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1
Family Meetings with Vulnerable Patients-An
Exploration of Multidisciplinary Team
Practices and Communication
Introduction
Results- Cycle 1
Family meetings are intended to encourage active
participation and empowerment of older people and
their families in decision making however, doubts
exist as to whether they effectively carry out
this role. The aim of this study is to observe
and describe in rich detail the communication,
language and behaviours of older patients, their
family members and members of the
multidisciplinary team (MDT) within family
meetings in a hospital setting.

• - All patients gt65. 7 men,3 women.
• 7 patients assessed as having a level of
  cognitive
• impairment.
• - 4 out of 7 assessed as being without capacity
  and
• did not attend the family meeting.
• - Family member attendance varied between 2-7
  attendees
• - Staff attendance varied between 3-6 attendees.
• Consistently good eye contact maintained between
  staff and family members.
• Eye contact poor with patients, particularly
  those with a cognitive impairment.
• Older people with higher levels of cognitive
  impairment had noticeably lower participation
  levels than family caregivers
• Participation levels of family members was much
  higher than patient participation
• In half of all meetings observed, no final
  decision was made.
• All older people who attended and eight families
  believed they had been included in the
  decision-making process.
• Two families believed decisions had already been
  made by staff unilaterally but they still felt
  the meeting process had been useful.
• Patients with a cognitive impairment were
  observed to be talked over with usage of the
  3rd person by both staff and family members.

Methods

• The study design incorporates a 3 stage action
  research cycle. This is used to develop a
  framework which will recommend ways of improving
  practice through partnership in working with the
  MDT as co-researchers. The study explores the
  experiences of participants in family meetings in
  a clinical setting using an ethnographic
  approach. Cycle I included a convenience sample
  of ten family meetings with inpatients of a
  Department of Geriatric Medicine.
• Cycle II includes a convenience sample of ten
  family meetings with inpatients under the care of
  the Stroke Service who were assessed as having a
  cognitive/communication difficulties. A mixed
  method study design is adopted which includes
  participant observations of family meetings,
  questionnaires and staff focus groups.

• Care Planning Meetings within hospital setttings
  are an important forum for older people, their
  families and the MDT.
• Low participation levels of cognitively impaired
  patients is a concern given their vulnerability
  and supports literature findings which argue that
  the voice of the older patient may get lost
  within the meetings process.
• This studys findings demonstrate the importance
  of finding new ways of communicating with
  vulnerable cognitively impaired patients in
  meetings. Results have implications for
  developing more creative methods of communication
  between patients and health care professionals in
  hospital settings.

Conclusions

ReferencesEfraimsson et al. J
Clinical Nursing,200413562-57
CONTACT DETAILS Sarah Donnelly, Research Social
Worker/PhD Student, School of Social Work and
Social Policy, TCD. Ph-01 8963369 Email-donnels1_at_t
cd.ie
Acknowledgements-Special thanks to Atlantic
Philanthropies for part-funding PhD degree.
Donnelly, S Cahill,S Carter-Anand,J
Gilligan,R Mehigan,B and ONeill,D.
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