Top Things to Know: Engaging Families in Adult Cardiovascular Care
Published: April 21, 2022
Prepared by Paul St. Laurent, DNP, RN, Senior Science and Medicine Advisor, Lead
| Engagement improves the care experience | Engaging patients and family members in care is a recommended approach to improve the experience for both the person living with cardiovascular disease and their family members. “Family” is considered anyone the patient wants involved in their care. |
| Need to identify opportunities to engage in care | Cardiovascular health care professionals should identify opportunities to engage family members at all stages of cardiovascular care and recognize how to integrate family members into the health care team. |
| Graded involvement in care | Family engagement in care can range from passive to active. The most passive involvement may include allowing family presence during patient encounters, cardiac investigations, procedures, and during health care team discussions. The most active involvement may involve direct care contribution by the family member. |
| Autonomy to choose degree of involvement | The effort to include family in care must be balanced against the patient’s right to autonomy; some patients may not wish to have their family members engaged in their care or they may have desired limits on the degree of engagement. |
| Give care to the caregiver | Family engagement in CV care includes recognition of the unique physical and mental health consequences to the caregiver and recommends providing care for the caregiver |
| Engagement in care improves outcomes | Engaging families in care improves person-oriented outcomes. Evidence supports family engagement in care as a strategy to improve both patient and family outcomes. Interventions promoting family engagement have demonstrated an increased satisfaction with care and improved medical goal achievement. |
| Mental health benefits for family members | Family members themselves benefit from being engaged in their relative’s care. Person- and family-centered interventions have been shown to improve family psychological recovery and well-being and reduce depressive and anxiety symptoms. |
| Experience as a surrogate decision making | Family members often act as surrogate decision makers, and this can be a distressing experience. Many critically ill patients cannot advocate for themselves and therefore, family members are called upon to make medical decisions in their place. Specialized training for cardiovascular health care professionals could improve communication with surrogate decision makers. |
| Necessary to explore the knowledge gaps | There remain critical gaps in our understanding of the role of family and their impact on outcomes for patients living with chronic cardiac disease. Closing these gaps will require more research, given it may have the potential to reduce hospitalization and urgent care visits, and ultimately the costs and burdens to our health care systems. |
| Transitions of care | Family engagement in cardiovascular care as patients transition from pediatric to adult cardiovascular care is a unique time point that requires recognition of patient autonomy. |
Citation
Goldfarb MJ, Bechtel C, Capers Q 4th, de Velasco A, Dodson JA, Jackson JL, Kitko L, Piña IL, Rayner-Hartley E, Wenger NK, Gulati M; on behalf of the American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular Radiology and Intervention; Council on Hypertension; Council on the Kidney in Cardiovascular Disease; and Council on Lifestyle and Cardiometabolic Health. Engaging families in adult cardiovascular care: a scientific statement from the American Heart Association. J Am Heart Assoc. 2022;11:e025859. doi: 10.1161/JAHA.122.025859