ACTIVITY: Feedback
11.2 Understand and facilitate the patient's preferences for family involvement
11.3 Address the situation either privately with the patient or with the patient and family carer together
11.4 Respectfully attempt to contain the dominant family carer through directing their behaviour within the consultation
Reflections
Summary
Select your response
Select what you think are the top 5 information needs of family carers
Finding out about how to reduce stress in the person with cancer’s life
Accessing information about alternative therapies
Accessing information about the person with cancer’s prognosis, or likely outcome
Accessing information on what the person with cancer’s physical needs are likely to be
Learning about the impact that caring has on working life or usual activities
Accessing information relevant to their needs as a carers/partners
Accessing information about the benefits and side effects of treatments
Accessing information about the services within the hospital
Finding out about financial support and government benefits
Learning more about cancer screening
