Family Centred Education for Dementia Care

This assignment discusses the significance of family-centred education in dementia care, focusing on the benefits for patients with dementia and their families. It emphasizes the importance of culturally appropriate interventions and language that encourages partnership, involvement, and participation. The role of nurses in facilitating family-centred care is highlighted, along with potential barriers to its implementation.

Dementia is now the second leading cause of death in Australia and over 320,000
Australians are living with it (Australian Government National Health and Medical Research
Council 2015). Dementia is a progressive and degenerative central nervous system disorder
that develops over a relatively slow period of time and that causes multiple changes in an
individual’s ability to think, perceive and reason (Fortinash & Worret 2012). This paper aims
to discuss to the importance of family and carers education in relation to the plan of care for
patients with dementia, therapeutic communication skills that nurses can utilise during
family education and the barriers which can affect the family education.
The increasing prevalence of dementia is placing a growing physical, mental, emotional and
financial burden on patients, their family and carers (National Health and Medical Research
Council 2015). To address these challenges and to enable good quality and appropriate care
for the consumers, health professionals and the family or caregivers of the patient need to
develop a good partnership (Innes et al. 2012). When the patient with dementia is
cognitively impaired and lacks the capacity in relation to important decisions in their life,
having someone who has known the person well for many years and who can be seen as an
advocate for their needs is a great asset (Woods et al. 2008).
Family centred education recognise the family as the source of control and full partner in
providing compassionate and coordinated care based on respect for patient’s preferences,
values and needs (Barnsteiner 2014). It recognises the vital role that families play in
ensuring a patient’s health and wellbeing, include family members of all ages (with the
patient’s consent) in care planning and interventions (Fahlberg 2014).
Education is a major tool in increasing awareness about dementia and will help eliminate
stigma (Innes et al. 2012). It is crucial that dementia awareness strategies are balanced with
messages that reduce fear and stigma associated with dementia and that emphasise that
help is available (NSW Health 2010). The necessity of information, knowledge and basic
skills is identified as part of both the consumer and the caregiver’s quality of life (Innes et al.
2012). The family or caregiver can increase their knowledge base regarding the disease
process, positive behaviour interactions and therapeutic activities for the consumer
(Fortinash & Worret 2012). Increased awareness and reduced stigma will assist people with

dementia to continue to participate in activities they enjoy, to remain connected
to their communities and to be socially included (NSW Health 2010).
Family carers are the most important resource available for people with dementia (Innes et
al. 2012). Family centred care approach is designed to preserve and whenever possible, to
strengthen connections between the patient and their family (Geurts et al. 2012). Carers are
provided with support to enable them to maintain their own health, social and emotional
well-being such as access to counselling sessions (NSW Health 2010).
Nurses can also recommend more financial support for families and ways how to reduce
their expenses (Coyne et al. 2011). Carers are encouraged to think about their own physical
and emotional well-being, to involve family members, to maintain friendships, to make use
of respite and other support services and take up available educational opportunities (NSW
Health 2010). The caregiver and support system integrity will be maintained by involving the
family and significant others in planning, intervention and evaluation (Fortinash & Worret
2012).
Another benefit of family centred education program is that home-based carers had an
improved sense of satisfaction and sense of connection by leaning a range of
complementary and diversional therapies with the person they cared for (Lee & Adams
2011). Most caregivers do not have appropriate training for dealing with difficult behaviours
of patients with dementia, so caregivers find themselves using physical force (Nasso & Celia
2007). There are breaks and retreats provide for the caregivers to have the opportunity to
meet other carers and access education and respite (NSW Health 2010).
Taking care of a patient with dementia is known to be stressful, and caregivers often
experience high levels of burden (Innes et al. 2012). Family centred education operates as
an instrument of the family in intervening in the care plan which can support and
strengthen family functioning (Geurts et al. 2012). Psychiatric intervention for the caregivers
will help them adjust and cope with the difficulties that may arise (Fortinash & Worret 2012)
when taking care of patients with dementia.

The greatest source of support identified by people with dementia following diagnosis was
access to other people with dementia and their families who provided emotional peer
support, information, advice and practical tips (NSW Health 2010). Family involvement
promotes interpersonal connection between the patient and their carer, and not only
supports the maintenance of retained skills but also trigger long-held memories (Lee &
Adams 2011). It was viewed as essential for the patient’s care and welfare in terms of
reduced stress, reduced anxiety and reduced effects of hospitalisation (Coyne et al. 2011).
Therapeutic communication is the found of mental health nursing, and it us the mental
health nurse’s single most important tool (Fortinash & Worret 2012). It aims at initiating,
building and maintaining fulfilling and trusting relationships with the patient and their
families (Kneisl & Trigoboff 2009). Family-centred education offers partnerships between
the health professionals and families (Mena 2013).
Becoming aware of body language, voice tone, posture, position and communication style is
essential to build a strong relationship with the consumer and the family (Mena 2013).
Nurses also can teach the family about communication techniques, environmental
modifications and other pertinent interventions (Miller 2012). Creating an open forum or
discussion during the education program for family or carers allows them to share coping
patterns, solutions to workplace issues and improvements for overall patient satisfaction
(Nasso & Celia 2007).
Conflicts arise when there are differences in the ideas about care practices of the patient
with dementia (Mena 2013). Barrier that may affect the provision of effective family
education includes services not being available in their area (Woods et al. 2008), lack of
awareness of available services, inadequate development of a care plan and lack of
communication across services (Innes et al. 2012).
The lack of staff education and training was also identified as having an impact on nurses’
abilities to facilitate a productive family centred education (Coyne et al. 2011).
Ethnocentricity is also one of the potential barriers to group education. Some family

members look out of their own cultural eyes and measure others’ with their own cultural
yardstick (Mena 2013).
Furthermore, studies have concluded that caregivers are more likely to experience work
disruption, health problems and strain than other carers (Nasso & Celia 2007). They are
more likely to experience psychological distress, depressive symptoms, feeling of isolation,
and have an increased risk of physical health problems (Innes et al. 2012). Working family
members report having to rearrange work schedules, decrease work hours, or take an
unpaid leave to meet their caregiving responsibilities (Nasso & Celia 2007). The stress of
family caregiving for people with dementia has shown to impact a caregiver’s immune
system; thus increasing their chances of developing a chronic illness themselves (Lee &
Adams 2011).
As a health professional, I must not only be concerned with the care for the patient with
dementia, but also with the role of the family and caregiver in their plan of care. It is
important to be sensitive to, understanding of, and respectful of differences, and not just
cultural and income differences but also differences in family structure (Mena 2013). As a
nurse, I will consider interventions such as hand massage, touch therapy, music therapy, pet
therapy and physical exercise that are effective for addressing behaviours and improving the
quality of life for people with dementia (Miller 2012). I believe this will benefit both the
patient with dementia and the family.
I will also identify and address cultural aspects that influence people with dementia and
their family members because family centred education should be culturally appropriate.
Nurses should incorporate culturally appropriate interventions, particularly with regard to
referrals for services. People with dementia lose their sense of self and increasingly depend
on others for all their needs, nurses can help the family to affirm and strengthen the
patient’s sense of self as much as possible.
In summary, a strong professional and family support network is important to facilitate
discussions of the plan of care and how to involve the person with dementia. The benefits of
good family centred education is increased awareness about dementia, support services and

most importantly improve the quality of life of the patients with dementia. Nurses have a
significant role in to encouraging and empowering the family to participate in the delivery of
care. Any barriers to the involvement of families in the plan of care should be removed and
the language of partnership, involvement and participation put in its place.
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