CEA applied to FAMILY MEETINGS Allan R. Dionisio MD

You are dealing with several people, not just one.

Common Mistakes The “bantay” is the decision maker. The spouse or parent is the decision maker.

MEDICAL ROLES in the family The “family physician” The nurse/first assist The “specialty consultant” The medical board of directors

Who does what and when? 1.When someone gets sick in your family, who does he go to first? 2.Who assists that person? 3.Who does he go to when he doesn ’ t know what to do? 4.Who decides when admission is necessary?

Who does what and when? 5.Who will pay for this admission? 6.Who will stay with the patient?

Let’s say we have the right family members in front of us:

Neutrality

Equal time.

Each one: Has feelings that require catharsis. May have an emotionally critical misperception.

4-STEP CATHARSIS 1. When you heard the diagnosis/experienced the symptoms, what thoughts came to your mind? 2. What did you feel when these thoughts entered your mind?

4-STEP CATHARSIS 3. Probe the feeling. What is it about these thoughts that makes you feel that way the most? “Ano and pinaka…?” 4. Summarize the thoughts and feelings.

Go through the 4 steps with each person in turn.

List down the ECMs and prioritize according to: - most common - most upsetting - most serious obstacle to treatment

Educate about the most common/upsetting/serious obstacle first. Then address the other ECMs in order of priority.

Always make a clear connection between the data you are giving and the ECM.

Repeat the process for management issues.