Facilitating Life Transitions

Dr. Dawn-Elise Snipes

“Flower (Em)power”

Depicts a comprehensive and perennial

approach to treatment.
At the core of the flower is the clinician-
family partnership.
The Stem

Sustaining a caring environment

represents different interrelated
components of promoting family health.
The stem of the flower symbolizes the
advocacy activities and policy changes
needed to ensure that the clinical
activities that support and strengthen
families can grow
The Leaves

The leaves of the flower stand for

vision, values and principles and are the
source of a burgeoning
The Roots

Symbolize how this best practice model

is grounded in the following five axioms
Responsibility
Resources
Respect
Results
Recognition
Developing a genuine partnership
with families

Acknowledging and respecting the

important role of family in health care
situations
Determining the desired degree of family
involvement
Negotiating the roles of both nurse and
family within the partnership
Family Assessment

Address all of the following

Family structure
Environmental data
Family strengths
Family supports
Identify resources and supports to
assist families
Where?
Within the nuclear family
Between families (in laws, distant relatives)
Supports outside the family (i.e. Church,
non-related friends)
Sustaining a caring workplace
conducive to family-centered
practice

Ensuring that staff are oriented to family-

centered care, including family assessment;
Ensuring that staff have the awareness and
ability to effectively access resources
Providing ongoing opportunities for
professional development
Supporting family centered practice
in the workplace

Ensuring appropriate staffing levels,

assignments, and staffing categories
Implementing family-centered practices and
policies
Creating and maintaining physical work
environments that are conducive to
promoting family involvement
Best practice guidelines

Can be successfully implemented only if

there are
Adequate planning
Resources
Organizational and administrative support
Appropriate facilitation.
Developing a plan for implementation

An assessment of organizational readiness

and barriers to education
Dedication of a qualified individual to
provide the support needed for the
education and implementation process
Ongoing opportunities for discussion and
education to reinforce the importance of
best practices
Opportunities for reflection on personal and
organizational experience in implementing
guidelines
The family

Plays an integral role in promoting and

maintaining health of family members,
as well as providing physical and
emotional support.
Vision for Supporting Families

“In a perfect world ”

Families would be supported across the
care continuum in a caring, consistent,
timely and effective manner.
Families would have access to timely and
comprehensive information.
Families would be able to choose from a full
range of respite care and support services
which would be delivered consistently
across Ontario in a flexible, culturally-
sensitive, and affordable manner.
Cont. . .

Families would be comprehensively

supported by nurses and other care
providers because resources would be
available to allow this to take place.
Families would say their needs were met
and they were supported and strengthened
through the care experience
Values & Principles for supporting
and strengthening families

It is important for staff to recognize their

own assumptions and values about families
and cultural beliefs, and adjust their care
accordingly.
Families and family relationships are unique
and diverse, and may change over time
Families have expert knowledge and skills
that help them determine their own needs
and respond to expected and unexpected
life events.
Cont…

Partnerships with families are built upon

mutual trust, honesty, and collaboration.
Families participate in care only as much as
they are able, or want to.
Partnerships increase the likelihood that
clinicians will follow a family-centered
approach to care.
Support families in their choices.
Family members and the client may have
different and conflicting needs.
Clinicians should support family situations
The differences in family beliefs and
values in families will affect the
clinician-family partnership.
Key components of an assessment
and intervention framework

Listening to the family

Engaging in a participatory dialogue
between the nurse/counselor and family
members
Recognizing patterns
Family supports

Examine the types of supports the

family requires during the expected or
unexpected life event.
Issues that should be assessed include
The family’s appraisal of the stressor
Their concerns and sense of vulnerability
Information needs
The most common reason offered by
nurses and counselors for not routinely
assessing and involving families in their
practice is because they don’t have time
The shortest amount of time required is
15-minute for a family interview to be
purposeful, effective, informative, and
even therapeutic for family members.
Key components of a 15-minute
family interview

Therapeutic discussions and questions

Identifying who makes up the family unit
Identifying family and individual strengths
Nurses and counselors can support
families in recognizing their strengths
In times of stress each family copes in a
unique way.
Family-Centered Care

Major emphasis should be placed on all of

the following
Creating opportunities for families to become
more competent and independent
Strengthening families by building on their
strengths and natural resources
Enhancing the family’s acquisition of a wide
variety of competencies and resources
Supporting family-centered practice
in the workplace

Ensuring appropriate staffing levels,

assignments, and staffing categories
Implementing family-centered practices and
policies
Developing employee assistance programs
promoting family health
Key steps in implementing a best-
practice

Identifying a well-developed, evidence-

based clinical practice guideline.
Identification, assessment and engagement
of stakeholders.
Assessment of environmental readiness for
guideline implementation.
Planning and implementing evaluation.
Identifying and securing required resources
for implementation.
Developing an empowering
partnership with families

Recognizing the family’s assessment of the

situation as essential;
Acknowledging and respecting the
important role of family in health care
situations;
Determining the desired degree of family
involvement; and
Supporting interdisciplinary family-
centered practice in the workplace

Ensuring appropriate resources (e.g., time,

staffing);
Creating and maintaining environments
that are conducive to family-centered care
Developing programs that promote work
life balance for employees
Conducting a family assessment

The clinician engages in a partnership

with the family to assess their
perception of, and their capacity to
address, the life event.
Areas to be assessed include
Family perceptions of the event(s)
Family structure, composition, values
Home and community
Environmental characteristics
Family strengths
Summary

Using a collaborative, consultative

approach both in the workplace and in
treatment helps clinicians empower
families to:
Learn how to assess and meet their needs
Communicate
Take responsibility for their care and treatment