Caregiver and family education: Along with patient education, this is truly one of the most important aspects of occupational therapy in any rehab setting, from acute care to outpatient and everything in between.
With such a high level of importance comes the big responsibility to remember everything you need to cover in sometimes only one scheduled session. If you’re an OT student or a new OT practitioner, that can feel pretty intense.
When I was new at providing family education in acute rehab, 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 you aren’t used to doing a formal family education session.
To help guide you through your first few family educations smoothly, I’ve outlined the main family and caregiver education criteria to ensure you’ve covered the most important aspects. Ensuring you’ve covered the most important aspects for your patients will help to ensure a smoother discharge home. Some of these may not be applicable to every patient.
A quick note: I originally wrote this when I was an acute rehab occupational therapist, but it will be applicable to any adult-based occupational therapy setting.
The Essential Topics to Cover for OT Family Education
1. Diagnosis
I like to address this first since the family or caregiver may not understand much about their family member’s medical diagnosis.
I’ll first ask if they’re familiar with the diagnosis, then I will 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 much complicated medical jargon/terminology. This way, the family members can fully benefit from the education. You can also provide pre-printed, easy to understand handouts (such as about stroke, heart failure, etc.)
2. Basic ADL skills
How is your patient currently dressing, grooming, eating, bathing, and toileting?
Are they using the hemi-dressing technique? Requiring bed-level dressing/bathing for safety?
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. Instrumental ADL skills
Is the patient going to need assistance with meal preparation, medication management, 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)/adaptive equipment are you recommending for home? Remember to inform the patient’s family on how they can order it.
I almost always recommend Amazon initially for all basic DME and adaptive equipment since it usually has the best pricing as well as reviews for quality control. If your town has a low cost DME loan program, provide handouts for this as well.
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.
Still feeling nervous about transfers yourself or need some transfer training tips for your patient’s family? Be sure to refer to our other article, Transfer Training Tips for New Occupational Therapists for more information.
6. Functional Mobility
How is your patient going to be moving around in the home and community? Will they be using a wheelchair, walker, cane, no assistive device but contact guard assist when walking? Be sure to practice this briefly with caregivers as well.
7. Safety Education
Will your patient require fall precautions, supervision recommendations, diet precautions, or need a different 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
I almost always recommend discussing in-person and online support groups for the patient and their family members. Going home with a new, life-changing diagnosis with a loss or decrease in independence is a HUGE adjustment for everyone involved.
I personally try to address the caregiver burnout component away from the patient if possible. To see how I do this, along with support group resources, you can see our caregiver burnout article here.
10. Follow-up Recommendations
Are you recommending outpatient occupational therapy therapy, sub-acute rehab, or home health OT services post-discharge from rehab? Do you have any home exercise program handouts you can administer and demo?
If you’re not sure what to recommend following discharge during the family education (or you are PRN and new to this patient), consult with your therapy counterparts and rehab team to see what they are recommending.
Additional Family Education 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 from experience that this can happen 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 is very unfortunate, but does happen more than I would like. When this is the case, I educate anytime I can during treatment sessions when a family member is present; even before the scheduled family education time slot. It is of course never a bad idea to do this anyway when family is present.
Family dynamics can also be very different from family to family. It may be uncomfortable at times due to family tension, but just try to keep a professional demeanor and ensure you include everything you need for the education.
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For more information on the components of family and caregiver education, you can also check out this helpful and comprehensive resource Practical Skills Training for Family Caregivers from the Family Caregiver Alliance.
Now I hope you’re feeling all set to approach family/caregiver education with more confidence while covering all your bases! Of course you can 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, and what tips you would share with new OTs who are just starting out with providing family education in any setting.
This post was originally published on August 28, 2016 and last updated on June 8, 2023.
