Monday, October 21, 2013

Patient Advocacy: Dealing With Angry Family Members

Patient-advocates can help hospitals deal with angry family members
When people are anxious or angry, they may not be able to make sense of what a doctor is saying. When tempers run high, they find it difficult to express their most pressing concerns. Strong emotions can make processing new or complex medical information more difficult. What can be done in such a scenario?
Get a patient-advocate on board. Hospitals are stress-inducing places for all the right and wrong reasons. Patients and family members may experience a sense of loss of control in such an unfamiliar environment. They often do not understand a lot of what is going on and may feel vulnerable, helpless and stripped of all their rights and options. However this is a wrong perception. Even in hospitals, patients have rights, as well as, responsibilities. It’s the advocate’s responsibility to make them understand both.
Intense anger or anxiety can get in the way of good treatment and care. Once an 80-year-old patient was scheduled to undergo surgery for prostate cancer. He and his wife arrived on time for their early morning surgery. The nurse at the reception told them that the surgery was delayed until the afternoon. By mid-afternoon, they were told that — due to several unexpected emergencies — the surgery had to be postponed to the next day.
Already anxious about the upcoming surgery, the patient and his wife got so angry, they were ready to walk out of the hospital in a huff, but were calmed down by a patient-advocate. Yet the patient couldn’t sleep two winks that night, kept tossing and turning on his bed and his wife, who was even angrier, seemed to complain about everything in the room, including the AC, the water tap, and the cleaner. The next day, when the patient-advocate turned up for his visit with the couple, the wife pounced on him with the words, “Please tell us how to get out of this hospital?”
Maintaining his cool, the advocate smiled, patted the woman’s hand gently and said, “Why don’t you tell me what can I do to help you get through this tough day?”
That immediately calmed down the two and the wife began to slowly confess her fears and frustrations to the advocate. The advocate also took his time, explaining why surgeries have to be postponed when more serious cases arrive, and requesting them to be a little more understanding and patient with the hospital staff.
The fact is that while hospitals are familiar places for doctors and nurses, for patients and their families they can be extremely scary. Even routine events and procedures can produce anxiety in such patients. An eye check up can feel as traumatic as open-heart surgery. Knowing what people feel and helping them relax with comforting words can make a doctor’s job simpler, and this is what an advocate is trained to do.
A doctor once called up a patient-advocate saying, “This patient doesn’t understand anything. She refuses to go home. Can you please go and drill some sense into her thick head?”
The patient-advocate went and spoke to the distraught woman. Later he came back and asked the doctor, “Did you ask the patient why she didn’t want to go home?”
“No,” replied the confused doctor.
“Because she’s homeless and has nowhere to go…”
Unprovoked, nameless anger can be an expression of helplessness. It’s the patient-advocate’s job to see through the façade and dig out the real source and meaning of that anger and help resolve the issue quickly and efficiently.
When a Family is Angry
  • Ø  Don’t argue, even if you know their complaint is unjustified
  • Ø  Listen to what family members have to say — they might calm down if you listen to them and share their concerns
  • Ø  Do not insist on a meaningful conversation when families are emotionally upset and are not ready for this
  • Ø  Healthcare is a joint effort between patients, families, and health professionals. Be clear and specific about what each person can do to help
  • Ø  Encourage family members to participate in the loved one’s treatment.

The above is an extract from Dr.Aniruddha Malpani's book : Patient Advocacy - Giving Voice to Patients
The book launch will take place on Saturday, 16 November 2013 at Hall of Harmony, Nehru Center, Worl, Mumbai - 400018 during the 4th Annual Putting Patients First Conference.

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