Today I did my first family session! This means I talked to the patient’s family about advice for when the patient goes home, which is mostly about the types of supports she will need at home based on her observed performance at the hospital: Can she administer her own meds? Will she be able to remember when to take them, and recognize how many of each? Does she have the decision making ability to make healthy food choices, ensuring a balanced diet and proper nutrition? Can she eat on her own, or does she need reminders to continue, to eat foods she may not see on her plate, and does she need someone to remove non-edibles from her reach like straw wrappers, cup lids, and plastics utensils? Does she need reminders to shower, comb her hair, take care of her hygiene? Can the person problem solve a safety situation, like know not to put newspaper near a space heater?
As therapists, we are supposed to use what we see during our sessions to guess how our patients may perform on the functional tasks mentioned above, for example. I feel like that is the hardest thing to do! It’s difficult even when tests delineate the specific performance skills patient demonstrate difficulty with, and its “all laid out”- but more on that type of clinical reasoning later.
All in all, it went really well! However, I have to say that I felt really odd being in the position of “authority” explaining to the family what they must do to provide the person with the optimum structure at home. I almost felt like, who am I to tell this loving husband and daughter how to best support this lady, when they’ve been doing it their whole life?
I think the most helpful thing I could have done during that family session is to give encouragement. Both husband and daughter indicated they understood where my suggestions were coming from, especially as I described behaviors that led me to make the recommendations I did- the family said they could totally “imagine that happening.” Even so, the husband was really overwhelmed. He kept saying ” I can’t do that, she won’t let me” when I was talking about encouraging her to get out of bed and eat meals on time, and structure her day with different activities. I think the most helpful thing I could have said was to give the assurance that she is currently stabilized and more likely to follow directions if given in a certain way, and was to have explained how to direct certain activities- for example, using picture board schedules.
I’m not sure if anything I said went through to them or if it all went over their head, but it felt nice to come away from the session feeling that I helped someone believe it was possible, that they now had hope to live the life they way they always wanted to. In that sense, I guess even just that family session was occupational therapy for the family members, if it truly was enabling. 🙂