Patient and Family Engagement

1. Patient and Family Engagement

2. Why is it Important? • No one gets through a serious illness by themselves • No one should be discharged from the hospital without someone with them to hear the directions and ask questions • No one manages their illness well if they don’t understand their illness or the treatment plan

3. NAMI Survey of People who had been Hospitalized • Get well cards – 25% • Visits from family – 86% • Visits from friends – 45% • Have an easy time staying connected – 34%

4. NAMI Survey • Involve family and friends in recovery – 35% • Involve in treatment plan – 25% • Have someone with me at discharge – 27% • Encouraged to sign a privacy release – 27%

5. NAMI Survey • Provided me with info about my illness – 39% • Provided me with info about my meds and side effects – 43% • Had input into my treatment plan – 41% • Was listened to – 45% • Offered hopeful words about recovery– 40%

6. I would have liked to have more information on my new medication when I first started on it, instead of getting it from Target Pharmacy after I got out. • Treat me like a patient with an illness, not like I am incapable of making good decisions. • Due to my mental illness, physical symptoms were disregarded as figments of my imagination.

7. NAMI Survey Families • Sign a privacy release – 38% • Provided information on illness – 27% • Info on meds and side effects –26% • Taught me what to do to help –11% • Had input into treatment plan – 31% • Showed empathy – 40% • Hopeful words – 34%

8. We had to ask if they had a video or something to read to help us when our 18yr old son was hospitalized while he had been in college -there was no support for us as parents. We had to find that on our own and in our own community • They could have included me, consulted with me, and not dismissed me.

9. Parents who are obviously the ONLY other contact of patient should be included in treatment/care/discharge. • More descriptions of the unit, rules, population, etc. It was my son's first time in an adult unit. • Staff could have treated me like a caring parent - just like they would for a child with cancer,

10. Recognize the Importance of Families & Friends Family is not an important thing, It’s everything - Michael J. Fox

11. What Families Provide • Social support - improves physical health, helps with resilience and better quality of life • Practical help - transportation, housing, food, finding and keeping jobs, money, make appointments, fill medications, monitor stress,

12. What Families Provide • Advice, knowledge and encouragement • Recognition of early warning signs • Record keepers • Understand person’s strengths, talents and preferences • Advocacy for person – in the hospital and with the insurance company, county, etc.

13. What Families Need • Encouragement to maintain hope • Validation of worries/difficulties • Respect and empathy • Honest and caring communication

14. What Families Need • Resources and information • To learn and ask questions • Access to education and support • Information about the mental health system

15. Why Families Want Information • Reduce anxiety and confusion • Determine appropriate expectation for their loved one • Learn how to motivate their relative • Find out about mental illnesses • Assure accessibility to a professional during a crisis

16. Why Families Want Information • Understand the diagnosis and prognosis • Understand symptoms, medications and side effects • Get specific suggestions for coping with symptoms • Deal with practical issues • Make contact with peer support groups

17. True Family Engagement • Include families in discharge and treatment planning • Seek information from families about the history, background of their relative’s illness • Inform families of shifts in treatment strategies and changes in medications

18. True Family Engagement • Give timely reports on how things are going • Consult with and inform families about possibilities for improving their relatives condition • Establish clear open channels for family complaints and grievances

19. True Family Engagement • Listen to their concerns • Assess the strengths & limitations of the family • Address feelings of loss • Help improve communication among family members • Encourage expanded support networks

20. HIPAA v. Families • Families perceived as overprotective or unengaged • Families don’t want access to medical records but to information • They want to provide information to you and obtain information to help their loved one in the community

21. HIPAA v. Families • Family Involvement Law • HIPAA allows professional judgment • Ask questions and involve families in the beginning – ED evaluation • Ask questions and involve families at the end – discharge planning

22. HIPAA v. Families • Proactively ask for privacy releases • Ask more than once • Ask if you can share certain information • Provide general information • Can assume consent if patient in room and allows you to discuss situation

23. Understanding Discharge Plans • Are they realistic? Understandable? • Who can do what in terms of transportation, in-home services, checking medicine cabinet, obtaining new prescriptions, etc. • Teach Back – include family if possible

24. Patient Engagement • Identify support network • Teach them about their illness • Teach them about the treatment plan • Involve them in changes in medication

25. Patient Engagement • Partnering and decision making • Reflecting on pros and cons • Need enough information in order to made decisions • How do they want others involved in the decision making

26. Focus on Recovery • Social • Physical • Emotional • Spiritual • Occupational • Intellectual • Environmental • Financial • Focus on eight dimensions of recovery

27. Patient Engagement • TRIP MAP • Think about problems, pressures, people & priorities • Research facts and possible solutions • Identify options • Weigh the pluses and • Minuses for each option • Action planning • Ponder the results of the decisions

28. Community Resources • Family psycho-education classes • Support groups for the person with a mental illness and family members • Written resources • Advocates

29. Patient & Family Engagement If everyone is on the same page, it’s easier to move forward.

30. NAMI Minnesota 800 Transfer Road, Suite 31 St. Paul, MN 55114 651-645-2948 1-888-NAMI-HELPS www.namihelps.org