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Dr . Maria Muraca |
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Dialogue Issue 4 , 2016
the patient ’ s experience .”
The ripple effect
Take someone who ’ s off work for an extended period because of an illness or injury . Consequently , the family ’ s reality has changed . Some members of the household have had to assume caregiving tasks . The patient is feeling a diminished role within the family unit . Tension is high . Finances are tight . The supportive environment is shaky . And all of this is affecting the patient ’ s recovery . “ There ’ s a tremendous ripple effect ,” says Dr . Brown , a social worker by training , and Chair of the Masters of Clinical Science and PhD Programs in Family Medicine at Western . That ’ s why it ’ s important , she says , for doctors to tease out how ( or if ) family is being an impediment or a buoy . She defines family as two or more persons sharing a community and support system . When talking to patients , doctors can pose all sorts of relevant questions . How ’ s it going at home ? Who are you turning to during this challenging time ? How are other members of the family coping ? How is this affecting your daily routine and responsibilities at home ? “ You ask open-ended questions that are non-judgmental and that also show compassion
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,” says Dr . Brown , co-editor of a book called Challenges and Solutions : Narratives of Patient-Centered Care . Such probing accomplishes a few things . For one , it can boost patient satisfaction and hard outcomes . “ Giving the patient permission to share may be therapeutic in itself ,” says Dr . Brown . “ When a patient feels attentive listening , that can be beneficial in healing . You don ’ t have to do anything ; sometimes you just have to be there .” Dr . Muraca , who ’ s also an Assistant Professor , Family and Community Medicine , University of Toronto , talks about giving patients the “ safety zone ” to discuss the intertwining of family and health . In learning more about the variables at home – things that can influence the patient ’ s health , recovery and mental state – the doctor can offer helpful advice or make referrals to other forms of support . Another option is asking the patient if he or she wants to invite family members to talk about the issues at hand .
Understanding stressors
Routinely , of course , doctors deal with the opposite situation , serving patients who are affected by health care issues or other events in the home . “ A lot of what we see is influenced by the psychosocial component , the stressors going on in someone ’ s life ,” says Dr . Muraca . One of her colleagues on the North York Family Health Team , Dr . Marla Ash , cites a patient whose spouse was quite ill . The patient revealed the increasing pressure at home , not only because of the disease but because of how each of them was handling it . Their sources of comfort differed , and they weren ’ t fully connecting with each
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photo : arash moallemi |