Family education: One of the most important aspects of occupational therapy in the rehab setting.

With such a high level of importance comes the big responsibility to remember everything. As a student or new grad, that can feel pretty scary.

When I was new at family education, I would get super nervous around a patient’s family in fear that I was forgetting something important.

Covering everything in an hour’s time (or even a half hour!) can really put the pressure on you if you’re new at this and aren’t used to doing family education.

To help guide you through your first few family educations smoothly, I’ve outlined the main family ed criteria to ensure you’ve covered the most important aspects.

The Essential Topics to Cover for Family Education

1. Diagnosis

I like to address this first since the family may not understand much about their family member’s medical diagnosis.

I’ll first ask if they’re familiar with the diagnosis, then go into more detail if I feel they haven’t had quality education on this yet.

I’ve found that doctors can get way too technical, so I try to make sure I use easy to understand and not too “medical-ly” terminology. This way, the family members can fully benefit from the education.

2. ADL skills

How is your patient dressing, grooming, eating, bathing, and toileting?

Are they using the hemi-dressing technique? Bed-level dressing/bathing?

If so, actually demo this with your patient and have the family member complete it themselves if possible. I also let the family know that it’s best to let the patient do as much as they can upon going home to continue to increase their independence.

3. I-ADL skills

Is the patient going to need assistance with meal preparation, doing the dishes and/or laundry, cleaning the house, etc.?

If the answer is “Yes,” also be sure to address these as well. Oftentimes, I’ll bring the patient and their family into our training kitchen and discuss safe reaching strategies and easy meal prep ideas. I also address medication management at this time.

Money management, bill paying, and other more technical activities may need to be addressed depending on the patient’s cognitive level.

4. DME

What durable medical equipment (DME) are you recommending? Remember to inform the patient’s family on how they can order it?

I almost always recommend Amazon for all basic DME and adaptive equipment since it usually has the best pricing as well as reviews.

5. Transfers

How is your patient transferring to the toilet, bed, wheelchair, bedside commode, or tub/shower bench? You’ll want your patient’s caregivers to complete these transfers hands-on after you’ve given them a proper demonstration.

6. Functional Mobility

How is your patient going to be moving around in the home and community? Wheelchair, walker, cane, no assistive device but contact guard assist when walking? Be sure to practice this briefly as well.

7. Safety Education

Will your patient require fall precautions, supervision recommendations, diet precautions, or home set-up? Are there any clutter, cords, throw rugs that could be hazardous? Would a non-skid bath mat be helpful?

It’s a good idea to recommend a night lamp next to the bed to decrease falls at night when heading to the bathroom. You also may want to suggest eliminating access to keys to the car if there is a cognitive impairment.

8. Caregiver Body Mechanics

Observing how the caregivers are completing the transfers is hugely important since many people lift incorrectly and risk major injury. Having copies of body mechanics handouts is also helpful along with visual demonstration.

The Shepherd Center has more information about body mechanics during transfers for caregivers.

9. Emotional Support & Resources

You may want to discuss support groups for the patient and family members. Going home with a new diagnosis and suddenly requiring full time care is a HUGE adjustment for everyone involved. I try to address caregiver burnout away from the patient if possible.

To check out how I do this, along with support group resources, check out my caregiver burnout article.

10. Follow-up Recommendations

Are you recommending outpatient therapy, sub-acute rehab, or home health OT services post-discharge? Do you have any home exercise program handouts you can administer and demo?

If you’re not sure what to recommend, always consult another experienced occupational therapist in your workplace.

Additional Challenges You May Encounter

It’s possible you will been assigned to complete family education on another OT’s patient that you’ve never worked with before (trust me that this happens a lot!). If this does happen, talk to the patient’s physical therapist and speech therapist (if they have one) to get as much info as you can to avoid going in totally blind. 

Another issue is that your patient’s family may not show up for their scheduled family education, and you may not get another chance to educate them formally. This really sucks, but does happen more than I would like. When this is the case, I educate anytime I can when a family member is present; even before the scheduled family education time slot.

Family dynamics can also be very different from family to family. It may be uncomfortable at times, but just try to ensure you include everything you need and try to not to get in the middle of any tension.

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For more information on the components of family education, check out AOTA’s Practical Skills Training For Family Caregivers.

Now you’re all set to approach family/caregiver education with more confidence while covering all your bases! Of course feel free to modify your checklist as needed, as this isn’t necessarily a one-size-fits all depending on your patients’ situations.

I’d also love to hear in the comments what else you like to include in your family education session.

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