Family meetings - a qualitative exploration of improving care planning with older people and their families

Objective: To explore the opinions of participants in family meetings to improve the quality of this important rehabilitation tool. Design: Qualitative exploration of opinions and experience from staff, patients and families. Setting: Tertiary teaching geriatric rehabilitation hospital. Participants: Staff, families and patients who had recently participated in family meetings. Methods: Focus groups, written surveys and individual semi-structured interviews. Results: Three main themes were identified in the staff focus groups-preparation, staff skills and aftermath. Opinions from family members revealed a high level of satisfaction. The patient interviews revealed a worrying lack of informed consent and lack of clarity of the purpose. All three groups identified an unclear agenda as the underlying reason for unsatisfactory meetings. An unfavourable outcome decision (such as placement in institutional care) also influenced patient opinions on the process. The majority of patients found the family meeting to be helpful. Conclusions: Family meetings are much appreciated by patients and their families. A model of the family meeting process is proposed to account for our research findings and as a means to improve meetings. Adequate preparation and consent, and skilled facilitation may improve the effectiveness of family meetings while maintaining the patient's sense of autonomy.