Tips For Involving Families in Cognitive Rehabilitation
We often think of cognitive rehabilitation therapy as an individual journey for the patient. However, family-centered care and direct involvement from family members can benefit patients in many situations. In this article, we’ll discuss how and why clinicians may want to begin involving families in cognitive rehabilitation.
Family-centered care
Family-centered care is a healthcare model which encourages the inclusion of family members in the recovery process. Within family-centered care, the family collaborates with the patient and clinicians. Family involvement is generally not a consistent practice in cognitive rehabilitation settings. Research shows that in post-stroke care, families are sometimes left feeling unprepared for how to care for their loved one, and uninformed by clinicians and medical staff.
Research shows that providers are sometimes hesitant to involve family members out of concern for the patient-provider relationship or simply because of time and resource constraints. But when providers involve and support family members, it can benefit the patient in numerous ways:
- The family can communicate any issues with recovery to the provider
- Family can participate in rehabilitation exercises at home
- Patients may feel more supported and understood
- Clinicians can individualize the treatment plan to the patient and family situation
- Well-equipped family members can care for the patient at home
- Avoid frustration from family members who feel out of the loop
Family involvement vs. family therapy
There are varying degrees of involvement to consider. The family members and clinician can determined the appropriate course of action. They can determine this based on the patient’s condition and the family’s level of dedication to preparing for and being involved in care. For a mild cognitive impairment, offering family members information about patient care and encouraging them to contact the clinician with questions may be enough.
However, for more severe cases, more in-depth support will be of great help to the family and patient. Clinicians in cognitive therapy don’t traditionally offer family support, but many experts have recognized the value of family involvement and have argued for this to change.
A case study from Belgium notes that Traumatic Brain Injury (TBI) affects the whole family, and can be treated accordingly with family support sessions or family therapy in addition to other necessary care. After a TBI, it’s common for the patient to experience behavioral changes and lifestyle changes. It’s common for these changes to affect relationships between family members. This applies to other cognitive conditions as well.
Cognitive impairments may cause behavior changes, loss of income, and new responsibilities for family members. And as the family must put a greater focus on the needs of one person, other family members may not feel that their needs are met.
Approaches for family involvement
Working family therapy into a rehabilitation plan can make a big difference. Family support sessions can help family members face the trauma of big changes. They can also help the family to process the countless emotions that may arise after a loved one experiences an impairment, as well as accept and understand new roles within the family and learn healthy ways to cope.
Family members may also assume that the patient is more capable than they are, and perceive the patient’s behavior as hostile, uncooperative, or unmotivated. Conducting family information and support sessions can help family members understand the patient’s condition and approach the situation with more objectivity.
Understanding the roles within a family can help clarify the path forward. Clinicians could ask family members about the distribution of authority and the relationships between family members. This may help the clinician understand the family unit better and understand their responses to the situation. In the context of therapy, families can decide how to redefine and redistribute their roles.
Having a structure in place through the guidance of a clinician may make adjusting to these life changes easier.
Conclusion
Cognitive impairments can affect how a patient functions within their family unit. They can also change family members’ roles in the patient’s life. Providers can help families through these adjustments by providing or recommending family therapy or family support sessions. Research supports involving families in cognitive rehabilitation. Family-centered care can have great outcomes for patients and their families.
