Dealing with the Difficult Family

By CareerSmart Learning Contributor, March 16, 2017, as published by Healthcare Hot Spot


Healthcare providers often discuss difficult patients and how to best work with them, but the families that cause headaches are not always a hot topic.  However the family is described – demanding, challenging, “crazy”, etc. – working with them can test a healthcare worker’s limits, but there are ways to make it easier.  Families don’t act a particular way for no reason; there is always an underlying motive that directs their actions, words, and tone.  The following three feelings are common influencers on a family’s behavior:

1. Helplessness:  A family feels helpless because someone they love is in the hospital and all control is out of their hands.  If their loved one wants food, they have to call the nurse, if blankets are needed, they have to call the nurse.  Machines surround the family and patient, but the only thing they know how to work is the call button.  When a family is feeling helpless, educate them so they understand what the different machines do, what some of the numbers mean, and where the blankets are.  Restoring some power back to family will help them feel like they are part of the team, and not a bystander, in their loved one’s care.

2. Guilt:  This emotion can come from many avenues; guilt about their relationship with the patient, guilt that their loved one is in the hospital, or guilt that they couldn’t do more.  While this feeling can have diverse root causes, guilt is a heavy emotion.  Asking the family how they’re coping and truly listening to the family experiencing guilt is required to begin unburdening their hearts.  While a healthcare worker should not expect to help free a family from their guilt, the goal should be to understand the family dynamics and use that knowledge to better communicate with them.  If there is guilt because their loved one is hospitalized, ask the family if they want to play a bigger part in the care, keep the family briefed on the plan of care and the patient’s schedule.  If the family has guilt that they couldn’t do more to prevent the hospitalization, then include them in the discharge planning and suggest ways that they can help convalesce the patient during and after the hospitalization.

3. Anger:  Anger, like guilt, can come from a plethora of causes.  The angry family might be upset at hospital staff if they feel their loved one’s care is lacking or the family is taking their anger out on staff even though they are angry at someone or something else.  With angry families, boundaries need to be set, such as yelling or screaming at staff not being tolerated.  From there, talk with the family to figure out what they’re feeling and why.  If the family is displeased with the care, having the family speak with a supervisor might help them feel heard and that their concerns are being taken seriously.  If their anger is misdirected at staff, then reinforcing boundaries is a good starting point.

Regardless of the emotion that is driving a challenging family, it is up to the healthcare worker to remain calm and talk to them.  A simple conversation can help clear up any miscommunications and help the healthcare worker understand how the family is experiencing the hospitalization.  A conversation might not help the family experiencing guilt or anger resolve that emotion, but it will often provide a good foundation for a better healthcare worker-family relationship.  And when working with a difficult family, sometimes it is better for everyone involved that the healthcare worker take a few minutes to prepare or decompress after a stressful encounter.  Everyone deals with the uncertainty of hospitals differently and it’s important, although sometimes difficult, to remember and respect those differences.

March 16, 2017

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