No Families Allowed
Normally I welcome family members with open arms to therapy so they can watch and learn what we do. But when family begins to speak for the patients or tries to assist too much with their care, I want to draw the line. If families become intrusive and disrupt the normal progression of care, they need to be told to back off on their approach. When families get too involved, I often wonder if they were in the operating room with the surgeon, asking questions and trying to assist with surgery.
There are some family members who will sleep on a fold-away bed and rotate days with other family members so there is someone present 24 hours a day. Why? I doubt it has anything to do with trusting the care provided.
I made the mistake of seeing a patient when her family wasn't around early one morning. I wanted to assess how the patient did when she wasn't under the influence of family. I was grilled by a group of family members later that day who were trained investigators. I had to recite SPO2, blood pressure, pulse, response to treatment etc. Finally, the family asked what time I would see their mom the next day. When I told them that I vary my times to see people to better assess how they respond to treatment, they weren't happy.
I completely understand when family wants to be part of the complicated maze of healthcare and try to actively participate in every aspect of treatment. But when they don't go home, it's time to cut the apron strings and allow their loved one some time alone. Having too many family members involved can also complicate decision-making regarding end-of-life issues. Not every family member gets along or wants to be part of the process, but they are sometimes forced into it by their siblings.
I have debated putting a sign on the therapy door that says, "Therapy In Session, Do Not Disturb," and explain to family that therapy is a closed-room activity and we don't allow family members to come in. I don't know what kind of response some families would have to this and I don't know if I'm willing to risk the backlash of it either.