Guideline 13: Longstanding conflict within the family

7 out of 10
Title

Specific Strategies

If family conflict is detected, respectfully address the situation

  • Respectfully address the situation either with the patient alone or with the patient and family carer together.
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With the patient alone: “It seems that there might be some difficulties between you and [family carer]. Is this something you’d like to discuss? I, and the rest of our team, are here to support you”.

With the patient and family carer together: “I’m noticing that there might be some difficulties between you both at the moment? Is this something you’d like to discuss?”

  • If the family conflict/dysfunction is disruptive to the consultation, try to establish a path forward which minimises disruption caused by the conflict and ensures important clinical care can occur.
  • For example provide guidance regarding appropriate behaviours, establish ‘ground rules’ for when family attend.
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With the patient alone: “I am concerned that the difficulties between you and [family carer] are impacting on our ability to discuss your care. How would you like to progress with these consultations?

With the patient and family carer together: “I am concerned that this conflict is impacting on our ability to discuss [patient’s] care. Perhaps we can set some ‘ground rules’ for these consultations, so that we can focus on managing [patient’s] illness”.

  • If appropriate, refer the patient (and family carer) to a psychologist, counselor, or social worker for ongoing management of relationship difficulties.
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“It seems like these are quite longstanding family issues, which is not my area of expertise. However, we have a psychologist who works with our team, and speaking with [him/her] might be very helpful. Would you like [him/her] to give you both a call?”

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