Hospital discharge plans can be compromised because of lack of family support. This can create the condition for multiple admissions and otherwise avoidable pain and suffering by the patient.
Coming to terms with a serious illness or dying can be one of the most difficult tasks a family must confront. There are both immediate and long-term repercussions not just for the family as a unit but also for each individual involved. A family’s equilibrium can be rocked to the core. There can be disagreements with not only the quality and type of care, but who should be responsible to arrange, provide, and finance. This can create, at the very moment when families need each other’s support, a communication crisis. Necessary care can be delayed or delivered under less than optimum circumstances.
Loss, be it as a result of diminish functioning, chronic illness, disability, unexpected illness, or impeding death, is not a discrete event but involves a process over time. We each have a unique experience and individual coping style that may come at odds with other family members. One member may express anger while another only sadness. One may feel the need to take “action” prophylactically while another would like to evaluate further. One may be the primary caregiver and feel alone, another might focus on depleting financial resources. Often, as members individually cope and respond to the changing circumstances, the family structure is modified. Information may not be shared with all, sibling rivalries may resurface, or family coalitions may form hindering an opportunity for mutual support and consensus.
When families cannot work together as necessitated, often constructive assistance with difficult and emotional conversations can open communication, establish mutual trust, and create tolerance for a range of viewpoints. This in turn supports the patient’s care management after discharge.