Deb Gravatt and Sarah BriggsFamily Support Specialists

LifeShare Of The Carolinas

FAMILY SUPPORT PRACTICES

A Dual Advocacy Approach to supporting families in crisis

OBJECTIVES

• How Does Family Support Get Engaged?

• Role of the Family Support Specialist

• Patient Care Conferences: Why? When? What?

• Ensure Good Communication Between Key Members of the Healthcare Team

• Ensure Good Communication with the Organ Recovery Coordinator (ORC)

• Support Chaplains

• Support Nurses and Other Staff on the Unit

Family Support Specialist

First Steps: Onsite Engagement

• Activated by ORC after Referral

• First Interaction with Patient’s Nurse

• Talk with Attending Physician (if available)

• Identify Legal Next of Kin and Other Family Representatives

• No Donation Conversation until MD/Family Make Decisions to Stop Treatment

Care Conferences are huddles with healthcare team.

The purpose of these conferences is consistent communication and optimal support of the family.

PATIENT CARE CONFERENCES

What does the family know about the pati ent’s conditi on and medical plan?

First person consent?

Legal Next of Kin & Family Dynamics

Who else is involved?Chaplain, Social Worker, Childlife, Palliati ve Care, Rathbun House

PATIENT CARE CONFERENCE #1

Once the care team has basic patient info.

Establish that the patient is a potential donor and LifeShare is engaged.Why?

When?

What?

MYTH

LifeShare continually evaluates patients!Each organ is evaluated individually.

Even if only one organ system is viable that potential is one life saved!

People with significant medical histories cannot be donors.

UNTRUE

Ensure that legal decision makers are present and prepared for the news.

Evaluate the family’s understanding.

Ensure that organ donation is NOT a part of this conversation.

Communicate timeframes clearly.

Evaluate DCD potential.

PATIENT CARE CONFERENCE #2

When a plan is made for brain death testing or withdraw of support.

Prepare family for declaration of death or final decisions to withdraw care.Why?

When?

What?

MYTH

*LifeShare and the hospital staff we serve are interested in the well being of all patients!

*90 – 95% of all patients will never have the opportunity to donate organs.

Doctors won’t work to save my life if I am a registered donor.

UNTRUE

Ensure family understanding of declaration of death or futi lity.

Allow for Decoupling.

Who is the Legal Next of Kin?

Who are the supporting family members?

Who initiates the donation discussion?

PATIENT CARE CONFERENCE #3

After physician determines brain death or futility of treatment.

Prepare to discuss the offer of organ donation with the family.Why?

When?

What?

The process of allowing the family time to accept the poor prognosis

and the options presented to them for continued care or comfort care

before discussing the offer of donation.

Decoupling

All Major Religions Support

Organ Donation as an Act of Charity.

INITIATION OF THE DONATION DISCUSSION

Determine what barriers are present:Education, Acceptance of Death

Give Time for the Family to Compose

Affi rm Commitment to Support Patient’s Wishes if at all Possible

PATIENT CARE CONFERENCE #4

After the initial approach, when a first person disclosure is not supported.

Prepare for reapproach if necessary.Why?

When?

What?

MYTH

First Person Consent is legally binding.LifeShare will work with the hospital to try to fulfill the patient’s wishes

and the family’s needs.

The decision to donate is always up to the family.

UNTRUE

Confirm attending physician is sti ll managing and will declare in OR.

Communicate Family Needs with care team including OR staff :

Timing, Present in the OR, etc.

Communicate with OR staff about how to prepare for withdrawal.

PATIENT CARE CONFERENCE #5

After family consents to DCD and plans for recovery have been agreed upon

Preparation of Healthcare Team for Donation after Cardiac Death (DCD).Why?

When?

What?

AT THE END OF THE DAY…Our goal is to holistically support families

through this vulnerable time in their lives.

We strive to achieve this goal with genuine compassion, so that through the process of

family support, we germinate healing.

Through the process of organ donation we:

RECOVER HOPE