The Vilans Recognition Committee for Elder Care recently approved the intervention called, ‘The Family Dialogue’ at the level ‘good indicators of effectiveness’. The Family Dialogue aims to strengthen family functionality and reduce or prevent the burden on family members caring for an older person with long-term care needs.
The Family Dialogue consists of a minimum of two scheduled conversations between a patient, one or more family members, other key stakeholders and a district nurse. The district nurse may recommend the session for nursing diagnoses. This could include, for example, when one or more family members are overburdened or at risk of being overburdened or when family dynamics are disrupted.
Attention to values, desires and expectations
The nurse conducting the dialogue is skilled in leading and structuring the conversation. The conversation is set up using a clear structure and a number of core components which can be customised. One example of such a core component is to first discuss with each other who is involved in the care situation. Then to invite everyone to tell their story in relation to the care situation, expressing their most important, values, desires and expectations. In conflict situations, for example, this leads to family members gaining a better understanding of the needs that are behind grievances.
Clarity on what everyone can contribute
As an example, one participating family member from a research project says, “The division of labor becomes clear and simple solutions sometimes become possible when family members have spoken up. Another participating family member emphasises how important it is to express desires explicitly: ‘Many caregivers and their partners have the belief that they don’t want to burden their children, while in the Family Dialogue children say that they actually want to help.’
Family Systems Nursing
The Family Dialogue intervention is modelled on the theoretical principles of Family Systems Nursing (FSN). FSN is based on the idea that a family member’s illness also affects the health of all family members; and that the functioning of a family affects how the patient experiences his illness and how the family copes with the care situation.
Training is required
The application of The Family Dialogue requires that the nurse agrees with the principles of FSN and follows The Family Dialogue training. The training is accredited by the Quality Register for Nurses and Caregivers and is provided by certified trainers from the Department of Family Care of the Hanzehogeschool Groningen.
Assessment by the Recognition Committee
‘The Family Dialogue is a relevant and well developed intervention with much attention to implementation’, the Vilans Recognition Committee describes in its final assessment. ‘The reasoning is set out in an easy-to-read manner and contains relevant theories. There are excellent impact studies available, both qualitative and quantitative. The intervention appears to provide positive effects on perceived burden and family function. In addition, it appears that the intervention also leads to a decrease in the number of hours of district nursing care required.’any effective interventions have been developed in elder care, yet they are often difficult for other professionals to find and compare. The Vilans recognition programme provides insight into well-supported and effective interventions.